Medical and surgical report of the Presbyterian Hospital in the City of New York . a visible nodule at the marginof the kidney. Case III (1858),—Adrenal not detachable without rupture. Renalcapsule complete. Very similar to Case II, Case IV (4356),—Here the renal capsule is partially absorbed andthe adrenal indents the renal surface (Fig. i). It will be seen fromthe drawing that the kidney is in an advanced state of inflammation,much of the cortex being fibrosed. The condition was similar onboth sides. MALPOSITIONS OF ADRENAL TISSUE. 171 Case V (7465).—This case, of which only a small part is
Medical and surgical report of the Presbyterian Hospital in the City of New York . a visible nodule at the marginof the kidney. Case III (1858),—Adrenal not detachable without rupture. Renalcapsule complete. Very similar to Case II, Case IV (4356),—Here the renal capsule is partially absorbed andthe adrenal indents the renal surface (Fig. i). It will be seen fromthe drawing that the kidney is in an advanced state of inflammation,much of the cortex being fibrosed. The condition was similar onboth sides. MALPOSITIONS OF ADRENAL TISSUE. 171 Case V (7465).—This case, of which only a small part is shownin Fig. 2, is one in which a nodule of adrenal tissue (about one-sixthof an inch through) appears under the thick capsule of one (inflamed)kidney. The adrenal cells He in close apposition to the tufts and tubesof the kidney. Even with the highest power of the microscope nodividing line of connective tissue can be found. The columns ofadrenal cells penetrate the renal tissue in tortuous outlines, formingone of the most interesting of known examples of the cell-balance. Fig. I.—Adrenal adherent to and indenting surface of kidney, a, Dilated tuft; h, in-flamed and altered renal tissue ; c, partly absorbed capsule ; d, adrenal tissue. of different tissues lying in contact. The suprarenal tissue looksnormal. Comments.—Adrenal inclusions in the kidney were known alreadyto Rokitansky. The hterature of the subject is extensive, and it willbe needless to give more than a few references. Minute bits of in-cluded adrenal have been seen singly and in groups on and in the capsuleand in the cortex of one or both kidneys. M. Borst ^ and Beneke - haveobserved the renal cortex from one-third to all of its extent sprinkledwith adrenal dots. E. Schafer -^ mentions partial inclusions in theliver and kidney as not uncommon. E. Ziegler ?* says they are notvery infrequent. E. Neusscr • sums up the anatomical variations ofadrenal tissue as follows: Portions of the gland occur separate
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