68 The Normal Histology of the Human Hemolymph Glands 



ance; on section these are found to be small round masses of lymphoid 

 tissue projecting into the peripheral sinus. 



The size of the human hemolymph glands varies from that of a pin- 

 point to a large cherry or almond. The latter size is, however, uncom- 

 mon, the usual size being that of a yellow mustard seed or pea. In the 

 majority of cases their shape is round or oval, some are flattened, others 

 elongated, while not infrequently glands of an almond shape are found, 

 the larger end being somewhat recurved upon itself. They usually 

 possess a distinct hilum into which vessels enter. Their consistency is 

 somewhat softer than that of ordinary lymph glands depending upon 

 the amount of blood in the sinuses. If these are large and dilated the 

 capsule of the gland may be so stretched that it is easily ruptured and 

 the gland pulp have the appearance and consistency of a fresh blood- 

 clot; and these glands are undoubtedly many times mistaken for such. 



Attached to the gland there is usually a relatively large plexus of 

 vessels, the veins in particular being large and prominent. Occasion- 

 ally these remain dilated and filled with blood, and under such condi- 

 tions are of great aid in making the naked-eye diagnosis. No lymph 

 vessels can be demonstrated in the case of those glands, even the largest, 

 which contain blood-sinuses throughout, but in the glands of mixed 

 type, partly hemolymph and partly lymphatic, lymph vessels can be 

 made out. 



The number of hemolymph glands in the human body is exceedingly 

 difficult of estimation. Since the ultimate diagnosis depends upon 

 the microscopical examination it would be necessary in making an exact 

 estimation to examine every lymphatic gland in the body. Moreover, 

 since many of the hemolymph glands are very small and lie deeply 

 embedded in fat and connective tissue, it is necessary to remove all the 

 tissues in the regions where the glands are found and make serial sec- 

 tions of the entire tissue. The difficulty of this is evident. The number 

 of lymph glands visible to the naked eye in the retroperitoneal region 

 varies from 200-500, and the prevertebral tissues contain also numerous 

 nodes of lymphoid tissue too small to be seen on naked-eye inspection. 

 In a number of cases the entire retroperitoneal tissue has been exam- 

 ined, both in the fresh state and microscopically, but the results are so 

 much at variance that no definite statements regarding the number of 

 hemol3^mph glands can be made. Ordinarily the relative proportion to 

 lymphatic glands is 1-20 to 1-50, but this statement is based upon very 

 incomplete observations. It is very probable that the number of hemo- 

 lymph glands is much greater than that expressed by these ratios, since 

 in one case of pernicious anemia over sixty of the glands were removed 



