In attempts to identify the nature of discrete soft tissue masses in the right upper quadrant of the abdomen, or protruding above the diaphragm, it is necessary to consider the possibility of unusual lobulations of the liver. Four cases illustrate the occurrence of this condition in patients aged 58, 65, 66, and 75. In two of these patients the variant lobule protruded through a diaphragmatic hernia, causing symptoms in one in whom surgical repair was done. One patient had an anomalous liver lobe in the right upper part of the abdomen, and one had a circumscribed lobulation of the superior liver surface without herniation through the diaphragm. Although the abnormally located liver tissue was verified surgically in all cases, scanning of the liver by means of rose bengal with radioactive iodine tracer permitted preoperative identification of the tissue in two of the three patients in whom it was used. This simple procedure may often obviate the need for more hazardous measures.
Feist JH, Lasser EC. IDENTIFICATION OF UNCOMMON LIVER LOBULATIONS. JAMA. 1959;169(16):1859–1862. doi:10.1001/jama.1959.03000330031005
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