On the pathological anatomy of multiple lymphosarcoma and its status with relation to Hodgkin's Disease / by W.G. MacCallum.

  • William George MacCallum
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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    adrenal, which is almost entirely replaced by the tumor, here, again, in a very pure condition. The cortex is much less involved than the medulla, although in places it, too, shows extensive infiltration; outside there is a thick mass of the tumor. Pancreas has suffered in the same way and is converted into a solid mass of the tumor, with scattered pancreatic elements. The mucosa of the stomach is densely infiltrated with the same cells somewhat mixed with other cells of the type usually seen in the mucosa. From this record of cases it is seen on analysis that of the 8, 3 cases were essentially intrathoracic tumor growths (Cases I, IV, and VI), while in 5 cases the abdominal organs were chiefly involved, the most striking and the only constant lesion being that of the digestive tract. Thus it seems possible to divide these cases fairly sharply into two groups, of which the first is composed of cases, in which there is a tumor growth in the mediastinal tissues, while the second comprises those in which there are single or multiple tumor growths in the intestinal wall, extending or metastasing thence to other abdominal organs, occasionally to more distant structures. The 3 cases which show a mediastinal tumor growth extended to the other thoracic tissues as follows: Pericardium, 2 cases; myo¬ cardium, 1 case; pleura, 2 cases; bronchial glands, 2 cases; pectoral muscles, 1 case; cervical lymph glands, 2 cases; other lymph glands, 1 case; tonsil, 1 case. In no instance was there any metas¬ tasis to the spleen, liver, or other abdominal organs. This in itself seems to confirm strongly Kundrat’s idea of the regional distribu¬ tion of these tumors, and shows, perhaps, that they are not quickly spread about by the blood stream. It is curious that in one of these cases (Case IV) soft polypoid masses of the tumor actually hung in the cavity of the heart, and still there were no metastases which could be regarded as due to transportation of cells by the blood stream. The extension by lymphatic channels is, however, appar¬ ently easy, and not only do the bronchial and cervical glands become involved, but occasionally even more distant glands. The serous surfaces may be affected by the appearance of nodules or plates in their substance, but in one of our cases (Case III) the mediastinal mass was such that the pericardium was rendered quite rigid and the heart beat in a circumscribed cavity hollowed out of the tumor.