Bulletin of the School of Medicine, University of Maryland, Vol. 23

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Excerpt from Bulletin of the School of Medicine, University of Maryland, Vol. 23: July 1938Microscopic Report: Section of the cervix through the ulcerated lesion showed erosion of a squamous epithelium. Substituted in its place was a layer of round and polymorphonuclear cells. The stroma beneath was infiltrated with typical tubercles which consisted of an outer layer of round cells surrounding a mass of epithelioid cells. Some of the tubercles contained giant cells made up of several nuclei in a mural arrangement. Older tubercles composed of a necrotic center surrounded by round cells were noted. Supposedly the necrosis was caused by the lack of blood supply and dissolution of the giant and epithelioid cells. In places several tubercles coalesced and formed a large necrotic area. The muscular layer was composed of normal smooth muscle, no tubercles and in¿ammation were noted. Section of the uterus showed the same involvement as in the cervix but to a more marked degree. The mucosa was completely destroyed in areas, with round cell infiltration of the muscular coat beneath. The intact part of the mucosa was studded with numerous tubercles in all stages of development. No tubercles were noted in the muscularis of the uterus although, unlike in the cervix, signs of chronic in¿ammation were present. The tubes were but shells. Necrotic material filled the entire lumen. The mucosa and muscular layer were entirely destroyed. No epithelial cells were visible. Tubercles were seen in and on the serosa. The ovary and appendix on sectioning were normal with the exception of tubercles on the external coat.Ultimate result: The patient left the hospital three weeks after operation and improved for a few months. Pelvic examinations two months and six months after operation showed no palpable return of the disease. There was no ¿uid in the peritoneal cavity. She refused sanatorium care and during the following six months grew progressively worse and died one year after operation of kidney involvement and uremia.About the PublisherForgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.comThis book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully, any imperfections that remain are intentionally left to preserve the state of such historical works.