Some aspects of lymphadenoma (Hodgkin's Disease) / by H.D. Rolleston.

  • Humphry Rolleston
Date:
[1911?]
Catalogue details

Licence: In copyright

Credit: Some aspects of lymphadenoma (Hodgkin's Disease) / by H.D. Rolleston. Source: Wellcome Collection.

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    when it has once appeared it persists till death. From analysis of the recorded cases Batty Shaw finds that the average duration of the relapsing fever is about months. This relapsing fever recalls the intermittent hepatic fever associated with a gallstone “ floating ” in the common bile duct. In this condition periodic attacks of fever, pain, and jaundice occur with non-febrile intervals. It has been thought that these periods correspond with periods of susceptibility and of immunity to organisms present in the bile duct. From his analysis of bacteriological examinations Batty Shaw concludes that this relapsing fever of lymphadenoma is due to infection, but that the infection is not the same in all cases. It appears that there is not any leucocytosis daring the febrile periods (Phillips). Cutaneous Manifestations.—Bronzing of the skin, resembling that of Addison's disease, may of course be due to the administration of arsenic; but it may be seen in patients who have not had any treatment. The skin may also become brown as the result of the application of X-rays. Byrom Bramweil13 describes two exceptional cases in which pigmen¬ tation of the skin combined with leucodermia preceded obvious glandular enlargement by one and two years respectively. In these cases there was also pruritus, and it is possible that scratching may have played some part in producing the pigmentation, but it would not account for the leucodermia. Pigmentation of the skin, apart from the influence of arsenic and scratching, occurs in cases in which the suprarenals, though intrinsically healthy, are surrounded by masses of lymphadeno- matous glands. This can be explained either (i) as a result of irritation of the sympathetic nerve-fibres by enlarged retro¬ peritoneal glands, the resulting pigmentation of the skin being like that seen in other abdominal conditions, such as some cases of tuberculosis and malignant disease of the peritoneum, and also in pregnancy ; or (ii) by the internal secretion of the suprarenals being prevented from passing into the circulation—in other words, by suprarenal inadequacy as in Addison's disease. Purpura.—As acute lymphocytic leukaemia and multiple sarcoma may imitate acute lymphadenoma, they must as far as possible be eliminated before a case with purpura is accepted
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