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
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.
19/24 page 17
![points out, the retroperitoneal glands, or, as in the present case, some of the lymphatic tissue in the mediastinum. In a chronic case of Hodgkin’s disease under my care in 1902 complicated by tuberculosis [23], as cases of Hodgkin’s disease often are, there was a mass of chronic hard lymph- adenoma at the back of the upper part of the abdomen, displacing the stomach and liver forwards. The existence of acute febrile cases of Hodgkin’s disease (lymph- adenoma) and of a form characterized by “ chronic relapsing pyrexia” [19]; the association of areas of necrosis (or occasionally of widespread hyaline or amyloid changes) in the liver and other viscera; the fibrosis in later stages (which I think is probably analogous to the conservative fibrosis or cicatrization [2] in chronic tuberculous and tertiary syphilitic lesions) ; the apparent dissemination or generalization of the disease from a primary group of enlarged glands to other glands and to the spleen and liver; and the occurrence of miliary “ metastases,” possibly analogous to miliary tubercles, in various organs (including the bone-marrow), all suggest that Hodgkin’s disease (or a portion of the cases now classed together under that heading) ^ is due to some unknown microbe. In 1895 P. Delbet [4] obtained a bacillus from the blood and spleen of a woman supposed to be suffering from generalized lymphadenoma; and by repeatedly injecting large quantities of a pure culture of this bacillus he produced decided general enlargement of lymphatic glands in a dog. We do not, however, know that the disease in Delbet’s case was really lymphadenoma (Hodgkin’s disease) in the modern use of the term. In 1907 Proscher and White [13] reported that, by the Levaditi and Giemsa methods of staining, they had discovered spirochsetes in human lymphadenomatous glands, but Dr. Ledingham failed to detect any in the mediastinal growth or cervical lymphatic glands of the present case. In 1907 W. T. Longcope [9] tried to infect monkeys by inoculation with an emulsion of lymphadenomatous glands removed from patients by surgical operation, and though he did indeed set up a certain amount of general glandular enlargement, the histological picture was not that of Hodgkin’s disease. In acute cases ® (or acute termination of cases) of lymphadenoma, ' There may still be more than one disease grouped together under the heading lymph- adenoma or Hodgkin’s disease. * Acute cases of Hodgkin’s disease have been described by P. W. Andrewes, loc. cit., p. 310; W. B. Warrington, at the Liverpool Medical Institution, October 24, 1907, Lancet, 1907, ii, p. 1245; P. P. Weber, St. Bart.’s Hasp. Reports, 1907, xliii, p. 81 ; Hirschfeld and Isaac, Med. Klinik, Bcrl., 1907, iii, p. 1581; and J. Mitchell Clarke, Joum. of Path, and Boot., Cambridge, 1908, xiii, p. 92.](https://iiif.wellcomecollection.org/image/b2241941x_0021.jp2/full/800%2C/0/default.jpg)
