Acute cases of Hodgkin's disease (lymphadenoma) and the diagnosis of this disease from syphilis, tuberculosis, and atypical leukaemia / by F. Parkes Weber.

  • Frederick Parkes Weber
Date:
[1907]
Catalogue details

Licence: In copyright

Credit: Acute cases of Hodgkin's disease (lymphadenoma) and the diagnosis of this disease from syphilis, tuberculosis, and atypical leukaemia / 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.

    5/13 page 85
    enlarged lymphatic or liaemo-lymphatic glands at the sides of the aorta. Some of the mesenteric glands were enlarged; at one part there was a group (adherent to the surrounding struc- tures), one or two of which were caseous or calcareous. The left axillary lymphatic glands varied considerably in size, one of them being as large as a hen’s egg. They were of firm texture and pinkish-red colour, some of them containing patches of pale, yellowish, degenerated material. The left humerus was sawn through longitudinally and the bone- marrow of the shaft was found to be of red colour and gelati- nous consistence. Microscopical examination.—Sections of the diseased lym- phatic glands showed the characteristic growth of endothelioid cells met with in cases of lymphadenoma according to the de- scriptions of Andrewes, Keeb, and others.1 The glandular tissue, however, seemed (at least in the case of the axillary glands) very vascular and the blood-vessels engorged with blood. Various portions of the sections showed respectively necrotic, hasmorrhagic, and fibrotic changes. One relatively large blood-vessel was seen invaded by lymphadenomatous growth, and this reminds one of a figure in Longcope’s work on Hodgkin’s disease,2 showing a nodule extending through the wall of a blood-vessel. Such occlusion of blood-vessels probably plays a part in the production of the necrotic areas which form so characteristic a feature in the macroscopic and microscopic appearances of the parts affected by this disease. No typical tuberculous structure was seen in any of the sections examined. Some sections were stained by Levaditi’s method for the “ spirochaeta pallida,” 3 but with negative results. Sections of the liver showed numerous scattered areas of necrotic change accompanied by much extravasation of blood and much small cell infiltration. I take it that the appearances in the liver were complicated by the presence of cirrhotic changes, and I am not sure that the necrotic areas in this organ were completely analogous to the necrotic areas in the lym- phatic glands. At one part I saw a blood-vessel invaded by lymphadenomatous growth4 like the vessel I have already mentioned in speaking of the lymphatic glands. 1 See previous references. 2 Longcope, loc. cit., Fig. 11. 3 Vide E. Gierke, Miinchener Med. Wochenschrift, Feb. 27, 1906, p. 393. The spirochaeta pallida has occasionally been detected in tertiary syphilis, even if we do not include under this heading the diffuse changes in the liver, &c., of congenital syphilis, in which its presence has been abund- antly recognised. See especially E. Tomasczewski, “ Ueber den Nachweis der Spiroclxaete pallida bei tertiarer Syphilis.” Miinchener Med. Wochen- schrift, July 3, 1906, No. 27, p. 1301. 4 Compare Longcope, loc. cit., Fig. ix.
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image