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STUDIES ON PATHOLOGIC OVA. 



have written on hydatiform degeneration, it is difficult indeed to understand. 

 Gierse, who also took steps to ascertain what normal villi look like, stated that 

 villi with marked irregularities, as described by Desormaux, Breschet, Raspail, 

 and Seiler, undoubtedly were abnormal, surmised that villi in abortuses seldom 

 are normal, and added that between the slight pathologic changes in the caliber 

 of the villi and the most evident hydatiform moles the plainest transitions can 

 be found. Among other important things, Gierse also recognized the early fenes- 

 tration of the stroma and pictured such a villus under a magnification of 250 

 diameters. Although reported very briefly, his findings, wholly confirmed here, 

 still wait for general recognition. 



Just as the great majority of specimens described in the literature are large, 

 so 4 of the 8 specimens originally classed as such in the Carnegie Collection also 

 are large, and none of the 8 is very young, as the following protocols show: 



No. 70 (Dr. Charles H. Ellis) is a small, firm, 

 degenerate-looking, almost solid mass 40 by 30 

 by 28 mm., composed of small cysts, degenerate 

 deciclua, exudate, and degeneration products. 

 It is very similar to a very much larger specimen, 

 No. 323 (Dr. V. Van Williams), a large, firm, 

 felt-like mass 120 by 90 by 65 mm. The individ- 

 ual cysts, which vary from 1 to 20 mm., are 

 packed together rather firmly, though a few large 

 ones are free. The exterior of the specimen is 

 formed by a thick layer of degenerate decidua 

 and gives only a slight indication of its true 

 nature upon closer inspection or upon examina- 

 tion of the cut surface. No fetal remnants were 

 noticed, and microscopic examination shows that 

 the specimen is composed merely of a large 

 hydatiform mass which was retained for a long 

 time and then aborted in toto with the surround- 

 ing decidua and exudate. 



No. 719 (Dr. G. C. McCormick), on the con- 

 trary, is a fresh, loose, typical hydatiform mass 

 composed of loose hydatids of various sizes. 

 As the specimen floats loosely in fluid, it fills a 

 half-liter jar about two-thirds. A considerable 

 portion of the hydatid cysts are glued into a solid 

 mass by blood, exudate and decidua, which form 

 a layer on the exterior. 



No. 1323 (Dr. J. W. Schlieder) is also a large 

 mass very like the preceding, and completely 

 fills a liter jar. It is accompanied by much 

 clot and composed mainly of a large, thick- 

 walled, hemorrhagic, necrotic mass 80 by 50 by 

 45 mm., containing a large, thin-walled cavity 

 65 by 30 by 25 mm., which is broken at one end. 

 This cavity, which apparently is that of the 

 chorionic vesicle, is empty, smooth, and thin- 

 walled, except where it is composed of a char- 

 acteristic hydatiform mass. 



No. 1325 (Dr. Fred R. Ford) is a small, 

 irregular mass 40 by 33 by 20 mm., the exterior 

 of most of which is formed by a thin layer of 

 decidua. Within this is a small group of quite 

 typical hydatid cysts, the largest of which 



measures about 10 by 5 mm. The appearance 

 of the specimen suggests that it is merely a 

 fragment, though the amount of decidua present 

 indicates that the entire specimen probably was 

 not much larger. The history of this specimen 

 is especially interesting because of the diagnosis 

 of tubal pregnancy, caused by the presence of a 

 cornual myoma and the occurrence of repeated 

 bleeding. 



By far the most interesting specimen, in some 

 respects, of hydatiform degeneration among 

 those diagnosed as such upon gross examination, 

 is No. 1640. This abortus, received through 

 the courtesy of Dr. J. W. Williams, measured 

 40 by 20 by 15 mm. Upon examination, Dr. 

 G. L. Streeter found it to be composed of a 

 flattened decidual and chorionic mass which, 

 upon section, showed "pearl-like vesicular en- 

 largements which suggest hydatiform degen- 

 eration." The exterior of this specimen is com- 

 posed of a thin, hemorrhagic decidua which 

 completely surrounds the villi. The hydatid 

 nature of this clearly is recognizable upon close 

 scrutiny with the unaided eye, and easily be- 

 comes evident upon magnification of 12 diam- 

 eters with the binocular microscope. Exami- 

 nation of the histologic preparations reveals it to 

 be a very fine specimen of relatively early 

 hydatiform degeneration. 



No. 1914 (Dr. G. C. McCormick) is a fine, 

 very characteristic mass. It is like Nos. 749 

 and 1323, but very much larger, for in fluid it 

 completely fills a 2-liter jar. This specimen was 

 said to have accompanied a living 7-months' 

 fetus, having been expelled between the fetus and 

 the placenta. Only a small amount of clot, and 

 what seems to be a small portion of placenta and 

 membranes, accompanied it. Since the placenta 

 was not saved, it is impossible to say whether the 

 mass resulted from partial degeneration of the 

 placenta belonging to the living child or whether 

 it represented a degenerate twin placenta, which 

 is rather unlikely but not impossible, in view of 



