肝膽淨化讓人生彩色,還是當一個肝苦人(下)－生門古法洗髓功

肝硬變

Here is another example of macronodular cirrhosis, which is most commonly caused by viral hepatitis (B or C). Wilson's disease and alpha 1-antitrypsin deficiency can also produce macronodular cirrhosis.

這是大結節性肝硬化的另一例子。病毒性肝炎(乙或丙型)是大結節性肝硬化最常見的因素。威爾森氏症(肝豆狀核變性)和α型抗胰蛋白酵素缺乏症也會產生大結節性肝硬化。

肝硬變

This is an example of a micronodular cirrhosis. The regenerative nodules are quite small, averaging less than 3 mm in size. The most common cause for this type of cirrhosis is chronic alcoholism. All types of cirrhosis develop over a process of many years.

這是一個小結節性肝硬化的例子。這些再生的結節十分小，平均不到3毫米大。造成小結節性肝硬化最普遍的原因是長期酗酒(慢性酒精中毒)。肝硬化的形成都需經過多年的發展。

肝硬變的特寫鏡頭

A close-up view of a micronodular cirrhosis in a liver with fatty change shows the small, yellow nodules. Micronodular cirrhosis may also be seen with Wilson's disease, primary biliary cirrhosis, and hemochromatosis.

在此帶有脂肪變性的小結節性肝硬化的特寫鏡頭內，可見黃色小結。威爾森氏症、原發性膽汁性肝硬化和血鐵沉積症也都可以看到小結節性肝硬化的症狀。

這是肝adenoma

At the upper right is a well-circumscribed neoplasm that is arising in liver. This is an hepatic adenoma.

在此圖右上方是一個正在肝臟中生長，區隔地非常清楚的瘤。這就是肝腺瘤。

慢性酒精中毒的含脂肪變化

The cut surface of the liver reveals the hepatic adenoma. Note how well circumscribed it is. The remaining liver is a pale yellow brown because of fatty change from chronic alcoholism.

在此肝切面中可見一個區隔清楚的肝腺瘤。此肝臟的其他部分顯淡黃棕色是因為慢性酒精中毒所造成的脂肪變性。

衛星小結

Here is an hepatocellular carcinoma. Such liver cancers arise in the setting of cirrhosis. Though the most common cause of hepatocellular carcinoma worldwide is viral hepatitis, in the U.S., chronic alcoholism is the most common cause. The neoplasm is large and bulky and has a greenish cast because it contains bile. To the right of the main mass are smaller satellite nodules.

此圖中顯示一肝細胞癌。這樣的肝癌是因為肝硬化而產生。在世界上，引起肝細胞癌最普遍的因素是病毒性肝炎。在美國，最常見的原因則是慢性酒精中毒。在此所見的瘤顯得腫大且因為含有膽汁而偏綠色。在瘤的右方則是一些略小的衛星小結。

衛星小結

The satellite nodules of this hepatocellular carcinoma represent either intrahepatic spread or multicentric origin of the tumor.

在這肝細胞癌附近的衛星小結代表癌細胞正在肝內擴散，或是從數個不同源頭形成一個腫瘤。

另一種hepatocellular癌

Here is another hepatocellular carcinoma with a greenish yellow hue. One clue to the presence of such a neoplasm is an elevated level of serum alpha-fetoprotein. Such masses may also focally obstruct the biliary tract and lead to an increase in alkaline phosphatase.

這是另一帶有黃綠色的肝細胞癌。此瘤的存在可由血清中α胎蛋白量的增加而顯示。由於它的大小，這樣的惡性腫瘤也有可能堵塞膽道並且導致鹼性磷酸酶量的升高。

膽汁導管堵塞

Note the numerous mass lesions of variable sizes, which are metastatic tumors to the liver. Some of the larger ones demonstrate central necrosis. The obstruction from such masses generally elevates alkaline phosphatase levels, but not all bile ducts are obstructed, so hyperbilirubinemia is typically not present. Also, the transaminase levels are usually not greatly elevated.

在此圖內可看到許多不同大小的病變，是轉移至肝內的腫瘤。一些較大的瘤中心已開始壞死。誠如前述，如此大小的腫瘤可引起鹼性磷酸酶值的升高，但並不是全部的膽道都會被堵塞，所以高膽紅素血症通常不會發生。此外，轉氨酶通常也不會大幅度的升高。

這裡是肝metastases

This picture shows liver metastatic tumors from an adenocarcinoma primary in the colon, one of the most common primary sites for metastatic adenocarcinoma to the liver.

此圖顯示自大腸生長的腺癌已轉移至肝臟內。大腸是轉移性肝腺癌最普遍的發源點。

膽囊發炎,醫生通常比個剪刀手的手勢,尤其內視鏡普及後,取膽囊更是輕鬆,但是取出膽囊,問題解決了嗎?請看上圖,膽結石的問題不在膽而在肝.