Certain Unusual Lesions of the Lymphatic Apparatus

In 1832 Hodgkin1 called attention to the existence of a disease characterized primarily by progressive enlargement of the lymph nodes and associated, in many instances, with enlargement of the spleen.In the light of our present knowledge it appears that several of the cases originally described by Hodgkin were examples of leukemia or of gland- ular syphilis or tuberculosis, but that at least two were genuine instances of the affection to which Wilks,2 in 1856, gave the name of Hodgkin's disease and for which, in recent years, a definite histology has been established.Since the appearance of Wilks's paper in England, and a communication by Bonfils in France in the same year, many contribu- tions have been made to the literature of the subject, and undoubtedly several different lesions have been described under the title of ``Hodgkin's disease"; among them leukemia, non-caseous glandular tubercu- losis, lymphosarcoma and pseudoleukemia.Despite the confusion occa- sioned by lack of knowledge of the pathologic histology of Hodgkin's disease, the older observers came to recognize two types, and to regard them as different varieties of the same lesion=m- and characterized by great cellular richness, the other firm and tending to become scle- rotic.Indeed, in the latter type, giant cells were observed by Virchow in 1861 and by Langhans in 1872.Perhaps the first important step in the elucidation of a problem which is still beset by many difficulties was accomplished by Virchow when he established the independence of leukemia.Shortly thereafter a further advance was made by Cohn- heim,3 who, under the title of pseudoleukemia,4 described a case which *From