Surgery, a practical treatise with special reference to treatment / by C.W. Mansell Moullin ; assisted by various writers on special subjects.

Mansell-Moullin, C. W. (Charles William), 1851-1940

Date:: 1893

Credit: Surgery, a practical treatise with special reference to treatment / by C.W. Mansell Moullin ; assisted by various writers on special subjects. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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$CHAPTER V. Tumors. By Frederick S. Eve, F.R.C.S. [Tumors may be divided into two general classes, neoplasvis and cysts, but many pathologists only admit the neoplasms.] Cysts or Cystomata.—A cyst may be broadly defined as a cavity with well- defined walls and fluid contents. The walls are composed of connective tissue and are usually lined with epi- or endo-thelium. A cyst may be single or simple. Many cysts may be grouped together to form a conglomerate cystic tumor, or a cystic tumor may be miilti-lociilar. The latter term is applied when the mass is broken up into numerous cavities or loculi by partitions, and this condition is produced either by fusion of adjoining cysts or by the growth of secondary cysts within the walls of the primary cavities, as in ovarian tumors. The secondary cysts either project externally (exogenous cysts) or internally (endogenous). A cyst is said to be proliferous when a growth or vegetation springs from its walls into its cavity. Cysts have commonly been classified according to the nature of their con- tents, as : sebaceous, mucous, serous, mucoid, and colloid. A primary classification, according to their source, seems preferable, as fol- lows :— I. Cysts arising in normal structures. II. Cysts arising in persistent foetal rudiments and misplaced foetal structures (congenital cysts). III. Cysts formed within or of the nature of tumor formations. I. CYSTS ARISING IN NORMAL STRUCTURES. The first class, which comprises the larger number, maybe further subdivided, on an anatomical basis, thus :— {a) Cysts formed by distention of serous sacs and synovial membranes, or of diverticula from the .same; and by distention of connective-tissue interspaces (exudation cysts), /. e., hydrocele, ganglion, and adventitious bursse. {b) By distention of mucous membrane canals, /. e., hydro-salpinx, dilatation of vermiform appendix, etc. {/) By dilatation of ducts and glands (retention cysts), /. e., sebaceous cysts, ranula, spermatocele, and most of the cysts of the breast. (//) By distention of normally-closed follicles in glands, i. <?., Graafian follicle cysts and some cysts of the thyroid gland. (^) By dilatation and cutting off of portions of blood and lymphatic vessels. (/) By encapsulation of extravasations of blood, foreign bodies, and parasites, /'. €., arachnoid cysts, hsematomata, hydatids, etc. {a) The application of the term cyst to many cavities abnormally di.stended with fluid is purely arbitrary and founded on custom. Thus, among the first divi- sion, hydroceles are not usually described as cy.sts, although they are technically quite as much so as a dilated bursa patellae. Among other examples of this class is the common ganglion, which is formed by distention of diverticula from the tendons of the dorsum of the hand and foot. Adventitious bursae result from sepa- ration of connective-tissue bundles by exudation, the cavity becoming lined with endothelium. (/;) Hydro-salpinx or distention of the Fallopian tubes by fluid, and disten-$