Some aspects of lymphadenoma (Hodgkin's Disease) / by H.D. Rolleston.

  • Rolleston, Humphry Davy, Sir, 1862-1944.
Date:
[1911?]
Catalogue details

Licence: In copyright

Credit: Some aspects of lymphadenoma (Hodgkin's Disease) / by H.D. Rolleston. Source: Wellcome Collection.

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    to realise these two essential characters of lymph adenoma, namely, its histological structure and the accompanying blood picture, so as to distinguish it from the conditions with w^hich it is so likely to be confused, namely tuberculosis, the glan¬ dular hyperplasias included 'under the title pseudo-leukaemia, lymphocytic leukaemia, and malignant disease, especially lympho-sarcoma. The Spread of the Disease—Although the spread of the disease might be regarded as analogous to that of sarcoma, it is generally agreed that the disease always arises in lymphoid tissue, however slight the amount of that normal lymphatic tissue may be ; and that it is a widespread reaction of the lymphatic tissue to the unknown irritant and not a metastasis. As the larger lymphatic glands become affected, the minute lymphatic masses enlarge and subsequently also become affected; this explains the impossibility of curing lymph- adenoma by excision. Adami,23 who compares the process of lymph adenoma to cheloid growth, considers that the secondary changes in the liver and other parts are in the first instance a compensatory hyperplasia of the lymphoid tissue normally present in small quantities around the vessels. Moreover, as this lymphoid tissue is not contained within a capsule com¬ parable to that of the lymphatic glands, its early proliferation in the liver and kidney may simulate a malignant infiltration or even suggest that a process which began as lymphadenoma has become sarcomatous (Yamasaki 24). Subsequently, how¬ ever, these hyperplastic lymphoid collections show the same characteristic changes as those seen in the lymphatic glands first attacked. The Clinical Manifestations.—Lymphadenoma may be divided into three main groups ; (i) when the superficial glands are mainly enlarged, (2) when the symptoms are mainly due to the presence of intrathoracic lymphadenoma, (3) when the symptoms are mainly abdominal. The thoracic or abdominal symptoms not uncommonly supervene in cases which begin in the ordinary way. The disease is usually local for a varying time and then becomes widespread; the usual course is therefore chronic, but acute cases occur. It is usually stated 23 Adami : Principles of Pathology, 1910, I., 740. Yamasaki: Ztschr. /. Heilk., 1904, XXV., 269. 34