PSEUDOHERMAPHRODISM 335 



Circumference of biceps (rt.) 19 cm. 



" " (1ft.) 18.5 



" " forearm (rt.) 19.5 



(1ft.) 19 



" " wrists (each) 14 



" " hands (each) 19.5 



On the tenth of May, 1919, the mass in the lower left portion of the 

 abdomen was investigated by operation and was found to be omentum mat- 

 ted together by tuberculosis. Throughout the abdomen, also, there were 

 extensive areas of miliary tubercle together with much granulation tissue 

 which bled easily on touch. There was practically no ascites present. In- 

 vestigation of the pelvis showed an entire absence of internal genitalia of 

 the female type. Palpation of the region at the neck of the bladder failed 

 to find any structure suggestive of a prostate. The small mass in the right 

 groin was removed and found to be a rudimentary undescended testicle 

 which also showed evidence of tuberculosis. The patient died at home 

 of tuberculous peritonitis on the twelfth of July, 1919. ~No autopsy was 

 obtained. 



The pathological report, made by Dr. S. B. Wolbach, of the mass found 

 in the groin is as follows : 



Tenth May, 1919. Material: Orchid. 



Gross description : Specimen consists of a piece of tissue about 7 x 2% 

 cm., about two-thirds of which consists of an oval shaped portion which on 

 section contains a typical light brown spongy tissue of a testicle with, 

 however, numerous strands of fibrous tissue which give it a very tough and 

 fibrous consistency. There are numerous miliary, yellowish, opaque areas 

 scattered throughout this portion of the tissue. Surrounding this mass is 

 a fibrous capsule about 2 mm. thick. Covering a greater part of the entire 

 mass is a thin layer of tuberculous granulation tissue in which are numer- 

 ous pale tuberculous appearing nodules from 1-3 mm. in width. Tissue 

 is fixed in Zenker. 



Microscopic report : There are four sections of the tissue which show 

 it to be a rudimentary orchid with atypical spermatogenesis. The paren- 

 chymatous portion consists of alveolar structures of columnar or poly- 

 hedral cells inside a basement membrane, with, usually, a narrow central 

 lumen in which are many hyperchromatic dot-like bodies. These, however, 

 cannot be identified as mature spermatozoa, although they probably repre- 

 sent some stage in the spermatogenetic cycle, though possibly only pyk- 

 notic nuclear remains. 



Many of these alveolar structures seem to be well defined seminiferous 

 tubules with atypical spermatocytes in layers two and three cells deep, and 

 a few more or less spindle shaped cells with small, p'ale nucleus, prob- 

 ably Sertoli cells. No karyokinetic figures are seen. Many tubules 



