382 UNIVERSITY OF VIRGINIA PUBLICATIONS 



Liver weighed 175 grams. Dimensions 18 x 12 x 3 cm. Surface smooth and glis- 

 tening. Consistence soft, edge sharp. On section the liver was uniformly dark brown, 

 the lobules not distinct. Over the posterior border of the upper right lobe were a few 

 white pin-point areas of thickening in the capsule. A tapeworm was found in the 

 bile duct and adjacent intestine, and was identified as the "fringed tapeworm," 

 or "liver tapeworm," its technical name being " Thysanosoma actinioides." 



Left kidney. Capsule stripped readily leaving a smooth, brownish surface 

 with a thick cortex (between 9 and 11 mm.). Glomeruli showed as red points; striae 

 fairly well marked, boundary zone visible. The pyramids and pelvis of kidney ap- 

 peared normal. Right kidney had the same appearance as left. Combined weight 

 of kidneys 85 grams. The digestive tract presented no abnormality upon opening it 

 except for the presence of tapeworms. The pelvic viscera, uterus, tubes and ovaries 

 were clear except that a soft parasitic cyst was found attached to the right broad 

 ligament. 



Microscopic report. Paraffin sections. Stained with hematoxylin and eosin. 

 Heart muscle stained well and appeared clear and normal, both fibrils and striations 

 standing out distinctly. Scattered quite thickly through the heart muscle were deep 

 bluish masses, circular, or oval, from three to fifteen times the size of the heart muscle 

 cell. These were seen to be made up of a colorless, thin capsule in which were tightly 

 packed great numbers of comma-shaped, or crescentic-shaped, deeply blue staining 

 masses. There was apparently no reaction in the muscle outside but here and there 

 one gained the impression that these cysts containing blue chromatin masses were 

 embedded in a heart muscle cell. 



Lung. Section through nodule. The cavity was seen to be a dilated bronchiole. 

 The plug had fallen from the center, most of the mucosa had dropped off, and there 

 was left a wall containing abundant loose fibroblastic tissue outside of which were a 

 few compressed lung alveoli, passing rapidly into rather congested lung tissue. A 

 second nodule of lung showed on section a bright pink necrotic structureless center. 

 The mucosa was practically entirely gone or else overgrown by an abundant, loose, 

 fibroblastic tissue which occasionally nearly enclosed a small strand or two of colum- 

 nar epithelial cells. The new tissue contained, especially near the necrotic border,' 

 great numbers of lymphocytes and of eosinophilic cells. Apparently many of these 

 eosinophiles were mononuclear, although the majority were polymorphonuclear. In 

 the region outside of the organized tissue, more or less compressed lung was found 

 with the alveoli partially filled with an exudate composed chiefly of desquamated 

 epithelial cells and polymorphonuclears. Diagnosis— Organizing bronchiectasis and 

 bronchopneumonia. Other nodules from the lung presented much the same appear- 

 ance. In none of these sections were tubercles found in the consolidated area. 



Spleen showed lymphoid hyperplasia and some phagocytic endothelioid cells, 

 but otherwise appeared normal. The liver showed a definite though not very pro- 

 nounced increase in the cells surrounding the somewhat dilated bile ducts. These 

 cells were in part fibroblasts but chiefly lymphoid cells and a few eosinophilic cells. 

 Kidney capsule not thickened; glomeruli appeared normal; slightly congested. 

 Tubular epithelium slightly cloudy though hardly more so than normally. No in- 

 crease in the intertubular connective tissue. Lymph gland (from hilum of lung). 

 Capsule not thickened. Germinal centers well marked. A few of them showed 

 lymphatic hyperplasia with large cells near the middle and some evidence of 

 cell divisions in this region. The sinuses toward the center were widely dilated and 



