A case of primary melanotic sarcoma of the liver / by Sheridan Delépine.

  • Delépine, Sheridan, 1855-1921.
Date:
[1891]
Catalogue details

Licence: Public Domain Mark

Credit: A case of primary melanotic sarcoma of the liver / by Sheridan Delépine. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    to the fallacy of some of the results obtained by simply weighing a patient in order to judge of the state of his metabolism. I may indicate as points of special interest the following con- clusions. V. Conclusions. 1. A considerable overgrowth of the endothelial cells of the hepatic vessels may give rise to the rapid1 production of tumours having all the characters of sarcomata distributed all over the organ, but entirely confined to the liver. 2. The proliferation seems to be due to the elaboration of some substance by the hepatic cells in a state of disordered activity. 3. A large amount of melanin may accumulate in some of the nodules thus produced. This melanin does not seem to be produced out of any of the ordinary blood-pigments, and seems to be elaborated by the sarcomatous cells themselves. I venture to suggest that some pale or colourless material was brought to the organ by the vessels, and that it was out of this material that melanin was precipitated in the cells. 4. Some of the hepatic veins contained globules of a brownish substance, not so dark as melanin, and evidently fluid ; and these globules, I think, indicate the circulation of some such substance as the one just alluded to. This would explain how the urine of patients suffering from melanotic tumours and certain other disorders may become loaded with some product which, when ex- posed to the air, becomes very dark in colour (melanuria). Note.—This paper was originally prepared for the Pathological Section at the Annual Meeting of the B. M. A. held in Glasgow (1888); I was, however, unable to attend, and the paper was not published. Dr. Rolleston has attracted my attention to a paper by Dr Hale White, published in the ' Guy's Hospital Eeports ' for 1890 p 59 Those who wish to study the subject from a clinical point of view wdl do well to read the paper, which contains much information and a good digest of a number of cases. It may be interesting to notice that Dr. Hale White does not attempt to settle the patho- logical side of the question, owing to the discrepancies of opinion » Primary melanotic sarcomata of the liver have been remarked by several observers to have run equally rapidly to a fatal issue.