1923. No. 7. A CASE OF "virilisme SL'RRÉXAl' 



The nodule from whicli these sections are taken is on the right in 

 the abdominal cavity, and is marked by a cross in the general view. The 

 finding of eggs in the large tumour shows that the right ovary has not 

 deteriorated. 



There can therefore be no doubt that the tumour originated only in the 

 epithelial elements of the suprarenal gland, and that it is thus analogous to the 

 epithelial suprarenal tumours with which we are acquainted in human pathologv. 



As regards the character of the tumour it will be seen from the 

 sections (fig. 4 1 that the cells congregate in clusters of various sizes, se- 

 parated by septa of connective tissue. As long as these clusters are small, 

 the cells preserve the appearance of ordinary epithelial cells; but before 

 long globules of fat collect in them, and force them to assume irregular 

 forms. The sudan-stained frozen sections (fig. 9) were particularlv instructive 

 in showing how rapidl}- the gathering of fat-globules takes place. It is also 

 characteristic of these frozen sections that the cell-nuclei show no signs of 

 deca\-. The accumulation of fat in the cells of the principal tumour is 

 exacth' similar to that in the metastases. I have seldom found so typical 

 a glandular appearance as in the section (fig. 4 1 of a metastasis in the 

 serous membrane over a part of the intestine. As a rule, in the metastases 

 too, there is an appearance resembling that of reticular connective tissue, 

 because fat also accumulates so rapidly in the cells at their new points of 

 growth. It was only necessary for me to move the section shown in 

 fig. 4 very slighth- in order to find places with the ordinary reticular 

 appearance. 



With regard to the other conditions that were found by dissection I 

 will only mention that the heart was large and full of blood. The bird 

 was killed by wringing its neck. The lungs were also overfilled with blood. 

 After having made myself acquainted with the clinical discoveries regarding 

 persons who had died of a tumour originating from the suprarenal gland 

 and with indications of suprarenal virilism, and having found that death 

 was frequently accompanied by signs of aff"ection of the respiratory organs, 

 I examined the hen's lungs, and found metastases in them such as were 

 formerly so often found in man. The metastases in the lungs proved to 

 be of the same structure as those in other parts. 



The thyroid gland was excised with as little connective tissue as 

 possible, and weighed. The two halves together weighed 210 mg. This 

 weight is less than in the case of two other hens, where I weighed the 

 organ in one when fixed with formol (240 mg.), and in the other when 

 freshly excised (310 ing.l. The microtomic sections of the organ showed 

 an abnormal condition. Some follicles, it is true, contained a regular, 

 homogeneous, colloid mass of normal appearance, but in others the contents 

 were of a fluffy nature, while in yet others the epithelial cells had become 

 detached from the wall, and the lumen was more or less filled with round, 

 tumid cells (fie. 10 1. 



