Annual report of the Henry Phipps Institute for the study, treatment, and prevention of tuberculosis . of small white fibrinous nodules (especially on the mesialinferior surface). The ependyma is smooth and thickened. The spinalcord is negative. There are no well-developed meningeal tubercles other thanthose above noted. Microscopic examination: The areas over the base of the frontal lobeare caused by a localized thickening or induration of the pia. Under themicroscope it is a diffuse process composed for the most part of thickly placedfibrils, but differing from chronic leptomeningitis in tha
Annual report of the Henry Phipps Institute for the study, treatment, and prevention of tuberculosis . of small white fibrinous nodules (especially on the mesialinferior surface). The ependyma is smooth and thickened. The spinalcord is negative. There are no well-developed meningeal tubercles other thanthose above noted. Microscopic examination: The areas over the base of the frontal lobeare caused by a localized thickening or induration of the pia. Under themicroscope it is a diffuse process composed for the most part of thickly placedfibrils, but differing from chronic leptomeningitis in that it is particularlyrich in cell nuclei. The nuclei are small and circular with relatively littlechromatin. A few large, pale nuclei are present. The surface is roughened,due to the irregular massing of the cells and closely placed fibrils. There isno evidence of active arterial congestion or other evidence of a recent acuteinflammatory process. The cortex is rarefied in the outer layers. There ismarked passive congestion in the medulla. The hematoxylin-eosin methodconfirms the above NEUROLOGICAL WORK. 241 The small tubercles on the mesial surface of the brain are composed of anaccumulation of round epithelioid cells in which there is a small nucleus with arelatively large amount of protoplasm. There is practically no other change,except the general thickening of the pia-arachnoid above referred to. Morpho-logically the above-mentioned cells appear to be of a developing type andinconsistent with retrogressive changes. There are no areas of increasedblood-supply and no other evidence of inflammation in the neighboringmeninges. I was at first inclined to look upon this as a healing or healedprocess, on account of the absence of inflammatory type of cell formation does not correspond, however, to thatseen in healing or healed processes. However, we must takeinto consideration that these cells are due to proliferation of theendothelioid cells in the pia
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