PATHOLOGICAL ANATOMY AND HISTOLOGY 783 



It is possible that this rarity is connected with the alleged absence of 

 lymphatics in the hypophysis (Thaon(6)). Without lymph vessels in- 

 fection cannot readily spread by contiguity through the capsule of the 

 hypophysis from an infected sinus or from a leptomeningitis. 



Small abscesses due to the lodgment of mycotic emboli appear more com- 

 monly in the neurohypophysis. Simmonds(^) has reported 4 such cases- 

 and Schmorl mentions having observed the condition. The lesion consists 

 of a localized collection of polymorphonuclear leukocytes, with liquefaction 

 necrosis of the central 

 portion of the mass. 

 The chief etiologic fac- 

 tor is septicemia, espe>- 

 cially puerperal sepsis. 



The healing of an 

 abscess of the hypophy- 

 sis is similar in process 

 to the repair of a simi- 

 lar lesion in any other 

 organ, namely, the re- 

 sorption of the exudate 

 and replacement of the 

 destroyed parenchyma 

 by scar tissue. It is 

 possible, therefore, for 

 suppurative inflamma- 

 tion of the hypophysis 

 to destroy a sufficient 

 quantity of the gland to 

 cause hypopituitarism 

 in those patients who 

 survive the acute proc- 

 ess. Thus v. Hann reports three cases of diabetes insipidus in which he 

 found a sclerosing inflammatory process in the posterior lobe of the 

 hypophysis. Eonchetti found the hypophysis almost entirely destroyed 

 and in its place an inflammatory new formation. 



A diffuse fibrosis of the anterior lobe, frequently considered a type of 

 chronic inflammation, is quite common in the hypophysis in old age (Thorn 

 and Schoenemann) ; or associated with chronic tuberculosis of the lungs 

 (Thaon(&), Dialti, and others) ; or in primary atrophy of the hypophysis 

 (Cagnetto(fr)) ; in heavy drinkers and in severe arteriosclerosis (Sim- 

 monds(&)) ; in scleroderma (Alquier and Touchard) ; and in cases without 

 definite associated pathological processes (Schmorl, Fraenkel(a), and 

 Munson and Shaw). In three of Fraenkel's cases the induration was so 

 marked as to suggest the "cirrhosis of the pancreas sometimes observed in 



Fig. 2. Small abscess in the anterior part of the 

 neurohypophysis. Magnified 120 times. From a patient 

 with malignant endocarditis with multiple septic in- 

 farcts in the kidneys, spleen and brain. 



