A case of late Hodgkin's disease (lymphoma granulomatosum) : with remarks on various cases presenting the clinical picture of splenic anemia (Banti's disease) / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
1911
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Licence: In copyright

Credit: A case of late Hodgkin's disease (lymphoma granulomatosum) : with remarks on various cases presenting the clinical picture of splenic anemia (Banti's disease) / by F. Parkes Weber. 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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    1,700,000 in the cubic millimeter of blood; white cells, 1200 to 1900 in the cubic millimeter; hemoglobin, 30 to 35 per cent. The heart was somewhat enlarged and there was a systolic apical murmur. The necropsy showed the presence of chronic malignant endocarditis, and a microscopic examination by Dr. J. C. G. Ledingham of pieces of the spleen, liver, kidney, and bone marrow from the shaft of the humerus, showed, in all four organs, as their most con- spicuous pathological histological feature, a plasma cell develop- ment with the elaboration of new fibroblastic tissue. Perhaps, after all, in the present state of our knowledge, splenic anemia, with its later stage, known as Banti’s disease, is best looked upon as a symptom group, which may be set up by various patho- genic agencies, the nature of some of which is known, though that of others has not yet been discovered. In quite a considerable number of cases presenting during life the clinical features of splenic anemia, old thrombotic obstruction of the splenic and portal veins, with sometimes more extensive recent thrombosis as well, has been discovered after death. For examples of that kind we could refer to the published cases of Dock and Warthin,611904, Oettingerand Fiessinger,62 1907, Edens,63 1907, F. Deve,64 1908, and several others; occasionally the splenic artery has been found diseased. In some of these cases the spleno- megaly was doubtless secondary to the obstruction in the splenic and portal veins, but in other cases the vascular disease may have been secondary to a toxemia of splenic origin. Cases of biliary cirrhosis of the liver, Hanot’s type, with spleno- megaly,65 are, owing to the chronic jaundice, seldom likely to be diagnosticated as cases of splenic anemia. The Gaucher type of primary splenomegaly66 is scarcely ever met with. But there are certain cases of congenital or acquired chronic acholuric, so-called hemolytic jaundice, with splenomegaly and anemia,67 which might, owing to the temporary or permanent absence of obvious clinical jaundice, be-mistakenly labelled as examples of splenic anemia. Such cases might be headed splenomegalic anemia or splenomegalic hemolytic anemia, acquired or congenital, to avoid the confusion with splenic anemia.68 In a paper,69 with Dr. Dorner on “ Four 61 Amer. Jour. Med. Sci., Philadelphia, 1904, cxxvii, 24. 62 Revue de M6d., Paris, 1907, xxvii, 1109. 63 Mitteil. a. d. Grenzgebieten d. Med. u. Chir., Jena, 1907, xviii, 59. « Normandie M6dicale, March 1, 1908; abstract in Arch, des Maladies du Cccur, etc., Paris 1908, i, 006. 65 F. P. Weber, Trans. Path. Soc., London, 1903, liv, 103. ee Weber and Dorner, vide infra. 37 F. P. Weber, Amer. Jour. Med. Sci., Philadelphia, 1909, cxxxviii, 24; F. P. Weber and G. Dorner, Lancet, London, 1910, i, 227. 68 Armand-Delille, Soc. de Pddiatrie, Paris, June 23, 1910. Armand-Delille and Feuiltee, Soc. m6d. des Hdpitaux de Paris, February 2, 1909. Chauffard and Troisier, Soc. M6d. des Hdpitaux de Paris, February 19, 1909. R. Hutchison, Case of Splenomegaly, shown at the Clinical Section of the Royal Society of Medicine, March 10, 1911. 63 Weber and Dorner, loc. cit.