Multiple myeloma (myelomatosis) with Bence-Jones proteid in the urine (myelopathic albumosuria of Bradshaw, Kahler's disease) / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
1903
Catalogue details

Licence: In copyright

Credit: Multiple myeloma (myelomatosis) with Bence-Jones proteid in the urine (myelopathic albumosuria of Bradshaw, Kahler's disease) / by F. Parkes Weber. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    10/24
    marrow, and not overflowing into the circulating blood. Myelogenic pseudoleuksemia (using leukaemia in the sense of lymphocythsemia), myelogenic lymphosarcoma, lymphadenomatosis of bones, multiple myeloma (myelomatosis) of the lymphatic type. (b) Similar to the preceding, but the lymphocyte-like cells overflow into the blood-stream—myelogenic lymphocythsemia. I do not know of any cases illustrating this type, excepting cases of “ acute leukaemia.” Those of A. Denning1 and C. H. Melland,2 for instance, were examples of acute lymphocythsemia in which, post-mortem, practically no change was discovered in the leucocyte-forming tissues other than the bone marrow.3 (c) A new growth, formed in large part of lymphocyte-like cells originating in the lymph glands, or spleen, or lymphadenoid tissues generally (the bone marrow may likewise become involved), and not to any great extent overflowing into the circulating blood. Lymphatic, or splenic lymphadenoma, or pseudoleuksemia (using leukaemia in the sense of lymphocythaemia), Hodgkin’s disease. In the more chronic and fibrous varieties of this type the microscopic appearances differ, of course, considerably from those in acute cases. (id) Similar to the preceding, the lymphocyte-like cells invading the blood-stream—lymphatic or splenic lymphocythsemia. (e) A new growth originating in the bone marrow from cells derived from the myelocytes, and not invading the circulating blood. Myelogenic pseudoleuksemia (using leukaemia in the sense of myelogenic or spleno-medullary leucocythsemia). To cases of this type and to “ mixed cases ” partaking of this type the term multiple myeloma (myelomatosis) might, perhaps, be limited. (/) A new growth, differing somewhat from the preceding, and characterised by its myelocyte-like cells overflowing or being drawn out into the circulating blood, and by Bence-Jones albumosuria not occurring as it sometimes does in the last type. Myelogenic or spleno- medullary leuksemia (leucocythsemia). According to this scheme one must regard the excess of white corpuscles in the blood in all kinds of leuksemia as due to an inroad of tumour cells from a hyperplasia-like tumour formation in the leucocyte- producing tissues of the body,4 all forms of leucocytosis (including lymphocytosis) being merely expressions of some reaction in the tissues in question. A leucocytosis is therefore, strictly speaking, never an early stage of leuksemia (leucocythsemia); yet a true leuco- cytosis from any cause may perhaps sometimes be followed by true leukaemia, in so far as the reactive growth in the leucocyte-forming tissues (of which reactive growth the leucocytosis is the expression) ' Munchcn. vied. TVchnschr., 1901, Bd. xlviii. S. 140. '■■Med. Chron., Manchester, 1902, vol. iii. p. 372. I do not think that cases of acute leuksemia should be regarded as altogether different * “eS c^lr<m/lc Isuksemia, unless the special parasitic theory of the former be confirmed. Cf. Pappenheiin’s various writings, loc. cit., etc.