Round celled sarcoma of the anterior mediastinum : extensive metastases, including the brain, both choroid coats, oculo-motor and optic nerves, and external ocular muscles / by Arthur V. Meigs and G. E. de Schweinitz.

  • Arthur V. Meigs
Date:
[1894]
Catalogue details

Licence: Public Domain Mark

Credit: Round celled sarcoma of the anterior mediastinum : extensive metastases, including the brain, both choroid coats, oculo-motor and optic nerves, and external ocular muscles / by Arthur V. Meigs and G. E. de Schweinitz. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    2/16 (page 2)
    There was, perhaps, some slight difference in the volume of the two radial pulses at the wrists. The heart-sounds were clear and no murmur was audible. There was dulness on percussion at the lower portions of the lungs posteriorly, and whistling, dry rales were to be heard over the lungs every- where. There was a roaring sound as if from obstruction of the trachea or bronchi; this was more marked upon the right than upon the left side. He expectorated a good deal of watery, blood-stained fluid. Death occurred in great agony from suffocation about twenty-four hours after his admission to the hospital. The pnst-mortem examination revealed the presence of a large fleshy mass lying behind the sternum. This was wedge-shaped, with the base above, and was perhaps three inches wide by five vertically. It lay behind the sternum and over the pericardium, and completely surrounded the blood- vessels and the trachea, except a little of its posterior wall. The trachea was much compressed and pushed or dragged out of the median line. The innominate artery divided within the mass, and its two branches were narrowed. The carotid, a short distance from its origin, showed destructive erosion so great that the wall was very thin. The left innominate vein was included within the tumor, and it and the carotid and subclavian veins which formed it were all markedly narrowed. The heart appeared to be of about the normal size, and its valves, cavities, and openings looked natural. Upon its surface the vessels ap- peared tortuous and thick, and stood out in an unusual way. On cut- ting across such vessels they appeared to be surrounded with neoplastic material. At the apex there were several spots which were dark-red, re- sembing ecchymoses. At the base of the heart there was neoplastic material deposited upon the great vessels and on the auricles, and at one place this extended across to the parietal layer of the pericardium, which was ragged- looking. The pleural sacs both contained bloody serum, the right being tightly dis- tended, and the right lung compressed and carnified. Both lungs showed here and there upon their surfaces spots of neoplastic deposit, and upon the pleural surface of the diaphragm, upon the right side, there were a number of quite large nodules. The liver was large, weighed four pounds fourteen ounces, and was very full of blood. On section it presented the nutmeg appearance. The spleen was about five times the natural size and very firm in texture. The mesenteric glands were greatly enlarged and were sarcomatous. The kidneys presented numerous nodules upon their surfaces, and on section areas of sarcoma were seen scattered through the parenchyma. The brain itself presented no gross evidence of disease. The oculo-motor nerves were both enlarged, the right one being fully twice as large as the left and presenting a pear-shaped swelling just within the cranial cavity, before its entrance into the sphenoidal fissure.