118 



STUDIES ON PATHOLOGIC OVA. 



degenerated. Between the villi there is a great quantity 

 of trophoblast, fresh blood, and fragmented leucocytes. 

 When fresh blood and syncytium come in contact there 

 are many fragmented leucocytes. Slight infiltration of 

 the decidua is present. The latter is also fibrous. 

 (6) Mild infiltration; hydatiform degeneration. 



No. 130. 



(1) P. G. de Saussure, Charleston, South Carolina. 



(2) Ovum 15X10X6 mm., with vesicle 4X3X1.5 mm. 



(3) "The specimen was passed by the patient while 

 urinating, 14 days after the beginning of the last menstrual 

 period. She had no idea that she was pregnant, and 

 thought that the specimen was a piece of mucous mem- 

 brane from the bladder. It was hardened entirely in 50 

 per cent alcohol." 



(4) When received the specimen was only half covered 

 with villi, the other half haying apparently been stripped 

 off. There was also a tear in the chorion through which 

 a vesicle was protruding. Upon lifting the ovum this 

 vesicle fell out. The ovum was then carefully cut open 

 and was found to contain a considerable quantity of 

 magma reticule 1 . Within this there was a long pedicle, 

 measuring 7X2 mm. There was also a space in the 

 magma large enough to hold the vesicle which had escaped. 

 Both ovum and vesicle were cut into serial sections. 



(5) The serial sections of the ovum show that the am- 

 nion is still unbroken. Its greatest measurements are 

 10X4 mm., into which extends the umbilical cord. At 

 the end of the cord there is a mass of tissue, mostly broken 

 down, the remains of the embryo. This mass is ragged, 

 without any form corresponding to an embryo, and had 

 the amnion been torn no doubt it would have fallen out. 

 The blood-vessels of the cord are gorged with nucleated 

 blood-cells, but they do not extend into the embryo. 

 The chorion is normal in appearance. The umbilical 

 vesicle is pear-shaped and completely closed. At no place 

 is there a break to show its attachment to the cord. Al- 

 though considerably macerated, the sections show the 

 characteristic structure of an umbilical vesicle. 



No. 143. 



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



(2) Large double sac, 15X10 mm., attached to the 

 wall of the chorion. 



(4) The chorion appears normal. The double, cyst- 

 like body has thin walls and is filled with a clear fluid. 

 The specimen has been in strong alcohol for nearly 20 

 years. 



(5) Serial sections show a very degenerate chorion to 

 which the double vesicle is attached. The structure of 

 the walls of the two sacs is identical with that of the meso- 

 derm of the chorion with all of the epithelial cells fallen 

 off. The two sacs do not communicate; the larger has 

 smooth walls; the smaller has numerous small vesicles, 

 about 1 mm. in diameter, opening into it, and the cluster 

 of vesicles are directly blended with the mesoderm of the 

 chorion. The specimen undoubtedly belongs to the ve- 

 sicular forms, peculiar only on account of its size. 



No. 159. 



(1) W. W. Golden, Elkins, West Virginia. 



(2) Fragments of chorion with amnion. 



(3) "From a woman in good health who had aborted 

 about a year before during the third month. During the 

 second month of the pregnancy from which the present 

 specimen was obtained there was a slight flow of blood 

 without any pain. It continued for 2 days; 10 days later 

 it recurred and continued for 24 hours. Three days later 

 it recurred again, became profuse, and the abortion fol- 

 lowed. The supposed duration of pregnancy is 10 weeks. 

 No indication whatever of endometritis. Both father and 

 mother are perfectly healthy and are very anxious to have 

 children." 



(4) The specimen consists of portions of the mucous 

 membrane of the uterus, large portions of the chorion, 

 the amnion, but no embryo. 



(5) The decidua is markedly infiltrated, and leucocytes 

 have invaded portions of the chorion. The syncytium 

 is very active, and at numerous points the syncytium and 

 leucocytes have invaded the mesoderm of the chorion. 

 Some villi show a g9od deal of "granular hyperplasia" 

 and are being fused into a solid mass. The membranes 

 are greatly thickened and composed of a dense connective 

 tissue. The vessels are largely obliterated. The amnion 

 is curled up and thickened, and its walls have undergone 

 hyaline degeneration. The amniotic epithelium has pro- 

 liferated, forming islands at many points. 



(6) Mild infiltration. 



No. 180. 



(1) C. W. Dodge, Rochester, New York. 



(2) Ovum 20X15X10 mm.; vesicle 2 mm. 



(3) The woman was a patient of Dr. Edward Mott 

 Moore, of Rochester. On March 28 her right ovary was 

 removed. She left the hospital on April 15 and coitus 

 occurred on May 13. On June 19 menstruatipn appeared 

 and this ovum was expelled. 



(5) Sections of the chorion show that its mesoderm is 

 of normal thickness, but that it is fibrous and rich in 

 nuclei. Throughout the main wall of the chorion, but 

 not in the villi, there are numerous blood-vessels filled 

 with blood, showing that at one time an embryo may have 

 existed. The villi are normal in form, with a very exten- 

 sive syncytial layer of cells over them. At points this 

 forms large islands which can easily be seen with the 

 naked eye. . Within, immediately over the vesicle, an 

 island of this kind, a millimeter in diameter, arises from 

 the main wall of the chorion and sends processes up 

 between the villi. The mesoderm just below this island 

 is thinner than the rest, making it appear as if the violent 

 growth of the syncytium took everything before it, but 

 that in the attempt to produce new villi the fibrous meso- 

 derm of the chorion would not follow. At many points 

 between the villi there is a slimy mass of albumen, well 

 infiltrated with leucocytes and numerous small islands of 

 syncytium, some of which can be followed back to their 

 origin from the villi. The vesicle is composed of but one 

 layer of cells, that of the mesoderm with blood-islands 

 embedded within it. No trace of an entoderm can be 

 made out, although the lumen of the vesicle extends into 

 a pedicle which, as a single strand of cells, attaches itself 

 to the chorion. 



No. 257. 



(1) A. W. Lankford, Baltimore, Maryland. 



(2) Ovum 55X40X40 mm., containing a pedicle 14X2 

 mm., to which is attached a nodule 4X0.5 mm. 



(4) A large portion of the chorion is covered with well- 

 formed and apparently normal villi. One portion is 

 hemorrhagic and another fibrous, appearing as though it 

 had protruded through the os. 



(5) Sections through this portion show that the villi are 

 atrophic and have undergone fibrous degeneration. The 

 chorion is thickened and the decidua infiltrated with 

 leucocytes. The inside of the thickened chorion is lined 

 with epithelial cells which are continuous with those over 

 the cord; it appears as if the amnion had become com- 

 pletely blended with the chorion. The cord is also fibrous 

 with some spots which have undergone mucoid degener- 

 ation. It contains three large blood-vessels a vein and 

 two arteries which show perivascular infiltration and 

 fibrosis. The body at the end of the cord is simply its 

 continuation, with the umbilical vein running through its 

 entire length. 



(6) Marked endometritis. 



No. 279. 



(1) Dr. Kemp, Baltimore, Maryland. 



(2) A 100X60X60 mm. 



