Extensive gummatous lesions of the liver, diaphragm, lung, and spleen / by Sheridan Delépine and Richard Sisley.

  • Auguste Sheridan Delépine
Date:
[1891]
Catalogue details

Licence: Public Domain Mark

Credit: Extensive gummatous lesions of the liver, diaphragm, lung, and spleen / by Sheridan Delépine and Richard Sisley. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    ramified tracks, having an appearance similar to that of the smallest of the patches in the lung. The appearance suggested lymphatics distended with cells or some fatty products. The surface of the pleura itself was puckered, the depressions being filled up with lymph. Between the catarrhal patches the lung parenchyma was apparently simply congested and oedematous, and in places emphysematous. The emphysema was most marked along the anterior and lower borders of the lobes. In many places there were small hsemorrhages. The bronchi were full of muco-pus. Microscopical examination of the left lung.—Under the microscope the lobular or patchy character of the consolidation was very distinctly seen in some places, whilst in other parts larger tracks were found to be occupied continuously by exudation. The general congestion was very evident. When the lesions were examined in detail the following points were found. (a) The pleura was covered with recent lymph containing very few cellular elements, but on the immediate surface of the serous coat there was an almost continuous layer of epithelioid cells, evi- dently the result of an active proliferation of the pleural endothe- lium. The subserous layer of the pleura was unevenly thickened, its blood-vessels audits lymphatics considerably enlarged, especially the latter. Where the fibrous tissue was in excess it was com- posed of very clear bundles of white fibrous tissue of homogeneous appearance, and with comparatively few cellular elements. This tissue was at places much infiltrated with carbon. The inter- lobular and interalveolar septa were similarly affected, and some of them were much thickened. The distended lymphatics corre- sponded to the yellow patches and ramified tracks already de- scribed. They contained chiefly cells, among which it was possible to recognise here and there lymphatic corpuscles, red blood-cor- puscles, and a few large fatty cells. In most parts there was au imperfect network of degenerated fibrine, granular debris, and small rosettes of crystals of doubtful nature ; similar patches were found all through the lung, but more specially round vessels of medium and large size-that is to say, in the perivascular portions of the interlobular septa. Notwithstanding the large size of some of these masses they did not seem to press on the vessels The peribronchial tissue was not affected in the same way. Some of the masses came in contact with the walls of some of the bronchi but this was owing to proximity of the latter to the vessels.