Clinical records from the Glasgow Royal Infirmary / by Geo. S. Middleton.

  • Middleton, George S.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Clinical records from the Glasgow Royal Infirmary / by Geo. S. Middleton. Source: Wellcome Collection.

    96/102 (page 82)
    MYXCEDEMA—MEDIASTINAL TUMOUR. of the growth. Immediately behind the ascending aorta two little nodules of the growth project from the surface of the pericardium. The bronchi going to the apex of the right lung have been involved; and, having regard to the results of dissection, there is little difficulty in understanding the occur- rence of gangrenous excavation of the upper right lobe. “ On microscopic examination of the left lobe of the thyroid gland, the normal structure of that organ is found to have almost entirely disappeared, and has been replaced by a dense development of fibrous tissue. Here and there a few of the characteristic follicles of the thyroid are seen, but these are surrounded by a highly corpuscular interfollicular tissue which is evidently causing their rapid disappearance. The interior of the follicles is occupied by homogeneous gelatinous masses. “ Sections of the pituitary body reveal on the whole fairly normal characters, but at places it is thought that there is an undue development of spindle-celled tissue. Nothing particular is noted upon microscopic examination of the pineal gland.” The examination thus fully confirms the diagnosis, and accounts for the haemoptysis and the oedema which were so marked terminal features of the case. There is nothing to show how long the mediastinal tumour had been in existence. It had probably begun in the glands long before the occurrence of haemoptysis raised the question of the existence of a tumour in the lung, and it is not improbable that irritation, caused by its presence at the root of the lung, may have had something to do with the breathlessness and other symptoms which, on his first admission, were attributed to an overdose of the thyroid tabloids.