13923              POST-NECROTIC SCARRING

The patient was a man aged 58 who had had chronic pulmonary tuberculosis with cavitation and a positive sputum for 6 years.  He was treated with streptomycin and PAS and discharged to a sanitorium.  He was readmitted to the tuberculosis ward of the R.A.H. two years after the onset, and again 3 years later.  On the latter occasion he was found to be anaemic and renal function tests showed probable chronic nephritis with raised BUN.  He became sensitive to all antituberculosis drugs.  On his last admission there was severe anaemia, breathlessness and ankle oedema.  The B.P. was 205/120, the heart was enlarged and the liver was enlarged 4 fingers breadth below the right costal margin.  He died of renal failure.  At postmortem chronic pulmonary tuberculosis was found.  The liver weighted 1450 gms and the spleen 200 gms.

The specimen consists of liver which is divided into large irregular masses by strands of dense connective tissue.  The masses vary in size from about 2 cms to 8 cms in diameter.  The cut surface shows evidence of cloudy swelling in these masses of liver cells.  Histology shows very large regenerated nodules of approximately normal appearance.  The fibrous septa contain many chronic inflammatory cells.