Identifier: buffalomedicaljo6919unse (find matches)
Title: Buffalo medical journal
Year: 1914 (1910s)
Authors:
Subjects: Medicine
Publisher: Buffalo, N.Y. : (s.n.)
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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one which isthe size of a filbert, we see an isolated part which looks likea sequestrum and is the size of a pea, this is surrounded by aspace which is filled with fairly fresh dark red blood, and itswhole cut surface shows a pink imbibition. In the lateral part of this lymphnode we find the mainbranch of the bronchus for the upper lobe, but this is com-pressed so that its lumen is a mere slit. Leo-Wolf: Hemoptysis in Infants 747 Where this lymph node and the bronchus lie close togetherwe find in the outer layer of the lymph node as well as in thewall of the bronchus a discontinuity to the extent of two orthree mm., so that the space surrounding the caseous sequesterand the lumen of the bronchus communicate. The channel ofthi- perforation, for this is what this is, is filled with a bloodcoagulum which contains a fine-grained detritus. On the same cut surface we see in the center of the lobe thedin meters of several bronchi the lumina of which have beenenlarged by caseous degeneration.
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In the anterior part of the lobe we find the other end of thelymph node which we described as being the size of a cherrypit in the cut we have just spoken of, but here it is much lar-ger and is found to contain a focus of serous softening equalin size to that of a bean. In the tissue of the lobe itself we find a number of cavernousbronchiectases which are either simple dilatations and havesmooth walls, or are the results of caseation; some of thesecontain a little aspirated Jind coagulated blood. The infiltra-ted tissue between these bronchiectases contains numerous tu-bercles. 748 Leo-Wolf: Hemoptysis in Infants A very careful scrutiny of all cut surfaces reveals neitherin the bronchi nor in the microscopical blood vessels any per-foration except through the wall of the large bronchus. In this case the hemoptysis was evidently due to an erosionof the blood vessels of the bronchial wall. In the lower lobe of the left lung we find only a diffuseand quite recent thickening of some disse

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