114 



STUDIES ON PATHOLOGIC OVA. 



wall is thickened, edematous, and also contains some 

 Hofbauer cells and blood-vessels filled with blood. A 

 very few villi are present, and these are undergoing mu- 

 coid degeneration, but most of them are fibrous. The 

 degenerate, transformed remnants of the decidua show 

 extensive leucocytic infiltration, but in general the leuco- 

 cytes do not reach to the chorionic wall. There is some 

 coagulation necrosis. 

 (6) Marked infiltration. 



No. 596. 



(1) T. C. Smith, Washington, District of Columbia. 



(2) A 25X20X15 mm. 



(3) Last menstruation February 21, this being her first 

 pregnancy. Patient claimed at the time of her abortion 

 that this was her regular menstrual period. 



(4) The ovum is covered almost entirely with villi 

 which branch three or four times, and which on one side 

 are much less numerous and atrophic. Upon opening the 

 ovum it was found to be lined with a smooth surface, 

 but although examined under the most favorable condi- 

 tions in direct sunlight, no trace of an embryo could be 

 found. On one side there appeared to be a small mass of 

 reticular magma, and it was thought possible that the 

 embryo might be within it. Since the specimen was 

 perfectly white and transparent, however, it would have 

 been almost impossible to miss the embryo had it been 

 there. 



(5) Upon section, the wall of the chorion appears to be 

 normal in structure, but the villi have undergone partial 

 mucoid degeneration. The trophoblast is not plentiful, 

 but there are numerous nodules of it and tufts of syn- 

 cytium. Within the nodules of trophoblast there is some 

 fibrinoid and, often, scattered groups of vacuolated syn- 

 cytium. Although the entire ovum was embedded in 

 paraffin and cut into serial sections, no embryo was found. 

 Fine examples of vessels in the last stages of degeneration 

 are found in some of the villi. No decidua is included 

 in the sections. 



(6) Early hydatiform degeneration. Decidua absent. 



No. 606. 



(1) C. S. Parker, Baltimore, Maryland. 



(2) A 18X13X8 mm. 



(4) Part of the ovum is covered with branching villi, 

 quite uniform in size and 2.5 mm. long. The entire speci- 

 men projected would measure about 18X13X8 mm. 

 Viewed in direct sunlight, no trace of an embryo could 

 be seen, but it may have been lost with the missing por- 

 tion of the specimen. 



(5) The entire specimen was cut into serial sections, 

 which do not show any trace of an embryo. However, the 

 chorion and villi are so badly macerated that it is difficult 

 to make out any structure whatever. In fact, even the 

 nuclei of the chorionic membrane have disappeared en- 

 tirely, leaving only a fine reticulated structure. 



(6) Almost complete lysis. Decidua not included. 



No. 661. 



(1) G. L. Wilkins, Baltimore, Maryland. 



(2) A 45X25X25 mm. 



(3) Patient is a recently married woman who had 

 missed one period. No history of uterine or venereal 

 disease. Patient decidedly anemic. 



(4) The specimen is a smooth, pear-shaped mass, with 

 a stem 25 mm. long. The walls are thick and spongy, 

 and within there is an irregular cavity about 8 mm. in 

 diameter, which is lined with a smooth membrane and 

 filled with delicate reticular magma. It was thought 

 that the embryo mighl be present. 



(5) Sections show that the very thickened fibrous 

 chorion is encircled by a large hemorrhagic mass contain- 

 ing many villi and buds of syncytium, surrounded by a 

 thin layer of markedly inflamed decidua. The chorionic 

 wall, which is markedly fibrous, contains numerous blood 

 vessels filled with bood. The magma is very dense and 



directly in contact with the chorionic wall. In the center 

 of the ccelom the magma is partly granular and contains 

 a few Hofbauer cells. No trace of an amnion could be 

 found. Most of the villi are decidedly fibrous, but a 

 few show mucoid degeneration, with fenestration of the 

 stroma. The former retain some vessels. 

 (6) Marked infiltration. 



No. 663. 



(1) Lindsey Peters, Columbia, South Carolina. 



(2) A SOX 15X10 mm. 



(3) Patient 30 years of age. Five pregnancies: first, 

 term, child still living; second, twins at term, one child 

 living; third, stillbirth at term; fourth, term, child living; 

 fifth resulted in this abortion. Last menstrual period, 

 January 18 to 22; abortion, March 15. No infection of 

 uterus; position normal. 



(4) The specimen is a smooth, almond-shaped body 

 containing a small cavity filled with reticular magma. 

 No remnants of an embryo could be seen. The specimen 

 had been opened when received. 



(5) The chorion and some of the villi are fibrous; others 

 are mucoid and are attached to the inflamed decidua by 

 means of an extensive blood-clot. There is very little 

 fibrinoid substance or trophoblast, but numerous buds of 

 syncytium intermingled with fibrin and many leucocytes. 

 No amnion could be found. 



(6) Marked infiltration and some hydatiform degener- 

 ation. 



No. 702. 



(1) George H. Hocking, Govans, Maryland. 



(2) A 50X20X20 mm. 



(3) Patient is 42 years old and has two children, the 

 younger aged 6 years. Last menstrual period April 16, 

 but on May 20 there was a slight flow of a dark color. 

 On June 3 the mass was expelled without pain or special 

 discomfort. 



(4) The specimen apparently is solid, measuring SOX 

 20X20 mm. It appeared to be composed of numerous 

 clots and had a smooth external surface. Within it was 

 composed mostly of blood and contained a cavity a centi- 

 meter in diameter, filled with reticular magma. In the 

 center of the magma there was an opaque body, 5 mm. in 

 diameter. 



(5) Sections of the specimen do not show any remnants 

 of an embryo or amnion. The chorionic wall is loosened 

 up and destroyed almost completely for a considerable 

 extent. Large quantities of blood are present between the 

 villi. The entire mass is encircled by an intensely in- 

 flammatory necrotic decidua. The non-vascular villi 

 mostly have undergone mucoid degeneration. The inter- 

 yillous spaces are filled with blood and the trophoblast 

 is necrotic. 



(6) Intense infiltration. 



No. 7236 s . 



(1) L. L. Iseman, Chicago, Illinois. 



(2) A 45X25X25 mm. 



(4) Chorionic wall smooth and thin. 



(5) Sections show it to be composed of necrotic mem- 

 brane and a few necrotic villi. The intervillous spaces 

 are engorged with fresh blood. A necrotic, somewhat in- 

 filtrated decidua encircles the chorion, marked off on the 

 inner side by a layer of fibrinoid substance. No tropho- 

 blast. 



(6) Marked lysis of the decidua and slight infiltration. 



No. 736. 



(1) K. B. Varden, Mercersburg, Pennsylvania. 



(2) A 35X16X16 mm. 



(4) Almond-shaped hard mass measuring 35X16X16 

 mm., and entirely filled with hard, coagulated blood. 

 Towards one end there is a cavity 7X4 mm., lined with 

 smooth membrane. 



(5) This cavity is in a collapsed ovum filled with reticu- 

 lar magma and some blood-vessels in the chorion which 



