Symmetrical lymphomata of the lacrimal and salivary glands (Mikulicz's disease) / by S. Lewis Ziegler.

  • S. Lewis Ziegler
Date:
1909
Catalogue details

Licence: In copyright

Credit: Symmetrical lymphomata of the lacrimal and salivary glands (Mikulicz's disease) / by S. Lewis Ziegler. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    tumors underwent resolution, and in the case of Frost, where one lacrimal gland was extirpated and the other disappeared spontaneously and permanent- ly while awaiting the microscopic report of “sar- coma.” Lymphosarcoma may or may not be bilat- eral, and is rarely primary in this location. It rap- idly invades the surrounding tissues, spreads by metastasis, and when extirpated quickly recurs. Su- perficial cutaneous varicosities may form, and the skin may adhere and ulcerate. Carcinoma occurs but seldom, and is generally secondary to some ini- tial growth elsewhere. It is usually nonsymmetri- cal, invades the surrounding tissues, and is accom- panied by pain and cachexia. Tuberculous adenitis can generally be excluded by Koch’s tuberculin test. As a rule, the attack is not bilateral and other foci of infection may be found. Sooner or later there is a tendency to periadenitis, and suppuration may develop. Syphilitic adenitis can be differentiated by the history, the symptoms, and the therapeutic test. The glandular swellings may be unilateral. The additional evidence of en- larged cervical, epitrochlear, or inguinal glands will help to confirm the diagnosis. These two diagnostic possibilities have probably interfered most with the isolation of this disease. Abadie and de Lapersonne were both dubious about the tuberculous origin of their cases. Osier first inclined to hereditary syphilis in his case, although there was neither interstitial keratitis nor dental notching present. Complete involution of the glands occurred during an intercurrent attack of pleurisy. The patient’s death from tuberculosis two years later suggested a tuberculous origin, but the inference could not be substantiated. Posey’s case was diagnosticated as hereditary syphilis, because it yielded to potassium iodide after a year’s treat- ment. This does not necessarily confirm the diag- nosis, as the same drug is useful in Mikulicz’s dis- ease. Stieren has reported an interesting case of supposed tuberculous dacryoadenitis which his own careful tests showed was absolutely free from tu- berculous infection. These are all typical examples of Mikulicz’s disease, occurring in negroes, and have been included in the reported list. In rare instances the occurrence of lipoma of the lids has obscured the diagnosis. As both lids are usually involved, and the tumor is not so hard as
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