CHORION WITH AMNION. 



121 



(4) The entire mass measures 45X30X30 mm., and 

 contains a cavity lined with a smooth membrane. This 

 cavity is separated from the chorion by a delicate reticular 

 magma. 



(5) The chorion and villi are fibrous, and many of the 

 latter are embedded in blood and disintegrating. The 

 trophoblast is necrotic, and its nuclei are turning into 

 dust, while the stroma is being invaded by leucocytes. 

 The decidua shows marked general infiltration and some 

 necrosis. 



(6) Marked infiltration. 



No. 556. 



(1) E. J. O'Shaughnessy, New Canaan, Connecticut. 



(2) A 30X30X30 mm. 



(3) Patient has one child, 13 months old. Since birth 

 of child menstruated only once, September 3. Coitus 

 only once, about October 15. Abortion November 28. 

 Patient induced, or tried to induce, abortion by taking 

 12 gr. calomel and 20 gr. quinine about a week before. 



(4) The mole is the usual fleshy variety, with a cavity 

 lined by the amnion. The whole mass is 50X30X30 

 mm., within which is a cavity 30 mm. in diameter. In 

 this hangs a peculiar mass about 20 mm. wide, with a 

 ragged ending, which is probably the cord. It appears as 

 if the ovum had been injured mechanically in some way, 

 and that the embryo had been broken off. 



(5) Sections of the chorionic wall show it to be fibrous, 

 and many of the villi are also undergoing mucoid degenera- 

 tion. The trophoblast is scanty and mostly necrotic, 

 the greater portion containing nuclear dust. Where it 

 comes into contact with the decidua, however, it appears 

 to have been growing with some activity. The fibrinoid 

 substance over the villi is very extensive, and this in turn 

 is partly covered with a degenerate decidua infiltrated with 

 leucocytes. 



(6) Slight infiltration of the decidua. 



No. 564. 



(1) Josiah S. Bowen, Mount Washington, Maryland. 



(2) A 35X25X25 mm. 



(3) The ovum was found protruding from the uterus 

 and was removed with the curette. This is the second 

 time the patient has been curetted. 



(4) The specimen was perfectly smooth, but with spot- 

 ted surface. The larger part of it is solid. In the smaller 

 end there is a cavity measuring 20X10 mm., which is 

 filled entirely with granular magma. Deep down on one 

 side there is a smooth, pear-shaped opaque body, about 

 1.5 mm. in diameter and about 4 mm. long, which appeared 

 to represent the head of the embryo. The solid part of 

 the ovum is composed of an extensive mass of villi. 



(5) Part of the chorion containing the suspicious mass 

 shows no trace of an embryo in serial sections. There are, 

 however, numerous other large cheesy masses within the 

 amnion which probably represent the disintegrating em- 

 bryo, but which are without structure. The chorionic 

 wall and villi are very fibrous, and some villi show granular 

 infiltration. There is considerable fresh blood within the 

 intervillous spaces. The trophoblast is quite abundant 

 and active. The decidua has a great deal of fibrinoid 

 substance upon its chorionic side, and is extensively in- 

 filtrated with leucocytes, showing that the uterus was 

 markedly inflamed. There is a degenerate, thickened 

 amnion. 



(6) Marked infiltration. 



No. 5846. 



(1) Henry Rohlfing, St. Louis, Missouri. 



(2) A 37X31X21 mm. 



(4) About two-thirds of the ovum is coyered with long, 

 irregular villi, branching two or three times, while the 

 remaining part is denuded. Within there is an extensive 

 mass of reticular magma. By varying the illumination, 

 the faint outline of a sac with a transparent body within 

 was suspected. 



(5) Sections show the chorion and villi to be somewhat 

 macerated and hyaline. There is no trophoblast, but a 

 few buds of syncytium. The ccelom is filled with a dense 

 reticular and granular magma, and its serial sections 

 reveal the stub end of the umbilical cord about 2 mm. 

 in diameter, around the edges of which are attached large 

 folds of collapsed amnion. The outline of several blood- 

 vessels within the cord can be followed, and within the 

 amniotic cavity there is a debris of cells, showing that the 

 embryo has disintegrated. 



(6) Decidua not included. 



No. 605. 



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



(2) A 45X50X25 mm. 



(3) The specimen was aborted after uninterrupted men- 

 struation; an unsuspected case of pregnancy, believed 

 to be illegitimate. 



(4) The ovum is covered by a uniform layer of villi 

 which branch two or three times, and on one side is a 

 small patch of decidua. The interior is partly filled with 

 coarse strands of reticular magma, to which are attached 

 numerous granules. On one side of the specimen is an 

 umbilical cord surrounded by ragged amnion. The tip of 

 the cord has what looks like a piece of intestine and stom- 

 ach attached to it. The larger granules attached to the 

 reticular magma would seem to be remnants of the embryo, 

 parts of which appear to be normal. 



(5) Sections include part of the amnion and the attach- 

 ment of the cord to the chorion. The amnion is disinte- 

 grating, macerated, and the tissues of the chorion are dis- 

 sociated and also macerated. The chorionic membrane 

 is somewhat hyaline and contains a few blood-vessles, 

 around which there is an invasion of round cells. Other- 

 wise it appears to be normal. The villi are hyaline and 

 practically non-vascular, with degenerate stroma and 

 epithelium. Between them there is a great quantity of 

 necrotic trophoblast. A fibrous, degenerate yolk-sac and 

 a stump of the cord with the degenerate vessels are the 

 only embryonic remnants found. 



(6) Early hydatiform degeneration. Decidua absent. 



No. 611. 



(1) V. N. Leonard, Baltimore, Maryland. 



(2) A 45X24X20 mm. 



(4) The specimen is smooth, has thick walls, and con- 

 tains a well-defined cavity 25X8 mm. There is consid- 

 erable reticular magma within this cavity, and a loose 

 membrane, probably the amnion, is attached to one side 

 of the chorion. Adherent to this membrane is an irregular 

 fold, 5 mm. long, wlu'ch attaches it to the chorion. On 

 the opposite side a small nodule of irregular shape is 

 closely attached to the walls of the specimen. 



(5) Sections show that the thick-walled mole consists 

 of a thin chorion encircled by blood and a very hemor- 

 rhagic decidua, the deeper portions of which show marked 

 general infiltration. The amnion was not included in the 

 sections, but can be seen as a crumpled membrane within 

 the chorion among the blocks of tissue which were not 

 cut. The chorionic membrane is hyaline, and through it 

 are scattered numerous nuclei. It is surrounded by villi 

 of the same structure, radiating through much necrotic 

 trophoblast, with quite a good deal of fresh blood between 

 them. The trophoblast shows a little activity where it 

 comes in contact with the fresh blood. The fibrinoid 

 shows a curious stratification in some areas not seen in 

 other specimens. The very degenerate villi are encircled 

 by a very thick layer of fibrinoid substance, following 

 which is the very hemorrhagic and infiltrated decidua. 



(6) Marked infiltration. 



No. 645. 



(1) C. A. Bentz, Buffalo, New York. 



(2) Ovum 30X30X20 mm. 



(4) One end of the ovum is covered with ragged villi. 

 The chorion is lined with a delicate amnion, and at one 



