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 leukemic 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 leukemic 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 7.2x2.2x1.4cem. 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, 
