The pathology, affinities, and treatment of so-called bleeding polypus (discrete angeioma) of the septum / by L. Hemington Pegler.

  • Pegler, Louis Hemington, 1852-
Date:
[1905]
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Licence: In copyright

Credit: The pathology, affinities, and treatment of so-called bleeding polypus (discrete angeioma) of the septum / by L. Hemington Pegler. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    appearance, vascularity, seat, rate of development, deformity, and indirect involvement of the glands, an inclination was shown to regard the growth as sarcomatous. As, however already indicated, there were no sarcomatous cells and the growth was an atypical granulomatous bleeding polypus. When sarcomatous tissue has been reported in a case fall- ing under the general description of bleeding polypus of the septum, the statement has in my belief been too often accepted by subsequent writers and tabulators without sufficient allowance for the possibility of a misinterpretation of the microscopical appearances. Even in the case of far more equivocal tissue structure than bleeding polypus, say of the soft fibromas, the cautious pathologist knows that good clinical evidence is often invaluable, his diagnosis being in such a case partly dependent on clinical observation. On these and other grounds I feel justified in asserting that no septal growth having the naked-eve characters of bleeding polypus or discrete septal angeioma has been satisfactorily demonstrated to be sarcomatous. I am, however, not in want of support in making this declaration. Langerhaus (6), in his report upon Schadewaldt’s cases, thus concludes: “The absence of all cells which might direct suspicion to sarcoma proves that it is a non-malignant new formation,” and this embodies the views of Schadewaldt who quotes it. Other writers might be cited to the same effect, as, e.g., Walliczek (24), who writes: “In spite of the manifold combinations that occur between the three types these tumours are always benign.” 1G Heymann (18a) says many of the pedunculated tumours of the septum described as myxosarcoma belong to bleeding polypus and stand much nearer to granulation tumours than to genuine sarcoma. Yet in opposition to these very definite statements there are certain reports upon individual cases which have considerably influenced subsequent writers ; the following may be quoted as examples. Baumgarten17 re- ported a case as partly myxoma, partly myxosarcoma; Polynack18 reported a case of angeio-sarcoma displaying large and small blood spaces, the intermediate substance showing characteristic sarcoma formation; Dausac found in one specimen sarcoma teleangiectoides and in another endothelial angeio-sarcoma ; and Sendziak recorded a case of angeioma cavernosum sarcomatodes. Roth (24) states that his case agrees most with what Paltauf designates as angeio-sarcoma, but the latter seems to be an unhappily chosen term denoting only an atypical angeioma, its application not being obvious. Nevertheless, Roth in his recent paper concludes from the above reports (which he quotes) “that amongst the published cases of 16 Monatschrift fiir Ohrenlieilkunde, 1897. ir Sitzungberichte her Gesellschaft tier Ungarischen Ohrenarzte, 18 Ibid., June, 1902. March, 1898.
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