Mediastinal form of lymphadenoma (Hodgkin's disease) with extreme so-called pulmonary hypertrophic osteo-arthropathy / by F. Parkes Weber ; with a report on the histology of the case by J.C.G. Ledingham.

  • Frederick Parkes Weber
Date:
1909
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Licence: In copyright

Credit: Mediastinal form of lymphadenoma (Hodgkin's disease) with extreme so-called pulmonary hypertrophic osteo-arthropathy / by F. Parkes Weber ; with a report on the histology of the case by J.C.G. Ledingham. 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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    except that the cliaphragin, owing to intrathoracic pressure, projected downwards in the gastric region. Tlie liver (50 oz.) presented the naked- eye appearance of passive congestion. The spleen (G oz.) and the kidneys (together 12 oz.) appeared normal. Besides the mediastinal tumour, no other growth was found in the body, excepting that the lymphatic glands about the clavicles at the base of the neck were moderately enlarged. No macroscopic evidence of tuberculosis was dis- covered in the lungs or anywhere else. The medullary canal of the shaft of the left humerus was opened, and the marrow which it contained was seen to have undergone a red transformation. Portions of this marrow, of the mediastinal tumour, of an enlarged cervical lymphatic gland, of the spleen and of the liver were removed for micro- scopic examination. The joints and cranium could not be examined, but a piece of the upper part of the left humerus was removed for maceration and microscopic examination. The macerated bone showed an irregular sub-periosteal deposit of new bone on the shaft. This new bone formation was seen by microscopic examination of a decalcified piece to consist of a more or less thick layer of spongy bone developed between the outer surface of the periosteum and the original compact bone of the shaft. Eeport on the Microscopic Examination by Dr. J. C. G. Ledingham. The tissues were fixed in Orth’s fluid, embedded in paraffin and stained by various methods. The most useful stain for demonstrating the eosinophilia in the glands and the finer structure of the bone- marrow was Laurent’s eosin-methylene-blue mixtm’e. Cervical Gland (stain Laurent) {see fig. 6).—Examination of the section under low magnification revealed a loose reticular structure, in the meshes of which were enclosed enormous numbers of eosinophil cells, giant-cells and lymphocytes. No lymphoid nodes could be detected. With high magnification (Leitz, oc. 4, obj. xV oil imm.) the most striking feature was the accumulation of eosinophil cells presenting either single or polymorphous nuclei. Their distribution was not confined to any particular portion of the gland area, though in some parts they were more numerous than in others. As many as a hundred or more could be counted in one field of the oil immersion. The giant-cells were of all sizes, and their nuclei did not conform to any one type. The most usual nuclear form was that which has been
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