The patient underwent right hemihepatectomy
Pathology findings:
Right hemihepatectomy 1. Half of caudate lobe 2. Gallbladder 3. Right liver MACROSCOPIC DESCRIPTION: 1. "Half of caudate lobe, right hepatectomy": Three specimens received: Specimen 1 is a discoid subcapsular semicircular fragment of liver 30x20x12mm. Sectioning shows non cirrhotic slightly fatty liver parenchyma. No focal lesions are seen. Specimen 2 is a right hepatectomy with a surgical resection face 140x60mm. The liver is 95mm from medial to lateral. Most of the liver is covered by capsule. Sectioning shows non cirrhotic liver with two nodules. One is in the posterior mid liver and is 17x14x14mm. The nodule extends to within 1mm of the capsular surface of the liver and 9mm from the resection face. Second nodule is in the inferior mid portion of the liver and is 20x15x15mm. This is 10mm from the capsular surface and 15mm from the closest resection margin. Specimen 3 is a detached gallbladder is received 95mm x 40 x 30mm. Gallbladder wall is 2-3mm in thickness. A single pigment cholesterol stone is present measuring 40mm in maximal dimension. BLOCK DESIGNATION: A - Caudate lobe B-C - Superior nodule and closest margin D - Inferior nodule E - Gallbladder neck, body and fundus 2. "Abdominal lymph node": Specimen is a nodule 17x12x7mm. Multiple TS. (SD) MICROSCOPIC DESCRIPTION: 1. Liver parenchyma with two deposits of focally necrotic moderately differentiated adenocarcinoma maximum dimensions 17mm and 20mm. The resection margins are clear. The remaining liver parenchyma including the caudate lobe specimen show normal lobular architecture, normal portal tracts and focal macrovesicular fatty change. The gallbladder specimen has almost completely denuded mucosa, Rokitansky-aschoff sinuses, mild mural fibrosis and minimal inflammation. 2. Necrotic focally calcified adipose tissue surrounded by fibrous tissue with adjacent normal adipose tissue. No lymph node identified. DIAGNOSIS: 1. Half of caudate lobe, right hepatectomy and gallbladder: * Metastatic moderately differentiated adenocarcinoma consistent with a colorectal primary tumour. - 17mm and 20mm in maximum dimension. - Clear of resection margins. - Mild macrovesicular fatty change. * Chronic cholecystitis and cholelithiasis. 2. Abdominal lymph node: Encysted fat necrosis.