Visceral sarcomata : cases of sarcoma of the stomach, heart, mediastinum, etc. / by W. Gilman Thompson.

  • Thompson, W. Gilman (William Gilman), 1856-1927.
Date:
1910
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Licence: In copyright

Credit: Visceral sarcomata : cases of sarcoma of the stomach, heart, mediastinum, etc. / by W. Gilman Thompson. 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.

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    face and neck, and fullness in the head with dry cough and slight dysphagia. There were no other subjective symptoms of any kind until within an hour of sudden death. On admission to the Pres- byterian Hospital the patient’s neck was symmet- rically swollen, evidently as a result of venous con- gestion. The superficial veins of the neck, upper sternal region, shoulders and upper arms were greatly swollen and tortuous on both sides. In the left axilla and groin were a few moderately en- larged lymphatic glands. Across the lower thorax anteriorly were a half dozen red elevated plaques, about an inch in diameter, resembling urticaria, and in fact the eruption was mistaken for urticaria by a dermatologist who first saw the lad. I noticed, however, that although the redness disappeared on pressure, the swellings seemed firmer than the usual urticaria wheels, and in connection with the swollen lymph glands and mediastinal pressure, I regarded the case as one of probable lymphosarcoma, and di- rected the house physician, Dr. C. T. Roome, to ex- cise one of the cutaneous tumors for microscopic examination. Meanwhile the x-rz.y (Fig. 4) showed a heavy shadow in the upper mediastinum, through which masses resembling enlarged glands could be differentiated. There were no pulmonary symptoms other than an area of dullness cor- responding with the shadow, and a tracheal compression type of breathing. The cough was brassy, like the laryngeal cough of aneurysm. There was no fever, and the blood count was prac- tically normal, as follows: Hemoglobin, 95 per cent.; erythrocytes, 5,268,000; leucocytes, 11,600; polynuclear cells, 66 per cent.; lymphocytes, 33 per cent.; mast cells, 1 per cent. It was easy to exclude