M04 - Ischemic Necrosis - Liver
An 82 year old woman was admitted with obstructive
jaundice of 3 weeks duration eight weeks after a partial gastrectomy
for carcinoma of the stomach.
At laparotomy she had a mass in the head of the pancreas which was
obstructing the common bile duct. A cholecyst-jejunostomy was performed
to relieve the obstruction. The patient developed peritonitis from
rupture of the gallbladder and died three weeks later.
At autopsy the protal vein was thrombosed and there
were numerous infarcts in the liver. The mass in the pancreas was
identical histologically to the carcinoma of the stomach.
At the lower power view note that the pale areas are necrotic liver.
Looking at higher magnification, you will see that the necrotic
areas show no nucei but th ecell outlines are still evident.
At the periphery of the dead tissue there is cellular reaction.
Becuae of postmortem autolysis it is difficulet to identify the
cells with accuracy but they include polymorphonuclear leukocytes
(neutrophils, PMNs) and cells which are probably macrophages.