154 



STUDIES ON PATHOLOGIC OVA. 



its surface like small warts. The tissues of the embryo 

 show marked dissociation, the shape, border of the car- 

 tilages, and practically all of the organs being obliterated. 

 These changes extend to the extremities. The specimen 

 may be viewed as typical of general dissociation of the 

 tissues in an embryo of this size. It appears as though 

 the tissues grew independently for some time after the 

 strangulation of the embryo. 



(6) Slight infiltration of the decidua. 



No. 465. 



(1) H. W. McComas, Oakland, Maryland. 



(2) A 70X70X50 mm.; B 13 mm. 



(4) The ovum is pear-shaped, with a pedicle 40 mm. 

 long, representing, no doubt, the portion that was pro- 

 truding from the uterus. Parts of the decidua are hanging 

 to the chorion. Other portions of the specimen are covered 

 by very large villi, while the greater part of it appears to 

 be ulcerated. The amniotic cavity is very large, filling 

 almost the entire specimen. It contains a clear fluid and 

 a pathological embryo the head of which is broken off 

 from the body. The extremities are stunted and the cord 

 is 20 mm. long. The united portions of the embryo 

 measure together 13 mm. 



(5) Sections show that the villi are matted together 

 and covered with decidua. The mass between the villi 

 and the decidua consist of fibrin, mucus, blood, irregular 

 masses of trophoblast, and pus. The chorionic wall 

 appears to be normal in structure. Many of the villi 

 are fibrous and the trophoblast is scanty. The embryo is 

 dissociated and macerated. The lower part of the embryo 

 and the tips of the extremities are infiltrated with round 

 cells, making it appear like sections of the lymphatic 

 glands. The structures of the head are very much macer- 

 ated and appear to have succumbed before the lower end 

 of the embryo. The cord is degenerated, jelly-like in 

 consistency, and contains a cavity. 



(6) Slight infiltration of the decidua and hydatiform 

 degeneration. 



No. 499. 



(1) H. H. Arthur, Baltimore, Maryland. 



(2) A 45X45X40 mm.; B 17 mm. 



(3) "The specimen is from a frail girl, weight about 

 110 pounds. Gave birth several years ago to a premature 

 child at 7 months. Child now living and in robust health. 

 The last pregnancy, about 6 months ago, terminated in 

 abortion at about 8 weeks. Could get no information as 

 to its beiug induced, so presume it was spontaneous. The 

 specimen was delivered to me, and, besides considerable 

 clots, was partially surrounded by a sac containing intact 

 embryo. In the absence of any evidence to the contrary, 

 from an obstetric standpoint I consider it to be a case of 

 habitual tendency to abortion, as there was no history of 

 traumatism or interference in either instance. " 



(4) The ovum is composed of a thin white membrane 

 which is covered quite evenly with delicate long villi, meas- 

 uring on an average about 17 mm. long. Attached within 

 is a much deformed embryo, with kinked arms and legs, 

 protruding abdominal wall, very thin umbilical cord, and 

 complete spina bifida. There is also an exencephaly. 



(5) Sections of the chorion show that its walls are 

 somewhat fibrous, thick, and rarefied. The non-vascular 

 stroma of the villi is very degenerate and fenestrated. 

 There is very little trophoblast present. It appears as 

 though the chorion had macerated before we received it. 

 Sections through the umbilical cord show a marked dis- 

 sociation of tissue, and the intestines, which normally 

 protrude into it, seem to have dissociated completely. 

 The same is true of the walls of the large blood-vessels. 

 These are filled with blood, which, not being circum- 

 srcibed, penetrates into the surrounding tissues. Sections 

 through the embryo, which were much too thin, show 

 that, with the exception of the liver, the tissues are dis- 

 sociated, the processes being most marked in the intestines, 

 along the aorta, and in front of the head. The dissociation 



is well marked around the cartilages of the vertebra 

 column. The tissue of the brain is almost entirely de- 

 stroyed, and in it there is a mixture of nerve-fibers, con- 

 nective tissue, and blood-vessels. It has undergone almost 

 complete vascularization. The large blood-vessels are 

 gorged. Some of the nerves run almost to the surface 

 of this tissue, which would indicate that the brain had 

 been well formed before it degenerated into this vascular 

 mass. Within the tip of the tail the cord is still covered 

 by the skin of the embryo. 

 (6) Decidua absent. 



No. 510. 



(1) H. G. Steele, Keystone, West Virginia. 



(2) A 60X45 mm.; B 10 mm. 



(4) Scattered over the ovum are long, slender villi 

 which do not branch much, and over the top of these is a 

 large piece of decidua. 



(5) Sections were cut from two portions of the chorion. 

 In one the decidua is found to be very vascular, with a 

 great deal of fibrinoid substance on the side adjacent to 

 the villi. Large arms of decidua extend between the villi. 

 It appears as though the decidua had tried to make up 

 for the defective villi by growing towards the chorion. 

 In this region the chorion has undergone extensive mucoid 

 degeneration, with cavity formation. Some of the villi 

 contain many Hofbauer cells and very little trophoblast. 

 Sections from the other side of the chorion show the 

 chorionic membrane to be very thin, with an extensive 

 mucoid degeneration of the villi, some of which are mere 

 shadows, and are outlined by fibrinoid substance which 

 also reaches between them. There are a few masses of 

 necrotic trophoblast, otherwise the spaces between the 

 villi are practically empty. The tissues of the embryo have 

 undergone very extensive dissociation, but the liver, 

 heart, and stomach can still be made out. Most of the 

 myotomes and vertebrae are distinct. The umbilical cord 

 contains numerous large cavities, with plenty of Hofbauer 

 cells scattered through its tisses, as it is undergoing mucoid 

 degeneration. The dissociation of the lower part of the 

 embryo is almost complete, it having been converted into 

 a fairly uniform layer of round cells. The brain and spinal 

 cord seem to be more macerated than dissociated. The 

 brain protrudes through the skin in front, and at the 

 lower part the spinal canal is open. In this region there 

 is quite a tumor covering the spina bifida, which is com- 

 posed of a necrotic mass of tissue invaded by round cells. 

 Between the tumor and the cord, partly blocking the 

 opening between its lumen and the outside of the body, 

 are several small nodules of transparent tissue which have 

 the appearance of being made up of nerve fibers. In this 

 region, immediately below the epidermis, is a lens-like 

 body. The otic and optic vesicles are obliterated. There 

 is no branchial region, as the face has grown firmly to the 

 body, and at the juncture there are several pronounced 

 papillomata. 



(6) Slight infiltration of the decidua and hydatiform 

 degeneration. 



No. 512. 



(1) W. G. McCallum, New York. 



(2) A 30X27X18 mm.; B 10mm. 



(4) The chorion is thin and covered with irregularly 

 grouped villi. On one side a tuft of villi appears to be 

 normal in size and branching, but elsewhere they are 

 scattered and atrophic. The chorion is lined entirely by 

 the amnion, the two being very closely attached. The 

 stunted embryo is attached to the chorion by means of a 

 short, thin umbilical cord. The head is atrophic and 

 transparent, being partly broken from the body. It 

 appears as though the embryo had been broken for a 

 considerable time before the abortion. 



(5) Sections through the chorion at the point of attach- 

 ment show that the cord is attached directly to the amnion, 

 which is only in apposition with the chorionic wall. The 

 villi are thin, with a clear, non-vascular stroma, not rich 



