CHORION WITHOUT AMNION OR CYEMA. 



117 



No. 968o. 



(1) D. P. Quezon, Manila, Philippine Islands. 



(2) A 60X45X25 mm. 



(3) Specimen from young Filipino woman. 



(4) The chorionic sac, which measures 60X40X25 

 mm., had been cut into irregular pieces, and was found 

 intermingled with blood clot. In addition, about 50 c.c. of 

 free masses of blood were separated from the chorion. 



(5) The chorionic membrane appears normal, but the 

 villi are almost wholly non-vascular and many show 

 mucoid degeneration. The trophoblast is active and the 

 tips of the villi are well implanted in the large piece of 

 decidua. Where the two come into contact the fib- 

 rinoid substance is very evident. The chorionic vesicle 

 contains no blood-vessels, but a great many Hofbauer 

 cells. In the decidual fragments which have undergone 

 fibrinoid changes there is considerable infiltration. 



(6) Slight infiltration; hydatiform degeneration. 



No. 970. 



(1) R. W. Hammack, Manila, Philippine Islands. 



(2) Chorion 3X5 mm. with ccelom. In situ. 



(3) The specimen came from a Filipino girl, aged 16 

 years, who had taken hydrochloric acid with suicidal 

 intent four days before her death. At the autopsy acute 

 broncho-pneumonia, congestion of the kidneys, and hyper- 

 plasia of the endometrium were diagnosed, which led the 

 physicians to suspect early pregnancy. 



(4) The description of the uterus at the time of autopsy 

 is as follows: "Uterus large and soft and the serosa red. 

 The folds of the vaginal mucosa are present. The entire 

 vagina is purplish red; cervix slightly enlarged and soft. 

 In the fundus the mucosa is red, greatly thickened, soft 

 and irregular. On the posterior wall beneath the mucosa 

 is a firm, slightly movable nodule, a little less than 10 

 mm. in diameter. This was not opened. The cavity of 

 the uterus is enlarged; the musculature is very slightly 

 thickened and pink. The Fallopian tubes are of normal 

 size, moderately hyperemic. The right ovary contains a 

 large corpus luteum. The left ovary contains a small 

 cyst, 20 mm. in diameter, containing reddish fluid." 



The specimen received at the laboratory consists of 

 vagina and uterus, with both tubes and ovaries, all in 

 one mass. The uterus had been opened, and adherent 

 to the mucosa were masses of blood. The entire uterine 

 mucosa is covered with hemorrhagic nodules measuring 

 in general about 10 mm. in diameter. One of these, 

 located medianly, is larger than the rest, and a narrow 

 block of tissue cut out of this and sectioned was found to 

 contain part of the ovum. All of these sections were 

 saved, and an adjoining block was taken and cut into 

 serial sections in celloidin. Even this did not contain 

 the entire ovum, but careful examination of the next 

 block revealed the remainder. 



(5) The ovum with its villi measures 3X5 mm. The 

 coelom is filled with a homogeneous substance, through 

 which are scattered individual cells and also some strands 

 of tissue from the chorionic membrane. The villi are 

 about 0.5 mm. in length and covered with an active 

 trophoblast. This layer of trophoblast, which ramifies into 

 the adjacent tissue, is intermingled with a great deal of 

 fibrinoid substance and cells, and penetrates the blood- 

 sinuses. There are many buds of syncytium and con- 

 siderable inflammatory reaction in the surrounding tis- 

 sues. Towards the lumen the ovum is covered with de- 

 cidua reflexa, marked off with a layer of fibrinoid substance. 

 The sections examined show no trace of an embryo. On 

 account of the swollen condition of the chorionic mem- 

 brane and the lack of sharpness of the mesenchyme, the 

 specimen does not appear normal. 



Sections through the corpus luteum show it to be lined 

 by a layer of lutein cells about 2 mm. in thickness. There 

 is no central cavity, although the surrounding ovarian 

 tissue is very hyperemic. There is no blood within the 

 central cavity, but regarding this point it is impossible 



to make a definite statement, as both ovaries had been 

 cut into before the specimen reached the laboratory. 

 (6) Slight infiltration; intra-uterine absorption. 



No. 978. 



(1) G. C. McCormick, Sparrows Point, Maryland. 



(2) A 31X16X15 mm. 



(3) Patient aged 39 years; married Otcober 8, 1902. Six 

 pregnancies: five at full term and this abortiot, Novem- 

 ber 13, 1914. Last menstrual period September 19 to 23. 

 Condition of uterus good. No venereal diseases. Fam- 

 ily fertile. 



(4) The specimen consists of a shrunken chorionic sac, 

 partly embedded in blood-clot. The whole mass measures 

 31X16X15 mm. On opening the sac the interior was 

 found to be filled with caseous magma. No embryo could 

 be seen. 



(5) The chorion is composed partly of well-formed villi 

 and partly of a hemorrhagic mass. Sections through the 

 latter show that the blood is penetrated by villi which 

 have undergone fibrous and mucoid degeneration. There 

 are also numerous buds of syncytium in addition to masses 

 of syncytium which have undergone necrosis. The de- 

 cidua is thin, necrotic, and somewhat inflamed. Clumps 

 of erythroblasts lie along the inner surface of the chorionic 

 membrane. Neither the latter nor the villi contain pre- 

 served blood-vessels. 



(6) Marked infiltration; some hydatiform degeneration. 



No. 986. 



(1) W. C. Stick, Hanover, Pennsylvania. 



(2) 45X28X17 mm. 



(3) Patient aged 24 years; married in 1912. Two preg- 

 nancies, both ending in abortion, May 27, 1914 (specimen 

 No. 905), and this one, November 19, 1914. Last men- 

 strual period began about September and lasted for six 

 weeks. No infection of uterus. Venereal diseases nega- 

 tive. Family fertile. 



(4) The specimen consists of an irregularly flattened 

 sac 45X28X17 mm., to which is attached a blood-clot. 

 On one end there is an oval area measuring 27X27X22 

 mm., which is covered with chorionic villi. On opening 

 the chorion it was found to be filled with a pronounced 

 layer of thick, creamy material which could be pulled 

 off only with difficulty. The particles thus detached 

 proved to be very tough. 



(5) Sections of the chorion show that it is covered with 

 villi which have largely undergone mucoid degeneration. 

 They are largely non-vascular and some of them are 

 fibrous. Between the villi are numerous islands of tro- 

 phoblast and also considerable stringy matter in which 

 masses of syncytium are buried. The overlying decidua 

 is marked by a zone of fibrinoid substance and contains 

 numerous small abscesses. 



(6) Severe endometritis with abscess formation; prob- 

 ably very early hydatiform degeneration. 



GROUP 3. 



No. 77. 



(1) A. Horn, Baltimore, Maryland. 



(2) A 70X50X30 mm. 



(4) When the specimen was cut in half there was found 

 within it a spherical cavity 20 mm. in diameter, lined with 

 a smooth, fibrous membrane and filled with a clear fluid 

 which permitted a careful inspection of its interior. On 

 one side of the cavity was a small elevation 1 mm. in 

 diameter and 0.25 mm. high. 



(5) Sections are made of the walls of the specimen 

 through the elevation, which proved to be a fibrous thick- 

 ening of the amnion at its junction with the chorion. 

 There are no blood-vessels in any portion of the chorion 

 which have not undergone mucoid and fibroid degeneration 

 and contain some Hofbauer cells. Except for a new 

 nuclear remnants, the stroma of some villi is completely 







