NODULAR CYEMATA. 



129 



(3) "Patient 31 years old, married 10 years, but has 

 never been pregnant before. Last period November 10, 

 and on December 24, after a hard day's work, she had a 

 sudden gush of blood, and since then has been wasting at 

 times until abortion, February 4." 



(4) Chorion is partly covered with long villi, which are 

 fibrous in some places and edematous in others. The 

 amnion within, which occupies the entire cavity of the 

 chorionic vesicle, is partly filled with granular magma 

 through which can be seen the outlines of an atrophic 

 embryo. 



(5) Sections show that the brain and most of the spinal 

 cord have been destroyed. In the middle of the embryo 

 the aorta and ccelom are sharply defined, but elsewhere 

 the tissues are entirely obscured by numerous round cells. 

 The epidermis is intact. The decidua is decidedly infil- 

 trated and also contains a few large local accumulations 

 of leucocytes. 



(6) Marked infiltration. 



No. 304. 



(1) G. L. Hunner, Baltimore, Maryland. (Brodel col- 

 lection.) 



(2) A 15X7X6 mm.; B 4 mm. 



(4) The specimen is surrounded by much decidua, which 

 is infiltrated with leucocytes. 



(5) The strorna of the villi and chorion are decidedly 

 macerated and degenerate, with remnants of blood-vessels 

 within them, and are covered with an active trophoblast. 

 The decidua is encircled with pus and fragments of uterine 

 mucous membrane. The ovum is partly filled with magma 

 rticul6, in which is embedded an umbilical vesicle 2 

 mm. in diameter, attached to the remnants of an embryo 

 without myotomes. The neural canal is present and the 

 body runs out into a stem containing a tube (allantois) 

 which does not attach itself to the chorion. Remnants 

 of an amnion are present. All in all, the embryo appears 

 to be much like Graf Spee's specimen, which is 1.54 mm. 

 long. No trace of a heart could be found, but there are 

 numerous blood-islands in the umbilical vesicle and rem- 

 nants of blood-vessels in the chorion. 



(6) Severe infiltration. 



No. 309. 



(1) H. S. Steensland, Syracuse, New York. 

 .(2) A 23X20X20 mm.; B 4 mm. 



(4) This specimen, apparently normal, had been in 

 alcohol for three or four years when received, but was well 

 preserved. The amnion filled the entire chorion; other- 

 wise the interior also appeared normal. 



(5) Section showed, however, that the dilated amnion 

 was accompanied by marked changes in the embryo. All 

 of the tissues are infiltrated with round cells, obliterating, 

 to a great extent, both the tissues and the organs. The 

 central nervous system is markedly dilated and filled with 

 round cells. In front the walls are broken and the round 

 cells extend into the tissues of the front of the head. 

 The eye and ear vesicles also are dilated and filled with 

 round cells. No trace of a lens is seen, and the ear-vesicle 

 has two sprouts on its ventral side. The whole epidermis 

 is present. 



The specimen is markedly dissociated; only the central 

 nervous system, the head, and perhaps some hepatic 

 remnants are present. The embryo apparently was 

 sessile upon the amnion. All of the chorionic membrane 

 that was mounted contained a network of vessels, and 

 some of the villi also are splendidly vascularized. A 

 continuous network of vessels containing some blood-cells 

 is found just near the amniotic surface of the chorion, as 

 shown in figure 82. The epithelium of the chorionic 

 vesicle is full of syncytial buds and some maceration is 

 present, but there also is very evident hydatiform de- 

 generation. 



(6) Decidua absent. Partial hydatiform degeneration. 



No. 377a. 



(1) J. L. Crawford, Cedar Rapids, Iowa. 



(2) A 30X22X14 mm.; B 0.5 mm. long. 



(4) The specimen is well covered with villi, which, to 

 the unaided eye, appear quite normal. The interior of 

 the ovum contains a considerable amount of reticular 

 magma, within which is embedded a large sac (5 mm. in 

 diameter) containing a nodule (0.5 mm. in 'diameter) 

 the embryo. 



(5) Upon microscopic examination the villi : re found 

 to be very fibrous and tipped with trophoblast; at points 

 the latter forms islands with necrotic centers. Sections 

 show that the whole chorion is lined with the amnion 

 except at the point of the inclosed sac, which proves to be 

 the exoccelom. The embtyo is composed of a mass of 

 cells which extend into the mesoderm of the chorion. It 

 may represent the last remnant of the umbilical vesicle 

 No traces of blood-vessels are seen in any portion of the 

 embryonic mass, nor in the mesoderm of the chorion. 



No. 425. 



(1) M. Brodel, Baltimore, Maryland. 



(2) A 15X12X8 mm.; B 1 mm. long. 



(4) The ovum, which is covered with a few villi and 

 some decidua, contains a nodule about 1 mm. in diameter. 



(5) Sections show that it is lined with amnion and con- 

 tains at one point the atrophic nodular remnants of an 

 embryo which is much degenerated. These remnants 

 consist of an open neural groove, on either side of which 

 are two large veins filled with blood. No remnants of 

 any organs are present. Immediately below the neural 

 body is a sharp ring of tissue which may represent the 

 chorda. The amnion is fibrous and adherent throughout 

 to the choripn, which is covered with thin, fibrous de- 

 generate villi. The entire ovum is encapsulated in frag- 

 ments of decidua, which shows very extensive inflamma- 

 tory changes. 



(6) Severe infiltration. 



No. 433. 



(1) D. S. Lamb, Washington, District of Columbia. 



(2) A 23X21X11 mm.; B 4 mm. 



(3) Patient is a multipara, 30 years old, whose men- 

 strual period was one week overdue. 



(4) The ovum is well covered with villi, and its anterior 

 lined by a smooth chorionic membrane, to which is at- 

 tached an irregular body about 1 mm. in diameter and 

 4 mm. long. There is practically no magma present. 



(5) Sections of the chorion show that the villi are practi- 

 cally normal in form and arrangement, the tips being 

 covered with a very liberal amount of trophoblast. How- 

 ever, between the villi there is some fibrinous substance 

 through which are scattered numerous round cells and 

 in which are embedded masses of syncytium. The em- 

 bryonic mass is well preserved, and in it there are several 

 gland-like bodies, probably the allantois. This embryonic 

 tissue appears partly like an embryo and partly like a hy- 

 pertrophic umbilical vesicle. The tip is ragged, indicating 

 that most of the embryo has fallen off. At its point of 

 attachment to the chorion there is a delicate membrane 

 folded upon itself many times, which no doubt represents 

 the collapsed amnion. There are but few blood-vessels 

 within the villi of the chorion. 



(6) Very early hydatiform degneration. Decidua ab- 

 sent. 



No. 433a. 



(1) D. S. Lamb, Washington, District of Columbia. 



(2) A 27X25X15 mm.; B 3 mm. 



(3) Patient has one child, 3 years old. Her regular 

 menstrual period occurred February 1; there was a slight 

 show March 1, lasting a few hours, and on March 15, after 

 running to catch a car, the flow came on and continued 

 until March 21, when the specimen was passed. 



