CHORION WITHOUT AMNION OR CYEMA. 



Ill 



generation characteristic of hydatiform mole. Between 

 the villi there is a large quantity of blood, with an excessive 

 amount of trophoblast, which on one side forms a large 

 mass. Within the center of the specimen there is a small 

 collapsed chorion with poorly defined walls. The speci- 

 men was not cut into serial sections, so it is impossible to 

 state whether or not the embryo has been entirely de- 

 stroyed, but in all probability this was the case. 

 (6) Marked infiltration; hydatiform degeneration. 



No. 71. 



(1) G. H. Whitcomb, Greenwich, New York. 



(2) A 10X9X5 mm. 



(3) Dr. Whitcomb writes: "The specimen is from a 

 woman 23 years old, who had been married three months 

 before the abortion occurred. She had been troubled with 

 chronic cystitis and endometritis, but menstruated regu- 

 larly. After marriage she had two menstrual periods, but 

 the third failing to appear, she concluded she was pregnant. 

 Seven days after the lapsed period she slipped while 

 descending the stairs, and this was followed by some 

 tenesmus. Four days later I examined her and found a 

 free flow of unstained mucus from the uterus, with tender- 

 ness, hyperjemia of the pelvic organs, and irregular pains. 

 An examination of the urine on the following day showed 

 it to be loaded with pus and blood, and it contained also 

 the ovum. Two days later the decidua was discharged. 

 The specimen was preserved in 50 per cent alcohol. 

 Shortly after this the woman became pregnant again and 

 went to full term." From the above data the abortion 

 occurred 40 days after the beginning of the last menstrual 

 period. 



(4) When the ovum came to the laboratory three years 

 later it was well preserved and had not been opened. The 

 villi were even but slightly deficient on one side. Within 

 there was a small amount of magma r6ticu!6, and at the 

 bottom of one of the halves of the chorionic vesicle there 

 was found a very small nodule. 



(5) The nodule, which was embedded and cut into 

 sections 20 microns thick, appears to be of foreign material. 

 The syncytium of the chorion is normal, except for macera- 

 tion changes. There are no blood-vessels. 



(6) Decidua absent. 



No. 82. 



(1) H. F. Cassidy, Baltimore, Maryland. 



(2) A 75X60X40 mm. 



(3) "Last period began June 3, 1896, and the tumor 

 was passed March 8, 1897, 40 weeks later." 



(4) The specimen was brought to the laboratory fresh. 

 It was pear-shaped, purulent on the pointed end, and the 

 interior appeared to be composed of fresh blood-clots. 



(5) Sections of the large, solid mass, mainly composed 

 of clot, show that it contains a collapsed ovum with folds 

 of the fibrous chorion extending throughout the specimen. 

 On one side of the specimen there are a few slender villi. 

 Most of the folds of the chorion are composed of double 

 walls, usually in apposition and occasionally completely 

 blended. All of the chorionic membrane and some of the 

 few remaining villi are composed of relatively well pre- 

 served, dense, fibrous connective tissue. There is no 

 amnion. Along the main central body of the chorion 

 large quantities of fresh blood are found. The rest of the 

 tumor is composed of blood-clots and nests of leucocytes 

 and of syncytium. The syncytial nests, located in great 

 part along the chorion, are preserved better where they 

 come in contact with fresh blood, but are necrotic else- 

 where. At no point does the syncytium invade the cho- 

 rionic membrane. It is impossible to interpret this speci- 

 men without assuming that the chorion continued to grow 

 long after the death of the embryo. 



(6) Infection. Decidua absent. 



No. 93. 



(1) H. F. Cassidy, Baltimore, Maryland. 



(2) A 40X20 mm. 



(4) The specimen contained a cavity into which pro- 

 jected a large tongue of fleshy tissue. Within the latter 

 there is a blood-clot, as well as a sharply defined cavity. 



(5) Sections through different portions of the specimen 

 show the outer sac to be the decidua and the tongue of 

 tissue, the chorion. Within the central cavity of the 

 tongue (ccelom) lies the greatly macerated amnion. It can 

 not be stated definitely whether or not remnants of the 

 embryo are present, as the specimen was not cut into 

 serial sections. The walls of the chorion are thickened 

 and irregular, and around it are packed hypertrophied 

 villi, with great quantities of blood between them. Cover- 

 ing the villi is a layer of blood and fibrin separating them 

 all from the decidua. The latter is fibrous and shows 

 decided general infiltration. 



. (6) Marked infiltration. 



No. 123. 



(1) H. J. Boldt, New York. 



(2) Ovum 17X14 mm., with vesicle 1.8X1.5X1 mm. 



(3) "The last menstrual period prior to the abortion 

 occurred August 14 or 15. Abortion September 10. The 

 whole ovum was placed in 95 per cent alcohol within 10 

 minutes after abortion." 



(4) The entire ovum was covered with villi, apparently 

 normal, but surrounded by a layer of pus and blooa. 

 After opening it, the ccelom was found filled with a mass 

 of coagulated fibrinous albumin, the magma reticu!6, 

 within which no embryo could be seen. The two halves 

 of the ovum were then stained, which brought out promi- 

 nently a small vesicle embedded in the magma. This 

 vesicle had a rounded opening upon one side, with a long 

 pedicle upon the other, which extended towards, but waa 

 not attached to, a small mound on the inside of the chorion. 

 Vesicle and chorion were both cut into serial sections. 



(5) The sections of the vesicle appear to be those of the 

 normal umbilical vesicle. The opening on the side is 

 undoubtedly due to a tear, judging by its broken edges. 



(6) Marked infiltration of the decidua. 



No. 147. 



(1) A. C. Pole, Baltimore, Maryland. 



(2) Ovum 30X27X20 mm. 



(3) "Last period began January 1, and the specimen 

 was discharged March 23." 



(4) The ovum is only in part covered with villi, the 

 remaining portion of the chorion being clear and trans- 

 parent. The ccelom is completely filled with magma, which 

 has turned very white hi the alcohol in which the speci- 

 men was preserved. On one side of the choripn and closely 

 attached to it, there is a small vesicle and an irregular mass 

 which may represent the remnants of the embryo. The 

 magma contains some degenerating erythroblasts. 



(5) Sections of the chorion show that the mesqderm is 

 very fibrous and rich in cells. The vesicle within is about 

 a millimeter in diameter, and is located 2 mm. from the 

 chorion, but not attached to it. Its walls are composed 

 of only one layer of cells on one side of the vesicle, while 

 on the opposite side there is a second layer of mesoderm 

 0.5 mm. thick, in which are embedded numerous blood- 

 vessels filled with blood. There are also a few blood- 

 vessels in the chorion in the immediate neighborhood of the 

 vesicle, which are likewise filled with blood. 



(6) Decidua not included. 



No. 153. 



(1) E. W. Stick, Glenville, Pennsylvania. 



(2) A 50X20X20 mm. 



(3) Last period began April 30; abortion July 15. 



(4) The mass is pear-shaped and proves to be a ruptured 

 chorion partly inverted and embedded in an organized clot 

 of blood and fibrin. The chorion is, of course, ruptured, 

 and at the point of rupture there is a mass of blood which 

 forms the large end of the pear-shaped mass. There is no 

 amnion within the degenerate chorion, nor could the 



