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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    Anatomical Diagnosis. Lymphosarcoma of mediastinum and cervical lymph glands of pericardium, myocardium, and pleurae. On the left side of the neck, commencing at the clavicle and extending up nearly to the angle of the jaw, there is an irregular, firm swelling composed of several more or less distinct masses. The glands in the axilla and inguinal region not enlarged. In the thorax there is a large tumor mass, irregular in shape, with numerous smooth projections. It extends farther into the right than into the left pleura, pushing the heart to the left side and extending down over the pericardium in front. All of the great cardiac vessels, with the excep¬ tion of the inferior vena cava, are surrounded by the tumor. The posterior mediastinal glands are converted into a tissue of the same character as the tumor. On section, the tumor is mottled, in general of a grayish color, firm in consist¬ ency, although abundant juice could be squeezed out from it. There are numerous points of hemorrhage and here and there large yellow caseous areas, sharply separated from the surrounding tissue. The cervical glands are matted together in a mass like the tumor, internal jugular, carotid, and pneumogastric nerves run over this mass, but are not involved. The right pleural cavity con¬ tains 1800 c.c. of clear fluid. The right lung is compressed by the exudate, the lower portion airless. The anterior edge of the lung is adherent to the tumor, which invades the lung slightly. The left lung is free, and air-containing through¬ out. The right tonsil is greatly enlarged, and on section of the same consistency as the tumor. The pericardium is rough and dull, and over the greater part of its extent covered with slightly projecting tumor masses, especially on the parietal layer. The diaphragm also shows some tumor masses. The mesenteric glands are enlarged; some of them present the appearance of the tumor. The abdom¬ inal organs in general show nothing special. Scrapings of the tumor showed nothing but small lymphoid cells, varying slightly in size, with a large nucleus and a small protoplasmic margin. Frozen section showed a very slight amount of stroma. Sections of the heart showed an infiltration of the heart muscle with fat. Microscopic examination of the tumor shows that it is uniform in character wherever it occurs. It is found to infiltrate into the tissue spreading apart the tissue elements, but not growing in the form of solid nodules. The tumor sub¬ stance is made up of a very delicate stroma, in the meshes of which lie cells of uniform character; all are rounded, with rather ragged protoplasm and vesicu¬ lar nucleus provided with a nucleolus. The cells measure 5 to 8 mikra in diameter, the largest not exceeding 9 mm. Mitotic figures are abundant. Some portions of the tumor growth are very compact, .while other areas are loose and spread wide apart. Areas of necrosis occur here and there. The pleural tissue is densely infiltrated with these cells, which outline the fat cells by filling up the space between them. Liver, spleen, kidney, and lung are practically normal on section.