CASE HISTORY

Patient was admitted to hospital as a case of idiopathic hypochromic anaemia. Blood count on admission RBC 3,000,000, Hb 30%, WBC 10,000, 53% polynuclear. Mean corpuscular volume 57cu.μ. Reticulocytes 2.3%. She was given a generous diet and the anaemia improved. She was then given iron with a very marked improvement in the anaemia. whilst in hospital she developed persistent diarrhoea with urgency of defaecation, due to an old straining prolapse associated with a patulous anus. This persisted in spite of repeated changes in the form of administration of iron. The faeces were examined for occult blood, but none was found. The blood condition cleared up satisfactorily, the last count being RBC 5,500,000, Hb 72%, WBC 16,000, 83% polymorphs, though in spite of this, a high reticulocyte count persisted. her general condition became poor, patient looked ill and showing cyanosis and signs of dehydration. In spite of this she insisted on going home against advice. Readmitted 27.10.36 very much worse. Conscious, cold and badly dehydrated. Pulse slow, face cyanosed. On admission continuous intravenous glucose saline drip started. In spite of  this patient gradually got worse and died. Blood count on readmission RBC 6,000,000, Hb 80%, WBC 68,000 with 94% polynuclear. A number of the latter were young band forms.

HPATHOLOGY

The specimen consists of the last foot of the large intestine together with the anus.  Throughout the whole length of the specimen the mucosa is covered with numerous pedunculated polypoid tumours. These vary from pin-head size up to large tumours several centimeters across. the latter are limited to the lower part of the specimen. At autopsy the remainder of the large intestine showed a condition of polyposis similar to that seen at the upper end of the specimen. There is no evidence of malignant disease at any point.