Notes on cases of tumour in the mediastinum / by E. Symes Thompson.

  • Symes-Thompson, Edmund, 1837-1906.
Date:
[1865]
Catalogue details

Licence: Public Domain Mark

Credit: Notes on cases of tumour in the mediastinum / by E. Symes 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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    pulsation of the dilated veins of the neck. The percussion note was wooden over the manubrium sterni, at the right side, and here the breathing was bronchial in character. The patient died greatly emaciated. A tumour was found, at the post-mortem examination, encircling the aortic arch (which doubtless communicated the pulsation to the veins of the neck); the tumour extended upwards and downwards by the side of the trachea. The lymphatics of the neck were greatly enlarged. In the lower part of the right lung was another tumour, i which had pressed upon and made a concavity on the upper j surface of the liver. The lung itself was a mass of cancer, partly I solid and partly broken down into creamy juice. This patient did not come under observation till a very 1 advanced period of disease—long after the lung had become involved in secondary deposit—and the nature of the disease J could not be doubted. In the following case, however, the j patient was first admitted before any lung-symptoms had become developed. The observation of this case gave rise to the paper already alluded to by Dr. Budd, in which some details are given; but from my own note-book I cull these additional facts, which bear upon some points shortly to be noticed. Case II.—A healthy young compositor, finding that his face became livid and that he got very giddy when he exerted himself, applied for admission at King’s College Hospital. The face and neck began to swell, and the swelling increased so much on lying down, that he was forced to sleep in an arm-chair; the veins of the neck became large and tortuous, and he suffered for days together from difficulty of swallowing. Nothing abnormal could be detected in the chest on percussion or auscultation, but a suspicion of aneurism or tumour, compressing the vena cava , descendens, was hinted at. The symptoms became mitigated I under the use of iodide of potassium. A month later, however, the dyspnoea returned, the face became bloated, voice husky, and a loud clanging cough, with streaky, puriform expectoration, j occurred. On percussion, dulness was now detected, to the right of the middle line of the sternum, but there was no thrill or pulsation. Paroxysms of spasmodic dyspnoea became frequent, and the ■ i patient died in a fit of delirium. A tumour was found in the mediastinum, embracing all the , structures at the root of the lung. On microscopical examination | the stroma was found to consist of elongated, nucleated fibre- II cells, some multicaudate, the interspaces being tightly packed I with aggregated cancer-cells, the appearances being similar to II ^