Status Thymico-lymphaticus: Acute Edema of Lungs

Abstract

Reading the June, 1930, issue of Radiology (page 605), I was much interested in H. P. Doub's editorial entitled “The Problem of Enlarged Thymus.” Because of the wide diversity of opinion relative to thymic symptoms and studies of that gland, the following report may be of interest. The case came under my observation in November, 1928, while I was Director of the X-ray Department of the United Hospital, Port Chester, New York. The patient was a supposedly normal child four months of age, without a history of previous illness. While his mother was out of the room, in another part of the house, he was left in his crib alone, any abnormal condition being unsuspected. Upon his mother's return she found him cyanotic and practically moribund. Dr. R. A. Higgons, of Port Chester, was called immediately, but by the time he arrived the child was dead. The supposition is that the child became frightened because of his mother's absence from the room. The following is the autopsy report made by Dr. Margaret Loder, pathologist of the United Hospital, Port Chester, New York: “Body is that of a male child, normally developed, particularly large and fat for the age (four months). Testicles descended normally. A few small glands are palpable in the left inguinal region, and one fairly large gland in the right cervical region (anterior). Ear drums appear normal. Frothy material is oozing from both nostrils. “Chest.—Thymus gland is enormously hypertrophied, measuring 80 × 70 × 30 mm. and weighing 50 grams. Central portions of both lateral lobes show some liquefaction necrosis. Gland covers the aorta, trachea, and bronchi, and comes clown well over the pericardium. Both lungs show marked edema throughout. The same material that was seen coming from the nostrils oozes from the larger bronchi. There is no obstruction in the bronchi, trachea, or posterior pharynx. Thoracic nodes are not enlarged. Heart appears normal; chambers are empty. “Abdomen.—Lymph nodes are enlarged throughout the mesentery, which enlargement appears to be due to a simple hyperplasia, and there is apparently no necrosis of these glands. Other organs appear normal. “Extremities and genitalia.—Normal. “Diagnosis. — Status thymico-lymphaticus: acute edema of lungs.” In my paper entitled “Studies of the Thymus, with Roentgen Findings” (Am. Jour. Roentgenol. and Rad. Ther., March, 1929, XXI, 256), I reported the death of a child four years of age who died suddenly in primary anesthesia. The autopsy findings were as follows: status lymphaticus, the thymus gland weighing 35 grams. No previous X-ray examination of this patient's chest had been made. There is every reason to believe that many cases of sudden death occur in which autopsy findings are not obtained.