110 



STUDIES ON PATHOLOGIC OVA. 



mm. in diameter was closely adherent to the chorion. On 

 opening, it appears to contain granular debris. In general 

 its walls are tough, and at its attachment to the chorion 

 there is a small nodule, probably the umbilical vesicle. 

 The villi of the ovum are well formed, but long and slender. 



(5) Sections show that they have undergone mucoid 

 degeneration and are matted together with a great mass 

 of inflamed decidua. 



(6) Marked infiltration. 



No. 994. 



(1) A. F. Ries, Baltimore, Maryland. 



(2) A 68X26X24 mm. 



(3) Patient aged 25 years, married about 7 years. Four 

 pregnancies: normal birth five years ago, another three 

 years ago, an abortion in May 1913, at four months, and 

 this abortion. Beginning of last period, September 5, 

 1914. Abortus protruding from mouth of cervix Novem- 

 ber 25; curetted November 28. Fertility of family good. 



(4) The abortus measures 68X26X24 mm. and con- 

 sists of villi and a pointed hemorrhagic mass. Probably 

 this lay within the cervix. The villi are of very irregular 

 shape, some of them long and shaggy, and have attached 

 to them numerous opaque nodules which, in some cases, 

 are more than a millimeter in diameter the trophoblastic 

 nodules or appendici durate. 



(5) Sections of the mole show the villi to be matted 

 together with a large mass of fibrinoid substance, to con- 

 tain considerable numbers of leucocytes, and to have 

 undergone mucoid degeneration in many cases. Between 

 the villi there is more or less fresh blood, within which are 

 buds of syncytium showing a quite active growth. 



(6) Marked infiltration and early confluent hydatiform 

 degeneration. 



No. 1015. 



(1) A. F. Ries, Baltimore, Maryland. 



(2) A 41X37X31 mm. 



(3) The patient had a miscarriage 10 years ago, this 

 being the third one. Menses appeared "on and off" from 

 July to November 26, with alternate weekly flowing. On 

 the latter date the bleeding was profuse and abortion oc- 

 curred on December 7. 



(4) Specimen consists of "a hard, firm mass, which on 

 section gives no evidence of pregnancy. Apparently a 

 tumor." 



(5) Microscopic examination reveals a mass of necrotic 

 dicidua and villi. 



GROUP 2. 



No. 20. 



(1) J. W. Williams, Baltimore, Maryland. 



(2) A 20X14.6 mm. 



(4) From the exterior the ovum appears to be quite 

 normal, with well-developed villi, which are represented 

 better near one end and look somewhat swollen and matted. 

 Within the ccelom, however, there is a great quantity of 

 magma, within which were buried several nodules. These 

 were removed and sectioned. 



(5) Sections revealed no amnion lining the chorion, and 

 the small nodules are only masses of magma which contain 

 no cells. The villi, the stroma of which is clear, are 

 covered by the usual quantity of trophoblast. They are 

 non-vascular and slightly macerated. At isolated points 

 between the villi are small masses of a granular substance 

 which present the appearance of coagulated albumin. 



(6) Probably early hydatiform degeneration. Decidua 

 not included. 



No. 21. 



(1) T. S. Cullen, London, Canada. 



(2) Chorion 12X9X5 mm.; vesicle within, 5.5X3.5 mm. 

 (4) From external appearances, the ovum is apparently 



normal, with well-developed villi branching a number of 

 times. Upon opening the chorion it was found that the 



ccelom was filled with a quantity of magma re'ticulS, within 

 which was embedded a very large transparent vesicle. 



(5) The main vesicle is brought into contact with the 

 chorion by means of a small secondary vesicle; both are 

 inclosed by a layer of mesoderm within which are numerous 

 blood-islands. The smaller vesicle is lined with a layer of 

 large, spindle-shaped cells. The cavities of both vesicles 

 contain cells which are scattered throughout the magma. 

 There are no blood-vessels in the chorion. The syncytial 

 layer is diminished but well formed upon the tips of the 

 villi. Here in many places it accumulates in layers, form- 

 ing masses. Both chorion and yolk-sac are very degen- 

 erate. The amnion is absent. The yolk-sac has finger- 

 like extensions, some of which may represent cyemic 

 remnants, but this is unlikely. 



(6) Decidua not included. 



No. 29. 



(1) W. D. Booker, Baltimore, Maryland. 



(2) A 30X30X30 mm. 



(4) The ovum was covered by a few atrophic villi, and 

 within no trace of an embryo could be found. The coslom 

 was filled with a cheesy mass of granular magma as usual. 

 After the magma had been searched through most com- 

 pletely, the portions of the chorion which might have a 

 remnant of the embryo attached were stained and cut into 

 serial sections, but nothing whatever could be found. 



(5) Sections of the chorion show that its walls and villi 

 are fibrous and thickened. The amnion is absent. A few 

 villi show mucoid degeneration, but the stroma of most of 

 them is fibrous and macerated. Some few show very 

 intense so-called granular hypertrophy or, better, hyper- 

 plasia. Many are non-vascular. Appendici durate are 

 numerous, and groups of degenerate villi are contained 

 within degenerate masses of trophoblast. The latter and 

 fusion of the villi are most numerous opposite areas of 

 greatly thickened chorion. Leucocytic infiltration in 

 wholly absent. 



(6) Decidua absent. 



No. 55. 



(1) W. T. Watson, Baltimore, Maryland. 



(2) A 35X20X14 mm. 



(3) Last period, January 18 to 22; abortion March 13. 



(4) The specimen is a very fleshy mass containing a 

 sharply defined, spherical cavity, 15 mm. in diameter, with 

 smooth walls, but no trace of an embryo. 



(5) Sections showed that the sharply defined cavity was 

 the ccelom, as its walls were formed by the chorion. The 

 thick, fleshy mass is composed of villi, syncytium, blood, 

 fibrin, and pus. The fibrous walls of the chorion, which 

 contain remnants of blood-vessels and decidua, are in- 

 vaded by leucocytes and partly disintegrated. The main 

 bulk of the villi and syncytium stains poorly and appears 

 necrotic. The stroma is fibrous, more or less degenerate, 

 invaded by leucocytes, and covered in part by very active 

 syncytium. The cavity of the coslom is partly filled with 

 a granular magma, in which are embedded some cells. 

 The whole picture is that of severe infection. Very little 

 decidua is present, and this is fibrous, infiltrated, and necro- 

 tic. 



(6) Marked infiltration of the decidua; severe infection. 



No. 70. 



(1) C. M. Ellis, Elkton, Maryland.. 



(2) A 45X30X28 mm. 



(3) Patient had regular periods until July 28, 1896, 

 when she missed one. On October 20 she had a profuse 

 hemorrhage; after this there was no flow until February 4, 

 when this specimen passed. 



(4) The gross specimen is very solid because of the large 

 amount of clot at one end, at which groups of character- 

 istic hydatids are found. 



(5) Sections show it to be composed of a mass of dis- 

 tended and cystic chorionic villi undergoing mucoid de- 



