NODULAR CYEMATA. 



131 



show that its wall is very hemorrhagic, the membrane 

 somewhat fibrous, and the villi mostly neerotic, the rest 

 having undergone what appears to be mucoid degenera- 

 tion The decidua is neerotic and markedly inflamed. 



(5) Sections through some tufts of villi show them to 

 be quite normal in appe.-irunce, with a great deal of tropho- 

 blast between them. The embryo represents a transitional 

 stage between the nodular and cylindrical forms. It is 

 still possible to make out the head end upon microscopical 

 examination. The central nervous system is partly dis- 

 sociated, but throughout the embryo more or less of the 

 tube-wall is still indicated. Some portions of this wall are 

 broken through, and the contents are continuous with the 

 surrounding mesenchyme. In the other portion of the 

 embryo the spinal cord is double, but only one eye-vesicle 

 is present, and that one very atrpphic; the other has 

 entirely degenerated. Lens and otic vesicle are lacking, 

 as is also the heart. The ccelom is fairly well formed, and 

 the ventral region of the embryo is filled by a small but 

 much distended umbilical vesicle. It appears as though 

 the embryo did not develop after it had reached a growth 

 of 1.5 mm., but simply distended the cavities laid down 

 at that time. The aninion is somewhat fibrous, and the 

 umbilical vesicle does not protrude into the exoccelom, but 

 seems to be contained within the body of the embryo. 

 Along the dorsal side of what appears to be the pharynx 

 are two very large blood-vessels filled with blood, which 

 extend for a short distance in the middle of the embryo. 



(6) Marked infiltration. 



No. 528. 



(1) G. Ackerman, Wheeling, West Virginia. 



(2) A 30X20X20 mm.; B 4 mm. 



(4) The chorion is covered partly with normally formed 

 villi and partly with blood-clot.' The coelom contains 

 considerable magma and an amniotic cavity about 13 mm. 

 in diameter. Within the amnion are large flakes of sticky 

 magma encircling a knob-like embryo 4 mm. long, which 

 is attached to the amnion at its point of juncture with the 

 chorion. 



(5) The chorionic wall and its villi are somewhat edema- 

 tous and fibrous. There is very little trophoblast, but a 

 small group of quite irregular tufts of syncytium are seen 

 at the tips of the villi and upon the outside of the chorionic 

 membrane. The embryo was cut into sagittal sections and 

 shows extensive dissociation. The only structure which 

 can be made out with certainty is the central nervous 

 system, which reaches through the whole length of the 

 embryo and has a thin-walled tube filled entirely with 

 round cells. The eye and ear vesicles are absent, but 

 in their places there is the distended brain-tube broken 

 through at points, where the cells within the lumen mix 

 freely with those of the mesenchyme. There are several 

 large blood-vessels within the embryo, and also an indica- 

 tion of the heart. 



(6) Infiltration. 



No. 529. 



(1) M. B. Wesson, New York. 



(2) A 25X15X15 mm.; B 3 mm. long. 



(4) Chorion is partly covered with long, slender villi 

 and the coelom entirely filled with dense, irregular reticu- 

 lar magma. On one side of this were found two small 

 bodies about 2 mm. apart, at first thought to be the 

 umbilical vesicle and the embryo. 



(5) Serial sections were cut of the entire specimen and 

 those containing the embryo were preserved. The chori- 

 onic wall is fibrous, but the villi appear to be more nearly 

 normal, the larger ones containing many sprouting blood- 

 vessels. Attached to the villi is a considerable quantity 

 of syncytium and a small piece of decidua which shows a 

 marked inflammatory reaction. The two bodies seen 

 within the ovum before the sections were cut prove to be 

 two portions of the umbilical vesicle, one of which is 

 free and the other attached to the chorion by means of a 



very pronounced pedicle. The pedicle contains a marked 

 allantois and is rich in blood-vessels, which branch out 

 into the adjacent chorion and villi. The other portion 

 of the umbilical vesicle contains blood-vessels, the blood- 

 islands within the pedicle apparently being separated from 

 the blood-vessels. In addition to these two bodies a 

 third was found within the specimen, which represents the 

 lower part of the embryo, having a sharply defined spinal 

 cord, the chorda, and myotomes. It appears to belong 

 to an embryo about 3 mm. long. 



(6) Marked infiltration; hydatiform degeneration. 



No. 543. 



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

 (2). A 70X30X25 mm. 



(3) Menstrual periods irregular; last one occurred on 

 June 10, but continued for one day only. Abortion 

 August 24. 



(4) Pear-shaped specimen, the stem of which is solid 

 and comprises about one-half of the entire mass. The 

 other half contains the chorion, which is about 25 mm. 

 in diameter and has a cavity 17 mm. in diameter. This 

 is filled with delicate but pronounced reticular magma, 

 in the center of which is a nodular embryo 3 mm. long. 



(5) Sections show the chorionic membrane to be nor- 

 mal in structure, but the villi are fibrous and matted 

 together. They are encircled by a zone of fibrinoid sub- 

 stance, followed by one of decidua which is extensively 

 inflamed. The intervillous spaces are partly filled with 

 maternal blood, in which there is a very great excess of 

 leucocytes. In the fresh blood grow numerous buds of 

 syncytium. What was taken for a nodular embryo 

 seems to be a free umbilical vesicle, lying near a thin 

 atnnion wliich is thrown into numerous small folds. Out- 

 side of this are small remnants of a macerated embryo 

 which is probably not over 2 mm. long. Where the 

 umbilical vesicle and the amnion come together there is a 

 thickening, and therein are several large blood-vessels. 

 We have here a case of marked hydramnios with dis- 

 integration of the embryo, leaving the umbilical vesicle. 



(6) Marked infiltration. 



No. 568. 



(1) Solomon Dodds, Baltimore, Maryland. 



(2) A 48X36X21 mm.; B 0.5 mm. long. 



(3) The patient was 36 years old and had been married 

 6 years. Pregnant four times; two living children. The 

 other pregnancies ended in abortion, from one of which 

 the present specimen came. Last period November 23 

 to 30. There was some bleeding in February and the 

 abortion followed on February 6. 



(4) The ovum is within the decidua, 64X42 mm., 

 and measures 48X36X21 mm. It is completely covered 

 with villi which branch two or three times, and lying 

 free within it is a large, smooth vesicle equally distended, 

 27 mm. long and 17 mm. wide. Within the vesicle, to 

 one side and at its point of attachment to the chorion, 

 there is a small nodule about 0.5 mm. in diameter. This 

 is the remnant of the embryo. The vesicle is undoubtedly 

 the amnion. 



(5) Sections through the chorion show the tissues to 

 be atrophic and hyaline, with a small amount of tropho- 

 blast. The tips of the villi are embedded in a layer of 

 fibrinoid substance which, in turn, is covered with a thin 

 layer of decidua showing inflammatory changes. There 

 is a great deal of reticular magma between the chorion 

 and the amnion. The small, knob-like embryo has an 

 irregular shape, and its main portion is taken up with a 

 large, irregular vesicle filled with cells and lined with 

 several layers of epithelium. No doubt this is a remnant 

 of the central nervous system. There seems also to be 

 present a rudimentary allantois, a body cavity, a few 

 blood-vessels, and a very small, irregular umbilical cord. 



(6) Marked infiltration; some hydatiform degeneration. 



