Identifier: medicaldiagnosi00gree (find matches)
Title: Medical diagnosis for the student and practitioner
Year: 1922 (1920s)
Authors: Greene, Charles Lyman, 1862-
Subjects: Diagnosis
Publisher: Philadelphia, Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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Hodgkins disease in man. Fraenkel and Much have reported Gram-positive granular non-acid-fastbacilli, and some observers have considered these as degenerated tuberclebacilli, but on the whole, little evidence has been adduced to support theolder supposition of Sternburg that the disease is of tuberculous origin. The etiology therefore remains unknown. Glandular Enlargement.—Dorothy M. Reed reports the following his-tologic picture as characteristic of Hodgkins disease: (a) Swollen endothelial * No knowledge of the actual duration of this disease is available for the reason thatnone have been seen in the early stages and watched throughout the course of the disease. HODGKIN S UISKASE 165 cells lying upon the fibrils of the reticulum; (b) Large epithelioid giant cellslymphocytes and eosinophiles occupying interstices of the stroma. Theessential clinical change is one of enlargement of the lymph glands involvingprimarily limited areas, but tending to extend widely. The cervical and in-
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Fig. 54.—Hodgkins disease, enlarged glands filling the mediastinum. (Dr. Frank S. Bisscll.) guinal glands are usually the first affected, the former giving to the diseaseits most marked characteristic. The tissues of the neck may entirely losetheir normal contour, and the glands there and elsewhere tend to steadilyenlarge without marked tenderness or symptoms of inflammatory change.They tend to maintain their individual outline until late in the disease, i66 MEDICAL DIAGNOSIS A sourceof error. Debated point. Importantdata. The HodgkinsCollar. and the skin usually remains unaffected and unattached to the subjacenttumors. When periadenitis occurs in the later stages lobulate tumors areformed which may lose the firmness characteristic of the earlier period,become softened and, rarely, may undergo ulceration. The deep glandsabove the trachea, those of the larger bronchi, of the mediastinum andretroperitoneal area become involved and in some instances form largetumors and greatly complic

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