CYLINDRICAL CYEMATA. 



137 



thick coat of villi. Examination under the binocular 

 shows the presence of undoubted hydatiform degeneration, 

 and a small nodule within, which suggests an embryonic 

 remnant. 



(5) Higher magnification shows this to be a specimen 

 of hydatiform degeneration, with non-vascular, glassy, 

 fcnestrated, and degenerate stroma, with only moderate 

 epithelial proliferation. A few small vessels still are found 

 in the chorionic membrane. Some villi contain consider- 

 able numbers of Hofbauer cells. The decidua was not 

 included and no embryonic or amniotic remnants were seen 

 in the sections examined. The trophoblastic nodules are 

 degenerate. 



(6) Hydatiform degeneration. 



GROUP 5. 



No. 110. 



(1) J. P. West, Bellaire, Ohio. 



(2) A 46X30X30 mm.; B 8 mm. CR. 



(3) "The last menstrual period began September 22 and 

 lasted 5 days. On December 8 there was a slight flow 

 which continued until the 13th, when the abortion took 

 place." 



(4) The shape of the ovum is oblong and its walls are 

 fleshy, the villi having all disappeared. Within there is 

 a clear fluid, with a granular deposit covering the embryo. 

 The embryo is greatly macerated and is but slightly at- 

 tached to the chorion. At the point of attachment there 

 is an elevated mound of necrotic tissue, to which the 

 embryo is stuck. There is no distinct cord and the am- 

 nion is absent. Evidently both chorion and embryo have 

 been dead for a long time. 



(5) The chorion is atrophic and the decidua is infiltrated 

 with leucocytes. The amnion, umbilical vesicle, and the 

 attachment of the umbilical cord to the chorion are com- 

 pletely destroyed. The embryo is atrophic, the face not 

 being developed at all. The central nervous system is 

 swollen; the outlines of the viscefa and body-cavity are 

 obliterated and filled with migrating cells. The liver is 

 small; the heart and blood-vessels greatly distended. 



(6) Mild infiltration and probably hydatiform degener- 

 ation. 



No. 115. 



(1) A. S. Atkinson, Baltimore, Maryland. 



(2) A 30X27X22 mm.; B3 mm. 



(3) The abortion took place two months after the begin- 

 ning of the last period. During the second month of preg- 

 nancy there was continuous bleeding. 



(4) The ovum was brought to the laboratory fresh, 

 immediately after the abortion. It was opened at once 

 in formalin and found filled with a gelatinous, transparent 

 mass, which became fibrous after the formalin had acted 

 upon it. Later on alcohol made it opaque. The chorion 

 is practically free of villi and looks necrotic. The embryo 

 is well in the middle of the ovum and apparently is separ- 

 ated from the chorion. The head, as well as the tail, is 

 atrophic. 



(5) Sections show that the villi of the chorion are also 

 atrophic, with but a small quantity of syncytium attached 

 to them. Both chorionic membrane and villi are wholly 

 non-vascular, and the stroma of many of the latter is clear. 

 Except for slight maceration, the amnion looks normal. 

 It is detached from the chorion and the embryo is prac- 

 tically sessile upon it. The entire chorion is surrounded 

 by a mass of decidua filled with leucocytes. The magma 

 of the ccelom is very dense and has within it but few 

 migrating cells. Within the greatly distended amnion lies 

 the embryo, looking much like a chick of the third day. 

 The peritoneal cavity communicates freely with the exo- 

 eceloin, in which hangs an atrophic umbilical vesicle. The 

 lumen of this is filled completely with entodermal cells, 

 its blood-spaces greatly distended but nearly empty, and 

 its solid stem ends abruptly after it enters the body' of the 

 embryo. There is no trace of either alimentary canal or 



liver. Rudimentary Wolffian bodies and ducts are 

 present. The central nervous system is solid. The heart 

 and large veins are simple in form and greatly distended 

 with blood. 



(6) Marked infiltration of the decidua; hydatiform de- 

 generation of the chorion. 



No. 141. 



(1) J. P. West, Bellaire, Ohio. 



(2) A 40X30X30 mm.; B 8 mm. 



(3) Specimen obtained from same patient as No. 110 

 described above. Woman has had 9 children and has 

 always been healthy until about 10 years ago. From that 

 time her health gradually became worse; now she is 

 extremely neurasthenic. Stomach is dilated, digestion 

 poor, bladder irritable, and urine scanty. Uterus large, 

 thick, and retroverted; leucorrhea. The uterus is about 

 three times its normal size and has a number of cysts in 

 the cervix. There were several earlier abortions; the one 

 before this took place December 13, 1897 (No. 110). The 

 last period began October 27, 1898, and the abortion fol- 

 lowed on January 13. 



(4) The chorion is fleshy, like No. 110, with but few villi, 

 and within the ccelom there is a great quantity of magma 

 re'ticule' and a dissociated embryo about 4 weeks old. 



(5) The sections show that the chorion and villi are 

 matted together and contain but few blood-vessels. The 

 trophoblast is very extensive, and where it is in large 

 masses the most central cells are necrotic. The mesoderm 

 of the chorion is fibrous and hypertropbic. There is a 

 considerable quantity of mucus or fibrin, rich in leuco- 

 cytes, between the villi. This condition may have been 

 more extensive elsewhere, as only the chorion in the neigh- 

 borhood of the embryo was examined. The great quan- 

 tity of magma reticule 1 within the ccelom has numerous 

 migrating cells scattered through it. The amnion is 

 partly in contact with the chorion, and at the points of 

 contact is normal in appearance, but in other places it is 

 cystic. Where it is separated from the chorion by the 

 excessive quantity of magma, the walls of the amnion are 

 greatly hypertrophied. The umbilical vesicle is collapsed 

 and its walls have undergone complete hyaline degeneration. 

 The central nervous system of the embryo is greatly di- 

 lated and dissociated. The body-cavity can barely be 

 outlined. The large blood-vessels are faintly marked by 

 the blood within them. The rest of the tissues form one 

 homogeneous mass of tissue cells infiltrated with round 

 cells, within which can still be recognized cartilages and 

 nerve bundles. The boundaries of the heart and liver are 

 wholly obliterated, due to their dissociation. 



(6) Probably some hydatiform degeneration. Decidua 

 absent. 



No. 142. 



(1) G. N J. Sommcr, Trenton, New Jersey. 



(2) A 50X40X30 mm.; B 15mm. 



(3) "Last period September 28. On January 3 there 

 were marked uterine pains; free hemorrhage February 1; 

 abortion February 4." 



(4) Chorion fleshy with some villi. Subchorial herna- 

 tomata are present. Within is a macerated embryo about 

 5 weeks old, embedded in a mass of fibrin-like magma. 

 Between the magma and walls of the chorion is a large 

 space filled with clear fluid. 



(5) Serial sections of the embryo and chorion show most 

 remarkable changes. The chorion and amnion are greatly 

 thickened and very fibrous, and appear in every respect 

 like the membranes in fleshy moles. The very degenerate, 

 fibrous villi are matted together by necrotic as well as 

 living cells. The fibrinous mass within the amnion is in 

 all probability blood which has entered from the exterior. 

 It has all the appearance of blood-clots found elsewhere 

 in the body, but in addition it has been invaded by wan- 

 dering cells from the embryo. The ccelom was partly 

 filled with a granular magma, into which project numerous 

 slender villi arising from the walls of the thickened am- 



