58 



cupiesanexcentric position in the protoplasm; 

 it is oval and not very distinct; the details 

 of its inner structure are not visible as it 

 stains rather diffusely with hematoxylin (ka- 

 ryolysis). 



There are a few other hepatic cells, the 

 nuclei of which are no longer visible; the 

 protoplasm of these cells is vacuolated and 

 stains deeply with eosin; in the marginal 

 zone there are large granules some of which 

 are close together, whereas others are far 

 apart; the cellular outline is interrupted in 

 that point. 



In other cells the protoplasmic disag- 

 gregation is more marked, and there are 

 spots where the hepatic cells are only round 

 masses which take a uniform reddisli-pink 

 color, when stained with eosin; they are 

 small and are found in groups of three or 

 four different sizes. 



The arrangement of the cells in trabe- 

 cules of REMAK is completely blurred by 

 the necrosis of the liver-cells. 



In the focal lesions just described, the 

 hepatic cells are isolated, or are remnants 

 of the trabecules of REMAK composed of 

 3,4 or at most 5 contiguous cells, all of 

 which have the above-described appearance. 



The liver sinusoids are dilated and filled 

 with red blood corpuscles and migratory 

 cells. 



The most characteristic feature is cer- 

 tainly the presence of a great number of mi- 

 gratory cells which surround and limit the 

 capillaries. These cells are very acti^re pha- 

 gocytes, as can be seen by the large quan- 

 tity of material accumulated inside their 

 protoplasm. 



The lesions above described have some 

 affinity to the lesions found in chronic pas- 

 sive congestion. It is, however, impossible 

 to include theni in any of the five types 

 described by LAMBERT and ALLISON. 



I noticed, on the other hand, that this 

 type is always present in sections where 

 the first aspect is found, or in sections 

 which include bacterial thrombosis of the 

 capillaries. 



The lesions of chronic, passive conges- 

 tion found all over the liver make the achr- 



acten'stics of this 

 decided indeed 



type of lesion very un- 



B) Diffuse lesions. 



Some of the types of chronic passive 

 congestion described by LAMBERT and 

 ALLISON were found all over the liver. 



Pieces removed from the liver which is 

 now in the Anatomical Museum of the Ins- 

 tituto Oswaldo Cruz, account for the distri- 

 bution of the lesions (v. diagram). This spe- 

 cimen comprises a longitudinal section of 

 the whole liver, passing more or less through 

 the middle of the antero-superior surface. 



Block 1: chronic passive congestion (cen. 

 .ra¡ degeneration with or without dilatation 

 of canillariesl. 



Block 2: Chronic passive congestion (di- 

 latation of the capillaries with atrophy of 

 the cells of the centre of the lobule). 



