Primary sarcoma arising in a cirrhotic liver / by H.D. Rolleston and R. Salusbury Trevor.

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

Licence: In copyright

Credit: Primary sarcoma arising in a cirrhotic liver / by H.D. Rolleston and R. Salusbury Trevor. Source: Wellcome Collection.

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    Journal of Pathology and Bacteriology, Vol. XV. PRIMARY SARCOMA ARISING IN A CIRRHOTIC LIVER.1 By H. D. Rolleston, M.H., F.R.GP., Senior Physician, St. Georges Hospital; and R. Salusbury Trevor, M.B., Lecturer on Pathology, St. George's Hospital. From the Pathological Laboratory, St. George's Hospital. Plate XXVIII. ABSTRACT OF CLINICAL NOTES. A man, set. 46, was admitted to St. George’s Hospital, on 1st July 1910, with nausea, vomiting, and progressive weakness and swelling of the abdomen. There was an alcoholic history, but none of syphilis or of hsematemesis. The patient was somewhat wasted, and had a florid complexion due to ex¬ tremely extensive dilatation of the facial capillaries. The veins of the skin over the abdomen were dilated. There was oedema of the lumbar region, but none elsewhere. The skin was slightly jaundiced. There was tenderness over the liver, and the margin could be felt below the costal arch in the nipple line. The spleen was not palpable. The urine (acid, sp. gr. 1024) was free from albumin and sugar. The abdomen measured 37 inches and contained free fluid. As the ascitic distension was considerable, the abdomen was tapped and a little fluid having a pressure of 5 mm. Hg and resembling blood rather than blood-stained ascitic fluid was obtained. The trocar and cannula were withdrawn and then introduced in two other places, but the fluid obtained was the same in character. In all 30 oz. were removed. Two days later the abdomen was again tapped and 6 pints of fluid with exactly the same appearances were withdrawn. Mr. W. E. Waller found the specific gravity was 1018, and that the red blood corpuscles formed 97 per cent, of the cellular elements; of the other cells, 48 per cent, were polymorphonuclear leucocytes, 34 per cent, swollen epithelial cells, and 18 per cent, lymphocytes. Three days later the abdomen was again tapped and 24 oz. removed. The fluid looked more watery than previously, but had the appearance of dilute blood. Bacteriologically, it contained groups of large Gram-negative diplococci. Though relieved by the tappings the patient steadily lost ground, and had rather persistent abdominal pain which necessitated his being kept under morphine. He passed into a condition of toxaemic delirium and died on 20th July, the temperature having shot up to 104° F. The diagnosis in life was hepatic cirrhosis.