Part 1 is labeled "liver" and consists of a 33.6 pound native hepatectomy, 50.0 x 47.0 x 17.0 cm. The capsular surface is tan and polycystic with cysts ranging from 0.3 to 11.0 cm. in greatest dimension. The capsular surfaces are pink to pink-gray and occupy approximately 95% of the liver surface. The caudate lobe is 15.0 x 9.0 x 8.0 cm. and is also almost entirely occupied by cysts. There is no adjacent inferior vena cava. The associated hepatic veins are pink-gray and free of obstruction. The attached gallbladder is 21.0 x 3.0 x 2.5 cm. with a pink- gray, smooth serosal surface. The gallbladder contains approximately 20 cc. of a viscus green bile. It is 6.0 cm. in open circumference and has a wall thickness of approximately 0.1 cm. The mucosal surface is trabecular, tan and hemorrhagic. The 1.5 cm. of attached cystic duct is free of obstruction and 2.0 cm. in open circumference. On dissection of the superficial hilus, patent portal vein, hepatic arteries and hepatic duct are noted. The cut surface consists of approximately 5% tan, congested hepatic parenchyma. The remainder consisting of pink- gray to pink-purple, fluid filled cysts, ranging from 0.3 to 11.0 cm. in greatest dimension. Some of the larger cysts also contain a gray-green, necrotic material. Representative tissue is frozen in bulk, submitted for outside research purposes and stocked in formalin. Gross photographs are taken and sections submitted.
Part 2 is labeled "left kidney" and consists of a 1,430 gram native nephrectomy, 24.0 x 11.0 x 9.0 cm. with attached fat and Gerota's fascia. The cortical surface is almost entirely obliterated by pink-gray and hemorrhagic cysts, ranging from 0.1 to 5.0 cm. in greatest dimension. The kidney has been previously sagittally sectioned, exposing a cut surface consisting of approximately less than 5% of identifiable renal cortex at the anterior and posterior aspects. The remainder of the kidney consists of fluid filled cysts ranging from 0.1 to 5.0 cm. in greatest dimension and pink-white, grossly unremarkable renal pelvis. Some necrotic, gray-green material is contained within the larger cyst. The hilar structures consists of patent artery vein and ureter. The ureter, 8.0 cm. in length, has an irregular pink-gray mucosal surface with some areas resembling diverticula. Representative tissue is frozen in bulk, submitted in Karnovsky's fixative for possible electron microscopic evaluation and stocked in formalin. Gross photos are taken and sections submitted.
Part 3 is labeled "spleen" and consists of a 130 gram, purple- gray spleen, 11.0 x 7.0 x 4.0 cm. Torn cauterized capsule is evident at the inferior aspect. A 5.0 x 4.0 x 3.0 cm. bulge is situated at the convexity. On cross section, a 3.0 x 2.0 x 2.0 cm. fluid filled, multilocular cyst is surrounded by red-brown, splenic parenchyma and patent malpighian corpuscles. Two separate cysts, 0.3 to 0.6 cm. are adjacent to the main cyst. No other lesions are noted. The hilus consists of patent vasculature with surrounding yellow and hemorrhagic fat. Gross photos are taken and representative sections of spleen with previously mentioned cysts are submitted in cassettes 3A through 3D.
