28 Harry C. Schmeisser. 



mononuclear in the intramuscular capillaries, with an occasional small 

 extravascular focus of infiltration, consisting of the same cell. 



Lungs. These are seldom involved. In two cases they were cedemat- 

 ous. In one, the tubular walls were wide and gray, occluding the 

 lumina. On section, the latter case presented a similar but more marked 

 picture. Microscopically the intertubular blood-vessels, their branches 

 which extend into the capillary bed, and the capillaries themselves, are 

 always filled with leukaemic blood. At times they are greatly distended. 

 The white cells are always increased in number, and sometimes the 

 blood seems to consist solely of closely packed, large mononuclears. 

 Mitoses are everywhere abundant. Very rarely, a few mononuclear 

 myelocytes with eosinophilic granules or large mononuclears are gath- 

 ered in small masses in the intertubular connective tissue. 



Gastro-intestinal Tract, Pancreas and Adrenals. These in gross 

 showed nothing of interest. No mesenteric lymph-glands were demon- 

 strated. The pancreas, microscopically in no case showed any infiltra- 

 tion of its parenchyma proper, but in several there were numerous nests 

 of myeloid cells in the interlobar fat tissue, usually surrounding one or 

 more capillaries, and composed of the large mononuclear, eosinophilic 

 myelocytes, both mononuclear and polymorphonuclear. Mitoses of both 

 the mononuclears were frequent. The blood-vessels in the parenchyma 

 and fatty tissue contained, as usual, the predominating large mononu- 

 clear. 



The adrenals also reveal interesting findings histologically. It is 

 quite common for the intertrabecular capillaries to be enormously dis- 

 tended with the characteristic leukaemic blood and for the myeloid cells 

 to have infiltrated between the capillary wall and parenchymatous cells. 

 These nests contain mostly the large mononuclear, but now and again 

 they seem to be very rich in lymphocytes. The parenchyma has suffered 

 greatly; its nuclei stain poorly and frequently its cells show disinte- 

 gration. 



Kidneys. Of the 13 cases, the kidneys of five were enlarged. The 

 smallest measured 7 x 1.5 x 1.2 cm., the largest 7.2 x 2.2 x 1.4 cm. The 

 weight of both kidneys ranged from 12-26 gm., or 0.8-1.4 per cent of 

 the body-weight. In one case the kidneys were extremely oedematous 

 and weighed 32 gm. or 2 per cent of the body-weight. 



The surface and section of the kidney may appear entirely normal, 

 but usually one can see, below its capsule, scattered, gray pin-point dots, 



