VIII, B, 2 Hammack: Primary Sarcoma 93 



small infiltrative growths, the largest completely encircling the 

 intestine and measuring 5 centimeters in length and 5 to 7 

 millimeters in thickness. This appeared as a grayish patch 

 from both the mucous and the serous surfaces, and projected 

 slightly into the lumen, but did not diminish it appreciably. The 

 folds of the mucosa were partly obliterated, but there was no 

 ulceration. The other two growths nearby had the same general 

 appearance, but were not completely circular. The mesenteric 

 glands opposite all of these were enlarged and firm. There were 

 no metastases to other organs. 



Microscopic examination. — The tumor was very cellular, the 

 cells showing great variations in size although the majority were 

 slightly larger than small lymphocytes, round, with pale-staining 

 nuclei and scanty cytoplasm. Multinuclear cells, which seemed 

 to occur in groups, and mitotic figures were not infrequent. In 

 the duodenum the intestinal wall was made up practically of 

 tumor tissue and the inner surface was largely necrotic. Exami- 

 nation of one of the tumors in the ileum showed that growth had 

 occurred in the submucosa and mucosa, while the muscular coats 

 were not invaded. The infiltration extended between the crypts, 

 which were rather few, to the surface, which was covered only 

 partially by epithelium and showed occasional small necrotic 

 areas. The tumor cells of this section were more typically lym- 

 phoid, and the multinuclear cells were infrequent. Mallory's 

 aniline blue stain revealed a delicate connective-tissue reticulum 

 throughout the tumor tissue. The enlarged mesenteric and 

 retroperitoneal lymphatic glands showed the same general struc- 

 ture with frequent necrosis. Diagnosis: Lymphosarcoma. 



Case 3.^ (Necropsy, 1963.) — The patient was a male Fili- 

 pino, aged 27, a soldier. The first symptom was an attack of 

 abdominal pain on June 7, 1912, which kept him from duty for 

 three days. On June 23, an abdominal mass was noticed. At 

 this time, on account of rapid loss of weight, he was sent to 

 Manila for hospital treatment. On July 10, a laparotomy was 

 performed and an inoperable tumor was found. The patient 

 died August 10, 1912. 



Necropsy findings. — The body was greatly emaciated. The 

 tumor occurred in the ileum, 1.5 meters from the ileocsecal valve. 

 It almost completely encircled the intestine lying within its walls 

 and extending for 2 or 3 centimeters between the layers of the 

 mesentery. Its longitudinal diameter was about 8 centimeters. 



• I am indebted to Maj. S. C. Gurney, medical division, Philippine 

 Constabulary, for the clinical notes on this case. 



