Volume 1

Atlas and essentials of pathological anatomy / by O. Bollinger.

  • Bollinger, O. von (Otto von), 1843-1909.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Atlas and essentials of pathological anatomy / by O. Bollinger. Source: Wellcome Collection.

    57/384 (page 15)
    Embolic Infarctions^ of the Spleen' with En- g<)3GME*n^t oF.TfTK .Organ; In the .spleen, enlarged by'engprgement to more than double it§-7normal, size,''are found several irregularly shaped «f^Qci of an orange-yellow color which are sharplj demarcated'; from' the surrounding, tissue. These foci are depressed below the level of the'surface, evidently by reason of a gradual contraction ancl absorption. On sectidirit jis seen that the form of the foci is usually that of a wedge whoge-p^int is directed toward the hilus^ The foci, a/e dry^; lustreless^ and friable,: in a condition of coagulation: necrosis. Here and there the foci; are surrounded by radiating, arborescent processes. The re- maining parenchyma of the organ is in a condition of cyanotic induration and chronic hyperplasia (chronic splenic engorgement). The immediate cause of the splenic infarctions, which are evidently several weeks or months old, is found in embolic occlusions of various branches of the splenic arteries. ; At the autopsy of the patient, aged twenty-three years (No. 97, 1888), the starting-point of the splenic emboli was found in a recurrent verrucose endocarditis of the aortic and mitral valves; there were also considerable hypertrophy and dilatation of the heart (weight, 500 gm. = 17^ oz., with a body weight of 37.5 kgm. = So lb.). The kidneys contained similar older infarctions of smaller size;' in the left cerebrum, in the region of the island of Reil and about the third frontal convolution, was another embolic softened area larger than a hen's egg (about four weeks oldj judging from the clinical symptoms), caused by embolic occlusion of the left arteria pro fossa Sylvii/ The benigii Condition of the embolic areas justifies the conclusion that the primary valvular disease of the heart was not of an infectious nature, although some defects of the inflamed valves would suggest a mycotiC'ulcerative origin of the inflammation. - : v- ^ - -