Malformations of the liver: some prenatal and postnatal developmental aspects

The discovery of a large articulated lobe weighing 165.4 g dependent from the anterior margin of the left liver lobe in a 93-year-old female culminated two decades of observation of anomalous liver conditions in anatomic cadavers. When this data was compared with the information previously recorded from a series of 52 perinatal livers, remarkable discrepancies between the adult and perinatal incidences of various anomalous manifestations were noted. Ectopic accessory lobes were very rare in our adult series as well as in the groups reported in literature reviews. However, they were a relatively common occurrence in the perinatal cases, as were also gallbladder bridges of hepatic tissue, hypertrophic papillary lobes, and marked accessory fissures. In contradistinction, marginal accessory lobes were not noticed in any of the perinatal livers. Because the liver undergoes considerable postnatal reformation, it was concluded that most ectopic lobes, gallbladder bridges, hypertrophic caudate lobe extensions, and accessory fissures disappear during postnatal remodeling, whereas marginal accessory lobes may result from retention of the original perinatal boundaries of the anterior liver margins.