On the pathological anatomy of multiple lymphosarcoma and its status with relation to Hodgkin's Disease / by W.G. MacCallum.

  • MacCallum, W. G. (William George), 1874-1944.
Date:
[1907?]
Catalogue details

Licence: In copyright

Credit: On the pathological anatomy of multiple lymphosarcoma and its status with relation to Hodgkin's Disease / by W.G. MacCallum. Source: Wellcome Collection.

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    at the hilum of each lung are enormously enlarged. From these there extend lobulated masses, of a soft, white, tumor growth, into the substance of the lungs, forming great masses in each lung. Smaller nodules are scattered throughout the lung substance, and appear on the surface. The lung in the neighborhood is edematous, somewhat compressed, shows opaque, yellow dots. The spleen is enlarged and soft, and velvety in appearance. On section, contains no tumor nodules. The retroperitoneal glands are enlarged and completely replaced by the tumor tissue. The microscopic character of glands, extirpated at operation, in this case, has been described by Longcope {Bull, of the Ayer Clinical Laboratory, October, 1903, No. 1), and the lesions found at autopsy agree well with what he has written. The lymph glands show none of their normal architecture, the sinuses and lymph cords being obliterated by the solid mass of new tissue, which here does not respect the capsules of the gland, but infiltrates through it. The tissue has a fairly dense stroma, and as far as its cellular structure is concerned, corre¬ sponds exactly with Dr. Reed’s description. The lymphoid cells are not asso¬ ciated with many eosinophile cells, but the large cells with large vesicular nucleus or nuclei are very abundant and characteristic. Of especial interest are the nodules in the lung where the process of growth may be looked upon as rather different from that seen in the glands, inasmuch as it is advancing into a tissue not of lymphatic type. The smaller nodules show this process best, and there the nodule is found surrounded by somewhat compressed alveoli, but including also within its substance many alveoli which have become collapsed and in which the desquamated epithelium is still to be seen. The stroma of the new tissue is here particularly delicate and spread out so that the cells, which lie in its meshes, are not crowded together, but stand rather far apart. Possibly some of the alveoli may be entered by the new tissue, but one gets the impression that they are merely separated and collapsed by the new-growth of tissue in their walls. Ralph L., aged fifteen years; colored; admitted June 15, 1904. (Medical No. 17223.) Previous history good. Last August became weak and easily exhausted. For four months had enlarged inguinal glands on left side. During the past winter had slight cough with mucous expectoration. The glands in the neck and axillae also enlarged. At present all the glands are greatly enlarged. The axillary and pectoral glands being matted together in large masses. Per¬ cussion note is absolutely flat over the entire right lung. Spleen markedly enlarged. Red corpuscles, 2,950,000; leukocytes, 10,600; no tubercle bacilli found in the sputum. Differential count: Polymorphonuclears, 64 per cent.; small mononuclears, 30 per cent.; large mononuclears, 5.3 per cent.; eosino- philes, 0.3 per cent.; myelocytes, 0.3 per cent. The right side is practically immovable, with harsh tubular breathing heard over the lung, with coarse, dry rales. Under arsenic the glands have diminished in size. Patient died July 18.