142 



STUDIES ON PATHOLOGIC OVA. 



However, the solid heart figures in this way in familiar 

 outline on the ventral surface. The embryo is attached 

 along its ventral surface to the amnion, from the anterior 

 limit of the heart backward. Near its caudal end it is 

 bent abruptly to one side. In this region the central nerv- 

 ous system is closed, and its round outline may be seen 

 twice'in the same section, with about 10 somites indicated 

 in the region between. There is a fragment lying on the 

 amnion near the embryo, which may represent the umbil- 

 ical vesicle. It is very small, with practically no vessels. 

 (6) Some early hydatiform degeneration. 



No. 489. 



(1) John A. Luetscher, Baltimore, Maryland. 



(2) A 45X30X25 mm.; B 2mm. 



(4) The ovum is smooth and partly covered with atro- 

 phic villi, over which there is an extensive decidua. The 

 large cavity within measures 30 X 23 mm. and is lined by 

 a smooth membrane which proves to be the amnion. 

 The amniotic cavity is filled with clear fluid, and on one 

 side, closely attached to the chorion, is a cylindrical 

 embryo 2 mm. long, shown in section in figure 28, plate 4. 



(5) Sections through the chorion show it to be covered, 

 as was surmised, with a capsule of decidua and mucous 

 membrane, half of which are infiltrated. Where the mu- 

 cous membrane comes into contact with the villi there is an 

 extensive fibrinoid degeneration. The chorionic mem- 

 brane is closely attached to the amnion, but where they 

 are separated the gap is filled out with a delicate reticular 

 magma. The villi are mostly non-vascular and fibrous, 

 but some seem to have undergone mucoid degeneration. 

 The latter are filled with Hofbauer cells. The intervillous 

 spaces contain blood and large necrotic nodules of tropho- 

 blast. Growing into this substance are numerous processes 

 of active syncytium. In other words, there is a very 

 perfect implantation in this specimen. The chorionic wall 

 contains a number of blood-vessels filled with blood. 

 The chorion in the neighborhood of the attachment of 

 the embryo shows a beautiful implantation. The tropho- 

 blast cells invading the uterine mucous membrane are 

 capped with fibrinoid substance, and the mesenchyme of 

 the villi has undergone extensive fibrous degeneration. 

 The non-vascular umbilical cord is in direct continuity 

 with the amnion, but not with the chorion. The embryo 

 itself has undergone extensive dissociation, but the brain, 

 heart, and liver can be outlined. The round cells of the 

 embryo extend out into the cord, and where they stop 

 there are many Hofbauer cells, making it appear as though 

 the latter arose in the chorion and are invading the embryo. 

 The dissociation of the brain is quite complete, and within 

 the embryo it is somewhat difficult to see a line of demar- 

 cation between the brain and the adjacent mesenchyme. 

 Unfortunately, we have no clinical history of this interest- 

 ing specimen, but its morphological study suggests that 

 the prime difficulty may have lain in the umbilical cord. 



(6) Infiltration, probablj luetic. 



No. 545. 



(1) Richard F. Rand, New Haven, Connecticut. 



(2) A 12X9X9 mm.; B 5mm. 



(3) Patient has one healthy child 14 months old. Last 

 menses September 2 to 7, normal. Coitus, September 15. 

 Menstruation due September 30, but failed to appear, 

 the patient feeling merely "out of sorts." Coitus October 6. 

 October 22, 23, and 24 had a very slight show; October 

 25, cramps and free flow. Embryo in sac found in clots in 

 the cervix. 



(4) The specimen is well preserved and partly covered 

 with villi. It contained a cylindrical embryo suspended 

 upon what at first appeared to be a large umbilical cord. 



(5) Sections show the chorionic wall to be very thin 

 and somewhat fibrous, as are also some of the villi which 

 have undergone mucoid degeneration. On one side they 

 are matted together with mucus and fibrin containing 

 only a few leucocytes. The trophoblast is scanty. The 



embryonic mass is closely encircled by an amnion. The 

 umbilical vesicle reaches from the lower surface of the 

 embryo almost to the chorion. In this region of the latter 

 there are but few villi. The umbilical cord is small and 

 runs around one side of the amnion to reach the chorion 

 at a point somewhat distant from the tuft of villi. The 

 vessels then encircle the chorion and finally reach those 

 villi which seem to have been still active. The embryo 

 has undergone extensive dissociation. The brain is almost 

 completely dissociated and entirely fills the atrophic head. 

 The eye-vesicles can still be made out, and the otic vesicles 

 are sharp and filled with round cells. The lower part of 

 the body has undergone less change than the head end. 

 The eye, spinal cord, and Wolffian bodies are well formed. 

 The heart has undergone the least change. The pleural 

 and pericardial cavities are well formed. The arm and 

 leg buds are just beginning, and in the lower part of the 

 body the myotomes are sharply outlined. 



No. 551. 



(2) A 11X6X6 mm.; B 3mm. 



(3) Last period June 27. Left husband June 7. Abor- 

 tion August 30, after two weeks of ill health. Pelvic in- 

 flammatory disease. The whole ovum was expelled, but 

 opened before fixing. 



(4) Amnion with distorted embryo 3 mm. long. Near 

 the latter is a vesicle 2 mm. long, and on the opposite side 

 of the amnion a granule 1 mm. in diameter. 



(5) The entire mass was cut in serial sections and those 

 containing an embryo were mounted. The cylindrical 

 embrj o shows extensive dissociation with an early stage 

 of destruction of the brain. The brain-tube with its eye- 

 vesicles is distended and the wall partly broken down, the 

 adjacent mesenchymal cells entering it. The spinal canal 

 likewise is distended. The heart has collapsed and the 

 inner walls are partly dissociated. There are several large 

 blood-vessels well distended with blood. The chorda is 

 present. The coelom is sharply defined and passes off into 

 the umbilical cord, which is attached to the amnion. 

 In this region the amnion is thickened and fibrous. The 

 yolk-sac passes through the patent ccelom well into the 

 body of the embryo. In addition to the attachment of 

 the embryo to the amnion, there is a special band of tissue 

 making a second umbilical cord which passes as an isolated 

 band over the region immediately belowthe heart and across 

 the amniotic cavity, to become attached to the amnion at 

 a point somewhat distant from the embryo. It contains a 

 blood-vessel filled with a great quantity of blood-cells, which 

 passes around the amnion behind the embryo and becomes 

 markedly dilated. In this section of the amnion there is 

 a capillary plexus encircled by numerous strands of mesen- 

 chymal tissue, making it appear as though the amnion 

 had been attached to the chorion in this region. Since the 

 chorion was not received it is impossible to establish this 

 point. Within this region there are several larger isolated 

 cavities having the appearance of diverticula of the amni- 

 otic cavity, and it may be that they arose from it. 



No. 587. 



1) F. A. Conradi. Baltimore, Maryland. 



2) A 58X38X29 mm.; B 7mm. 



(4) The chorion is pear-shaped, quite smooth, and with- 

 out villi. The walls are thick and fleshy, and surround a 

 smooth cavity, 32X23X23 mm., filled with clear fluid. 

 This cavity appeared also to contain a layer of reticular 

 magma (?). On one side of it, closely attached to the 

 amnion, was an oblong embryo shaped like a grain of 

 wheat, with a small additional knob at one end, probably 

 a remnant of the head. The length of the embryo is 7 mm. 

 and its greatest diameter is 4.5 mm. 



(5) Sections of the chorion show it to be composed of a 

 thin chorionic wall somewhat separated from the amnion, 

 and between the two there is a delicate retieular magma. 

 The entire mass is encircled by a decidua somewhat infil- 

 trated with leucocytes, which is separated from the 

 chorion by a layer of fibrinoid substance. Between the 



