EXAMPLES OF HYPERBLASTOSIS 345 



length call your attention to a most important group of hyper- 

 blastoses, those, namely, affecting the lymphatic tissues and the 

 bone marrow. 



That I may not be accused of forcing my point, I would here 

 quote the description of one of these allied conditions given by 

 a recent writer whose position is sufficiently indicated by the 

 fact that my quotation is taken from the " Referat " which he 

 was invited to give before last year's meeting of the Deutsche 

 Pathologische Gesellschaft. " The lymph nodes," states Pro- 

 fessor Eugen Frankel, " are liable to be most intensely affected, 

 swelling up into huge packets, and when it is the more superficial 

 lymph nodes that are involved, an immediate diagnosis can be 

 made. Often enough at autopsy it is determined that besides 

 the peripheral lymph nodes the internal collections are implicated : 

 those at the hilus of the lungs, in the mesentery, in the retro- 

 peritoneal tissue, exhibit similar change. It is in no wise necessary 

 that the nodes throughout the body are involved to the same 

 degree, although total exemption of one or other group is scarcely 

 ever observable. . . . The spleen also shows in general a notable 

 increase . . . indeed at times the enlargement of this organ 

 predominates to such a degree that the lymphoid enlargement 

 passes relatively into the background. . . . Cases, however, are 

 not infrequent in which the spleen remains small." And Frankel 

 points out that microscopically we deal in these cases with what 

 is purely a hyperplasia of the lymphoid tissue. This is a descrip- 

 tion of the condition which from a primary misfortune in nomen- 

 clature, from fastening the attention upon the outcome rather 

 than upon the underlying state, has for years been a source of 

 confusion : the condition, namely, described by Cohnheim as 

 pseudoleukaemia, by others as aleukaemic leukaemia, or as the 

 pre-leukaemic stage of leukaemia. For now many years my 

 teaching has been that lymphatic leukaemia is a blastomatoid 

 condition, 1 and I willingly accept as the preferable nomenclature 

 that supported by Aschoff, Schridde, Hirschfeld and Nageli, 

 namely, lymphadenosis or lymphadenia. The time, indeed, has 

 come when, for clear thinking, the term leukaemia should be relegated, 

 by clinicians and pathologists alike, to its proper symptomatic rank : 

 we should speak of lymphadenosis with or without leukaemia, 



1 Vide Adami, Principles of Pathology, first edition, vol. i., 1908, p. 678 

 et seq. 



