Glioma retinae : with report of five cases / by Christian R. Holmes.

  • Holmes, Christian R. (Christian Rasmus), 1857-1920.
Date:
[1902]
Catalogue details

Licence: In copyright

Credit: Glioma retinae : with report of five cases / by Christian R. Holmes. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    widely dilated, some more than twice the size of the normal arteria centralis retinae, and filled with blood cells. Around each one of the vessels the round cells of the tumor are closely pressed together, so that they often take on a poly- hedral shape. They take the stain very deeply, whereas, at a distance, much less so, so that the tumor has a peculiar spotted or lobulated appearance. Nowhere did I find places where the tumor cells formed the walls of the vessels, but everywhere there are large vessels with thickened and dis- tinctive vessel walls, showing the endothelial cells lining the vessel wall, the intima of the vessel, and around these grouped the cells of the tumor. The choroid is distinctly and sharply demarcated from the optic nerve by connective tissue fibers. The fibers of the lamina cribrosa are especially sharply defined and pushed backward by the tumor, which has encroached on the nerve head, and finally invaded and thoroughly destroyed its fibers. Nevertheless, the line of demarcation between the choroid and nerve head is very sharply defined. The optic nerve itself is greatly thickened, its nerve fibers being entirely obliterated by the extreme infiltration. Both artery and vein intensely dilated and filled with blood cells. To the side of the artery this tissue is one mass of round cells, and all along the nerve sheath are new-formed and widely dilated blood-vessels. The lymph space is obliterated, due in part to the infiltration and swelling of the nerve and in part to the infiltration of the arachnoidal sheath and space, and also of the dural sheath (Figs, 3 and 4), The side nearest the vein is likewise infiltrated with round cells, as is also its dural sheath. These conditions exist to the very end of the nerve. In some of the sections the arteria centralis retinae can be followed outward directly into the tumor mass, leaving no doubt that many of the large vessels permeating the tumor take their origin from the large central vessels. The retina has been pai-tly destroyed. The sections of the anterior half of tlio globe (Fig, 5) show the retina detached to the ora serrata, from which point it was pushed anteriorly toward the lens, from both sides coming up close to the lens and then going backward toward the nerve head—a typical, total, umbrella detachment. In the triangular space between the lens and receding retinal frame- work are the connective tissue fibers of the vitreous. All the anterior sections of the choroid show this to be infiltrated. The ciliary body and its prcx'cssos are atrophied, doubtless from pressure, and they likewise show slight infiltration. The lens has not been affected and is perfectly normal, although the tumor mass with large blood-vessels is pressed up against its posterior surface. The lens shows the peculiar bulged edges always found in cases of tumor in the eyeball.