CARCINOMA OF THE KIDNEY ARISING IN 
THE GLOMERULI* 
By JOHN HILL ABRAM, M.D. Lond., M.R.C.P. Assistant Lecturer on Pathology 
University College, Assistant Physician, Royal Infirmary Liverpool 
From the Thompson Yates Laboratories, University College Liverpool. 
My object in reporting this case is to place on record what seems to be an almost unique 
condition in the kidneys. 
Clinical History. — William D., .-et. i6, a groom, was sent to tlie Royal Infirmary by Dr. 
Blair Bell, of New Brighton, and was admitted under my care. He gave an eight months' 
history of pain in the back. He was emaciated and anaemic. Enlarged glands in groins, axilla, 
and submaxillary regions. Two tumours on the anterior surface of the sternum, over these the 
superficial veins distended. Liver enlarged. Urine (by catheter) 1025, no sugar, no albumin. 
Paresis in legs, knee-jerks present. Incontinence of urine and faeces. Fresh tumours developed 
on the ribs ; the liver became larger and nodular ; the weakness in the legs more marked ; the 
knee-jerks no longer obtainable. Towards the end, cough, blood-stained sputum ; thrombosis in 
left iliac vein ; left hydrothorax. Death after ten months' illness. 
Post-mortetn. — Numerous growths on ribs. Two masses of growth on the anterior surface 
of the sternum, a large mass on the posterior surface. For 3 in. above and below the sixth dorsal 
vertebra extensive growth in the pre-vertebral connective tissue, also infiltrating the nerve roots. 
Some patches of growth on the outer surface of the dura mater spinalis. The pleural cavities 
contain clear fluid. Both layers of pleurfe and the lungs show numerous nodules of new growth. 
Liver enlarged, right lobe practically replaced by growth, many nodules in left lobe. Spleen 
normal. Kidneys rather large, one or two small nodules of growth. The grovvth everywhere is 
firm and white. 
Histological Examination. — Portions of the various organs were hardened in the usual fluids, 
and the histological examination revealed a very interesting although unexpected condition. The 
new growth on the sternum was found to be not a connective tissue tumour, but epithelial in 
nature. The tumour tissue contained somewhat slender cells packed in irregular alveoli, the 
central portions showed many necrotic cells, and in parts the stroma had undergone myxomatous 
degeneration. The growth was limited to the periosteal surface of the bone, and the medullary 
substance was normal. The nodules on the dura mater presented a similar structure ; the nerve 
roots contained many degenerated nerve-fibres. The cord itself was practically normal. The 
growth in the liver resembled that on the bones. Here, too, the myxomatous change in the 
* Reprinted from the 'Journal of Patholo^'y and Bacteriology,' February, 1900. 
