On lymphadenoma : contribution to a discussion in the Section of Pathology and Bacteriology, at the Annual Meeting of the British Medical Association, Cheltenham, July-August, 1901 / by J.H. Bryant.

  • Bryant, John Henry.
Date:
[1901]
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Licence: In copyright

Credit: On lymphadenoma : contribution to a discussion in the Section of Pathology and Bacteriology, at the Annual Meeting of the British Medical Association, Cheltenham, July-August, 1901 / by J.H. Bryant. 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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    Reprinted from the British Medical Journal, September 14th, 1901. ON LYMPHADENOMA. CONTRIBUTION TO A DISCUSSION IN THE SECTION OF PATHOLOGY AND BACTERIOLOGY, At the Annual Meeting of the British Medical Association, Cheltenham, July-August, 1901. By J. H. Bryant, M.D., F.R.C.P., Assistant Physician to Guy’s Hospital. Dr. Bryant said: In this discussion of the pathology of lymphadenoma I shall confine myself to a few remarks on the relation fibrosis bears to lymphadenoma. My interest in this particular point was aroused by the following case which I had the opportunity of investigating. Clinically no doubt was felt about the diagnosis of lymphadenoma being correct; at tliepost-mortem examination, however, there were such marked fibroid changes in the parts involved, and the organs pre- sented such an unusual appearance that the question of it being due to some other conditions arose, and when speci- mens were subsequently examined under the microscope the doubt increased and the possibility of syphilis was raised. I submitted specimens to two of my colleagues skilled in the examination of pathological specimens, one held the view that the changes were probably due to syphilis, the other that they were the result of chronic lymphadenoma. As I have already stated tliei’e was no doubt clinically about the diagnosis of lymphadenoma, but when the possibility of syphilis arose as it seemed to me with such an obscure disease as lymphadenoma as far as the pathology is concerned, such a case as I am about to relate to you would form a text on which to discuss the I’elation fibrosis bears to lymphade- noma, and the connection, if any, that syphilis has to this disease. C. X,., aged 41, race official, was adraited into Philip Ward, Guy’s Hospital under the care of Dr. Hale White (to whom I am indebted for permission to publish the clinical notes) on May 8th, 1899, for swellings in the neck, axillie, and groins, and for wasting, anmmia, and indigestion. He was born in Surrey and had been connected with the turf all his life, having served as stable boy and jockey, but during the last 20 years his work had not been arduous, consisting chiefly of looking after the carriage enclosure at race meetings. He stated that he had always been moderate with regard to alcolioi. His family history was good. His father was alive and aged 79, mother 71, two sisters 39 and 44, and one brother 36 all of whom were well; 20 years ago he contracted gonorrhoea, and this was the only illness he had had with the exception of a few minor accidents until four years before, when his present trouble began to manifest itself. He first noticed a swelling under the left ear, which increased in size until the whole of the neck became involved in a large lumpy tumour, the right side of the neck then became enlarged ; then the axillae and finally the groins. He stated that the tumours have varied in size very much At first he did not give up his work, hut lie