120 



STUDIES ON PATHOLOGIC OVA. 



lacking. The eye-vesicle can still be made out and the 

 heart can be outlined. Within the body the spinal cord 

 is irregular and contains a lumen which at points appears 

 to communicate with the pharynx. In other portions of 

 the body the cord is absent. The amnion is attached 

 along the entire length of the body. 



No. 498. 



(1) Guy L. Hunner, Baltimore, Maryland. 



(2) A 40X40X40 mm. 



(3) "Patient aged 30 years, with one child 6 years old 

 and no miscarriages. Physician first saw patient June 10, 

 1909, because of backache, dragging feeling, and slight 

 piles. Menstruates every 5 or 6 weeks, stops 1 day, then 

 a scant flow for 3 or 4 days. I found uterus far back in 

 pelvis and containing a small round fibroid fundus. Cor- 

 rection of position and introduction of pessary. January 

 28 period began with terrible bearing down in lower abdo- 

 men. No flow until February 1. A large clot and free 

 flow on February 2; no more until Monday, February 6. 

 Another terrible cramp and some blood. This period was 

 3 weeks late; is often 1 week over time. Pessary removed 

 about 1 week before. Examination: Uterus far back in 

 pelvis, easily brought forward. Size of 2 months' preg- 

 nancy, but rather too firm feeling. Cervix soft, enlarged. 

 Breasts enlarged, firm colostrum. Diagnosis: Probable 

 pregnancy; fibroid. Patient was advised to keep quiet 

 and report in 1 month. On March 1, after pains during 

 the night, passed the specimen." 



(4) The chorion is partly covered with villi and entirely 

 encircled by the decidua. In the portion of the chorion 

 which is devoid of villi there is a large space between the 

 chorionic membrane and decidua. The interior of the 

 ovum is lined by a smooth membrane the amnion and 

 between it and the chorion there is a gelatinous mass of 

 reticular magma about 1 mm. in thickness and distributed 

 equally around the whole circumference of the ovum. No 

 remnant of the embryo could be found. 



(5) Sections through the wall include the amnion, the 

 chorion, a thick layer of fibrinoid substance with cells, and 

 a layer of decidua. The latter is infiltrated with leuco- 

 cytes. The chorion is thin and the villi are atrophic and 

 well separated, having undergone fibrous and hyahne 

 degeneration. There is considerable trophoblast, some 

 large masses of which are degenerate. There are also 

 small nodules of necrotic trophoblast scattered between 

 the villi and fusing with the chorionic epithelium. There 

 is a great deal of blood in the magma which lies between 

 the amnion and chorion, into which numerous strands 

 of mesoderm cells from the chorion radiate. Between the 

 blood and the chorionic membrane there are some Hof- 

 bauer cells, which also are found within the mesenchyme 

 of the chorion and its villi, which also contain some blood- 

 vessels. 



(6) Mild infiltration; early hydatiform degeneration. 



No. 505 



(1) Thomas S. Cullen, Baltimore, Maryland. 



(2) A 70X35X25 mm. 



(4) The mole has a thick wall and contains a smooth 

 cavity measuring 50X20X10 mm. A small nodule 

 was found attached to the lining membrane, but serial 

 sections show that it contains no embryonic remnant. 



(5) Sections of the chorion and amnion show that both 

 are fibrous. The wall is degenerate, many of the villi hav- 

 ing undergone fibrous degeneration, while a few are mucoid. 

 Others show "granular hyperplasia." Some of the villi 

 contain large central cavities. There is considerable fresh 

 blood between the villi which seems to nourish them. The 

 main wall of the chorion is necrotic in places and has been 

 invaded by leucocytes. There are many islands composed 

 of degenerate trophoblast and areas of villi are matted and 

 fused. 



(6) Severe endometritis. 



No. 518. 



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



(2) A SOX 45X40 mm. 



(3) The specimen came from a patient whose period was 

 two weeks overdue. 



(4) The ovum is covered with well-formed yilli which 

 appear to be normal in shape as well as in their mode of 

 branching. 



(5) Sections show masses of trophoblast between the 

 villi, many of which have undergone necrosis. The villi 

 and chorionic wall contain numerous large blood-vessels, 

 showing that at one time a normal embryo must have been 

 present. The cord-like structure seen within is 10 mm. 

 long and 1.5 mm. in diameter. This proves to be the 

 umbilical cord and contains a very large cavity, the tissue 

 of which is more or less dissociated. Scattered through 

 this tissue are a few very pronounced groupings of cells 

 which appear much like syncytium or trophoblast. It is 

 remarkable that this large, cord-like structure contains no 

 blood-vessels. 



(6) Hydatiform degeneration. Decidua absent. 



No. 531. 



(1) C. A. Rhodes, Atlanta, Georgia. 



(2) A 19X19X19 mm. 



(3) The specimen is from a multipara. This was her 

 sixth pregnancy, menses having been 17 days overdue. 



(4) One side of the spherical specimen is covered with a 

 crescent-shaped group of villi, and the rest of it is nearly 

 naked, only a few very small villi being present. Within 

 the chorionic vesicle there is a delicate reticular magma 

 and a detached umbilical vesicle suspended in the center 

 of the crelom. There are also very opaque particles 

 present. 



(5) The sections stained by the Mallory method show 

 beautifully the continuity of reticular magma with the 

 mesenchyme. The chorionic villi are covered with a 

 relatively small amount of trophoblast and contain rem- 

 nants of many blood-vessels. The walls of the free um- 

 bilical vesicle are dissociated, and numerous strands of 

 cells radiate from it into the adjacent magma. In addition 

 to this, another vesicle was found closely attached to and 

 directly continuous with the chorionic wall. This probably 

 is a rudimentary amnion. 



No. 533. 



(1) J. L. Fewsmith, Newark, New Jersey. 



(2) A 35X30X30 mm. 



(3) The patient missed one period which should have 

 occurred on May 17. She aborted June 15. 



(4) The ovum is pear-shaped and well covered with 

 villi and some decidua. In general its external surface is 

 irregular and ragged. The ccelom is well filled with a dense 

 reticular magma containing two irregular bodies, one 

 6 mm., the other 5 mm. long. The latter lies in the am- 

 nion (?), the former in the middle of the exocoelom. 



(5) Sections were cut of these bodies and of the chorion, 

 but they did not stain well. The chorionic wall is macer- 

 ated and nonvascular and some of the delicate villi aris- 

 ing from it are macerated and coalesce; others are 

 extremely degenerate. The trophoblast is scanty. The 

 round body, which appeared to be abnormal, was cut 

 into sections and found to be inclosed by a tough membrane 

 which does not stain. Its interior is filled with a granular 

 mass uniform throughout. Apparently we have here a 

 portion of the amnion with remnants of the yolk-sac, but 

 without any remnants of the embryo. The decidua is 

 very degenerate. 



(6) Very early hydatiform degeneration. 



No. 555. 



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



(2) A 30X20X20 mm. 



(3) Specimen said to be of a few weeks' gestation. 



