92 The Philippine Journal of Science 1913 



staining nuclei and a small amount of cytoplasm. They were 

 for the most part fairly uniform in size and shape, although 

 occasionally large forms were seen. Connective-tissue fibers 

 and cells and blood vessels were numerous. Here and there 

 were bundles of muscle fibers, many of which were swollen and 

 evidently degenerated. Where the epithelium was present, the 

 tumor cells extended up to it, and the glands were few and short, 

 and the villi absent. Diagnosis: Lymphosarcoma. 



Case 2. (Necropsy, 1777.) — The tumor occurred in a male 

 Filipino, aged 31, a sailor. The first symptoms occurred about 

 three months before death when he began to have paroxysmal 

 attacks of pain in the right hypochondrium, followed about a 

 week later by jaundice which soon disappeared. When admit- 

 ted to the hospital two months after the beginning of the symp- 

 toms, the patient was emaciated, and a soft tumor, the size of 

 an orange, could be palpated below the right costal margin. 

 Laparotomy was performed three weeks before death, but the 

 condition was found inoperable. 



Necropsy findings. — In the right hypochondriac region were 

 numerous fibrous adhesions binding the liver to the diaphragm 

 and the pyloric portion of the stomach to the liver. Behind the 

 transverse colon lay the greatly enlarged duodenum. The 

 stomach and upper part of the small intestine contained a large 

 amount of blood. The pylorus was large, and opened into a 

 greatly dilated duodenum. This dilated portion measured 16 

 centimeters in length, ending at the beginning of the transverse 

 portion of the duodenum, and its lumen measured 20 centimeters 

 in circumference at the widest part. The mucosa was destroyed 

 in practically all of this dilated portion, the surface roughened 

 and fissured, and from the posterior wall small irregular yellow 

 and reddish black necrotic masses projected. The wall of the 

 cavity was thickest posteriorly, and was everywhere thicker than 

 the normal intestinal wall. The papilla of the common bile duct, 

 with the pancreatic duct opening into it, was found 11 centimeters 

 from the beginning of the dilation. The mucosa of the lower 

 2 or 3 centimeters of the common duct was thickened and 

 slightly roughened, but proximal to this was normal. The 

 growth had invaded the upper portion of the head of the pancreas, 

 giving to it a moist homogeneous appearance. The lymphatic 

 glands behind the duodenum were much enlarged, and some were 

 almost entirely necrotic. Ten centimeters below the dilation was 

 a small plaque projecting into the intestine over which the mu- 

 cosa was intact. In the upper part of the ileum were found 3 



