This is a section through the liver, showing the central area of both right and left lobes; the
architecture is distorted, and the cut surface shows numerous nodules, up to 0.5 cm. in diameter;
the colour of the tissue is much browner than usual; in the upper part of the specimen there is a
rather poorly-defined, partly necrotic tumour.
This man was admitted to hospital some 14 days before his death, for investigation of a
three-month history of weakness, a three-week history of lumbar pain and a one-month history of
ankle oedema. On examination, the liver was found to be enlarged; bilirubin 20 mMol/litre,
alkaline phosphatase 200 U/litre, aspartate amino transferase 93 U/litre and alanine amino
transferase 47 U/litre. A liver scan showed a space-occupying lesion in the upper right lobe. At
autopsy, the appearances shown here were found; microscopy of the liver showed a cirrhosis, with
a heavy iron deposition, and a hepatoma.