Sarcoma of the small intestine / by E. Libman.

  • Emanuel Libman
Date:
1900
Catalogue details

Licence: In copyright

Credit: Sarcoma of the small intestine / by E. Libman. Source: Wellcome Collection.

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    and the other half is necrotic and cystic. On cutting the tumor open it is found to begin in the submucosa, reaching to the mucosa, but not involving it. Microscopical examination : spindle-celled sarcoma. Of the autopsy notes only the following are of special interest : The spleen shows acute inflammation and hemorrhages. The kidneys show chronic nephritis, with acute degeneration. In the liver there is a marked pigmentation presumably due to absorption of blood from the tumor. There are no metastases present. Note. This case was one of a solitary tumor of the intestine, which clinically bore the closest resemblance to acute appendicitis, the acute¬ ness of the symptoms being due in all probability to the hemorrhagic extravasation. Etiology. Frequency. A glance at some statistics will be neces¬ sary to show the frequency of sarcoma of the intestine, and the com¬ parative frequency of sarcoma and carcinoma. From 1859 to 1875 there was no case of intestinal sarcoma observed in the Berlin Patho¬ logical Institute. On the other hand, Smoler reports thirteen cases in Prague in fifteen years among thirteen thousand and thirty-six autop¬ sies. Nothnagel states that in twelve years there came to autopsy in Vienna twelve cases of intestinal sarcoma. This certainly indicates that the disease is an unusual one. Possibly the occurrence of four cases of lymphosarcoma in our service in a very short time would tend to show that we may have to deal with an endemic disease, for, as we shall later see, there is reason to suspect these tumors to be of infectious origin. Compared to the total number of lymphosarcomata the intestinal cases are not very infrequent. Nothnagel’s figures show that among two hundred and seventv-four sarcomata three involved the intestine, and of sixty-one lymphosarcomata nine were primary in the intestine. As to the frequency compared to carcinoma, Mueller reports five hundred and twenty-one cases of carcinoma, of which forty-one occur¬ red in the intestine, and one hundred and two cases of sarcoma, with only one instance of intestinal involvement. Similarly, Nothnagel’s figures show that among two thousand one hundred and twenty-five carcinomata two hundred and forty-three occurred in the intestine ; of two hundred and seventy-four sarcomata three occurred in the intestine, and among sixty-one lymphosarcomata there were nine of the intestine. So that sarcoma of the intestine is much more uncommon than car¬ cinoma. Location. Sarcomata have their seat of preference in the small intes¬ tine. In the large intestine they are much more uncommon, except in the rectum, where they occur quite as frequently as in the small intes¬ tine. A few figures will illustrate this. Krueger gives the following statistics of thirty-seven cases : Small intestine, sixteen ; ileum and VOL. 120, NO. 3.—SEPTEMBER. 1900. 21
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