A case of epithelioma of the ureter causing hydronephrosis / by Henry Rundle.

  • Rundle, Henry, 1845-1924.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: A case of epithelioma of the ureter causing hydronephrosis / by Henry Rundle. 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.

    3/6
    Epithelioma of the ureter causing hydronejTfn'osis^. By Henry Bundle, F.R.C.S. (per J. H. Targett, M.S.). History.—E. B—, a gardener, aged 46, a weak and emaciated man, was admitted into the Portsmouth Royal Hospital on April 2nd, 1895, under my care. His parents died from old age, but two sisters are stated to have died from cancer. Nearly the whole of his body was affected with psoriasis, which had existed for sixteen years. About a year before admission he noticed a fulness in the right side of the abdomen, which increased gradually and painlessly. On admission the abdomen was flaccid, except on the right side, where a fluctuating swelling, dull on percussion, occupied the front and lower part of the abdomen; it commenced two inches below the thorax, and extended to the middle line as well as far back into the lumbar region. Urine clear, freely voided, sp. gr. 1018, no albumen ; he had passed blood, but not recently. There was no history of pain and no other symptoms of renal calculus. On April 19th the swelling was tapped, and 80 ounces of fluid were evacuated. This fluid was alkaline, sp. gr. 1020, and became almost solid on boiling. The sediment obtained from the fluid was found to consist chiefly of blood and large granular corpuscles with a few columnar epithelial cells. For a fortnight there was no return of the swelling. The man became very emaciated, and so weak that he was unable to sit up in bed. Suspecting malignant disease, it was nol deemed advisable to attempt a removal of the kidney. The fluid having slowly re- accumulated, the cyst wastapped on May 29th and 60 ounces of fluid similar to that obtained before were evacuated. He passed into a semi-comatose state, and died from exhaustion on June 4th. Autopsy.—Numerous secondary deposits of growth were found in the liver, lungs, and abdominal lymphatic glands. Microscopical examination of these deposits revealed a squamous-celled epithe- lioma, but the central cells of the epithelial processes tended to undergo a granular rather than a keratoid change. Hence there were no cell-nests.