146 



STUDIES ON PATHOLOGIC OVA. 



December 1912, respectively, and this abortion, August 

 15, 1914. Last menstrual period June 24 to 27. Condition 

 of uterus normal. No venereal diseases. 



(4) The specimen consists of a small oblong abortion 

 mass, measuring 30 X 11 X7 mm. On opening, it is found 

 to consist chiefly of fibrous chorioru'c tissue so infil- 

 trated with blood as to be very fragile. Within is a pear- 

 shaped chorionic cavity 11 mm. in length by 5 mm. 

 greatest width, which contains a clear coagulated substance. 

 This substance broke easily and could be lifted out, and 

 proved to be a very interesting pathological embryo, 

 4 mm. long, with a transparent yolk-sac 3.3 mm. in 

 diameter. 



(5) The chorion is fibrous and covered with small de- 

 generate villi, matted together and surrounded by a de- 

 generate and inflamed decidua. Most of the trophoblast 

 is necrotic, and there is considerable nuclear dust, as well 

 as an invasion of leucocytes. The embryo is mostly disso- 

 ciated and is attached to the chorion at the lower end. 

 In its middle there is an accumulation of cells which appear 

 to be the remnants of the heart, and towards the upper 

 end the nervous system can be outlined. No eyes, ear- 

 vesicles, or extremities are present. The amnion is almost 

 completely destroyed, while the embryo is embedded in a 

 mass of granular magma which is being invaded by cells 

 from the embryo at a point where the two come in contact. 



(6) Mild infiltration, probably luetic. 



No. 1004. 



(1) E. Plass, Baltimore, Maryland. 



(2) A 256X52X68 mm. 



(3) The patient was the mother of 9 children and had 

 one abortion four years ago. Last menstrual period oc- 

 curred on October 1 to 5, and the abortion, which was 

 spontaneous, on December 4. 



(4) The decidual cast, which was open at one end, con- 

 tains a chorionic cavity 20 mm. in diameter. The latter 

 contains nothing but a portion of an umbilical cord 18 

 mm. long and 2 mm. in diameter. Since the amniotic 

 fluid had been drained off, remnants of the embryo may, 

 however, have escaped through the opening. 



(5) The membranes are fused and have undergone hyaline 

 degeneration. The villi are fibrous and degenerate. The 

 decidua also is degenerate and infiltrated slightly, with local 

 intensification. Portions of it have undergone fibrosis. 

 Except in a few places, only moderate syncytial prolifera- 

 tion is present. No remnants of the embryo were seen. 



(6) Decidua slightly infiltrated. 



No. 1022a. 



(1) Ernest C. Lehnert, Baltimore, Maryland. 



(2) A 62X33X24 mm. 



(3) The last menstruation occurred on January 2. 

 Hemorrhage began March 6 and abortion occurred 

 March 25. Abortion was said to probably have been me- 

 chanical. 



(4) The chorionic vesicle contained a blighted embryo 

 3 mm. in diameter. Examination of the former under the 

 binocular microscope shows the presence of splendid par- 

 tial hydatiform degeneration. 



(5) Histologic examination confirms the presence of 

 hydatiform degeneration, although the histologic speci- 

 men was not taken from the portion which showed the 

 hydatiform degeneration present in most pronounced 

 form. The stroma of the villi is degenerate and fenes- 

 trated and contains numerous atypical Hofbauer cells. 

 The epithelium is not increased and syncytial buds are 

 practically absent. The chorion and embryo also are de- 

 generate. Many of the oval and elongated degenerate 

 decidual casts show a finely granular cytoplasm, but the 

 decidua as a whole is too degenerate to enable one to judge 

 of the question of infiltration. However, since the villi 

 are embedded in large, dense masses of leucocytes, infec- 

 tion undoubtedly was present. 



The tissues of the embryo are dissociated and its devel- 

 opment was apparently normal for only the brain and cord. 



Possibly the optic cups and the ccelom are present. Al- 

 though an area of condensation is found in the more caudal 

 portion, it is impossible to identify this with the develop- 

 ment of any particular organ. 



(6) Partial hydatiform degeneration. 



GROUP 6. 



No. 54. 



(1) J. M. McMorris, Belle Plaine, Iowa. 



(2) B 11 mm. 



(4) Only the embryo was received at the laboratory. 

 The head is atrophic, but otherwise the specimen has the 

 appearance of a normal embryo of 4}^ weeks. 



(5) In the sections it is seen that the central nervous 

 system is solid, with the exception of the midbrain, whose 

 ventricle still communicates with the exterior of the body 

 through an open neuropore. Some of the vertebras are 

 fairly well developed; the liver is large, but the heart, 

 other organs, and ccelom are difficult to outline because of 

 the presence of marked disintegration. 



(6) Decidua and chorionic vesicle absent. Maceration 

 and disintegration of fetus. 



No. 69. 



(1) G. Henry Chabot, Baltimore, Maryland. 



(2) A 70X50X20 mm.; B 13 mm. CR (from mounted 

 section). 



(4) The chorion is smooth, not being covered with villi. 

 The head of the embryo is atrophic and club-shaped, the 

 body fairly plump. The arms are well developed, of the 

 5-weeks stage, and appear normal. 



(5) The central nervous system is distended and the 

 brain is macerated. The outline of the organs and of the 

 peritoneal cavity are not distinct, and the entire body is 

 filled with migrating cells. The main bundles of nerves 

 are filled with spindle-shaped cells, making them look like 

 the nerves of amphibian embryos. The epidermis is 

 hypertrophied, and at many points forms papillae. Some 

 of these have a short pedicte and could justly be called 

 appendices. The embryonic end of the umbilical cord is 

 atrophic, invaded by migrating cells, and its blood-vessels 

 are greatly distended. The whole chorion and part of the 

 cord have undergone fibrous degeneration. Twenty-five 

 vertebra? are present and quite well preserved. 



(6) Deeidua and chorion absent. 



No. 81. 



(1) J. H. Branham, Baltimore, Maryland. 



(2) A 65X55X35 mm.; B 20mm." 



(3) "Abortion took place just three months after the 

 beginning of the last menstrual period." 



(4) The apparently macerated embryo was broken in 

 its middle. The crest of necrotic tissue on the head, the 

 stumpy leg, the distended cord, and atrophic chorion, all 

 indicate that it is pathological. The two parts were cut 

 in serial sections and different portions of the chorion also 

 were examined. 



(5) Macroscopic as well as microscopic examination of 

 the chorion shows that it has undergone extensive degen- 

 eration. Subchorial hematomata are present, and the 

 chorionic membrane is non-vascular, fibrous, greatly 

 thickened, and fused with the amnion. The villi are 

 fibrous, wholly non-vascular, decidedly clubbed in some 

 areas, and coalescing. The umbilical cord is extremely 

 edematous near the abdomen, and contains only a trace 

 of the vessels. The embryo is somewhat atrophic. Its 

 central nervous system is macerated, and there is a marked 

 cyst-like dilatation at the tip of the spinal cord, which 

 incloses double cavities filled with mucoid reticulum. 

 This tissue is similar in appearance to the normal noto- 

 chord of the amphibian embryos. All the tissues, including 

 the cartilages, show more or less dissociation. A necrotic 

 crust covers the top of the head; the ectoderm is destroyed 

 and the mesoderm covering the brain is greatly thickened 



