An American text-book of surgery : for practitioners and students / By Phineas S. Conner, M.D., Frederic S. Dennis, M.D., William W. Keen, M.D., Charles B. Nancrede, M.D., Roswell Park, M.D., Lewis S. Pilcher, M.D., Nicholas Senn, M.D., Francis J. Shepherd, M.D., Lewis A. Stimson, M.D., J. Collins Warren, M.D., and J. William White, M.D. Ed. by William W. Keen and J. William White.
- William Williams Keen
- Date:
- 1899
Licence: Public Domain Mark
Credit: An American text-book of surgery : for practitioners and students / By Phineas S. Conner, M.D., Frederic S. Dennis, M.D., William W. Keen, M.D., Charles B. Nancrede, M.D., Roswell Park, M.D., Lewis S. Pilcher, M.D., Nicholas Senn, M.D., Francis J. Shepherd, M.D., Lewis A. Stimson, M.D., J. Collins Warren, M.D., and J. William White, M.D. Ed. by William W. Keen and J. William White. 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.
![into their suhstance, resulting in the formation of cysts (sarcomatous blood- cysts). Seats of Predilection.—They attack most freciucntly the ])enosteum, bone, lymphatic glands, subcutaneous tissue, testicle, eye, ovary, uterus, lungs, kidney's, and more rarely the skin, although they may originate wherever librous tissue exists. Sub-varieties. —('■0 The gliomn grows iVoin the connective tissue (neu- ron;lia) of nerve-centers, and its basis-suhstance resembles that structure; the ceUs are apt to be small. It occurs in the retina and brain. According to the latest investigations, as the neuroglia develops from the epiblast, gliomata can- not properly be considered sarcomata, but form a special group by themselves. {b) The li/mj)ho-sarcovia, growing in lymphatic glands, is composed of cells usually of large size, lying in a reticulum resembling lymphoid tissue, (c) The psananoma or nest-celled sarcoma is of rare occurrence, attacking only the pineal gland, (d) The alveolar sarcoma is so called because the basis-sub- stance encloses each cell in a separate space or alveolus, {e) In the melanotic sarcoma both the cells and the intercellular basis-substance are pigmented. Both the alveolar and the melanotic form may be of the spindle-celled variety. The melanotic form is found as a primary growth only in parts normally contain- ing pigment, as the skin and the choroid coat of the eye, becomes rapidly dis- seminated—the secondary growths being usually also pigmented—is probably the most malignant of the sarcomata, and by the older writers was called melanotic cancer or melanosis. Warts are sometimes pigmented, and thus look like this form of sarcoma, but warts are firm, often pedunculated or lobulated, and of slow growth: in rare instances pigmented warts undergo epitheliomatous change, when their rapid growth excites the suspicion that they are pigmented sarcomata, but in the epithelial growths the glands early become implicated. 2. The Spindle-celled Sarcomata are formed of cells varying much in size, some tumors being composed of very small oat-shaped cells, others of greatly elongated bodies with long, fine, tapering extremities. Often the cells are arranged in the form of trabecule, which so closely imitate fibrous bands that the tumor may be diagnosticated as a fibrous or even a muscular growth. The sub-varieties are the melanotic, pist mentioned, and the small-celled and large-celled. When portions of these tumors have undergone developmental chancres they are sometimes called chondro-sarcoma, osteo-sarcoma, etc. Seats of Predilection.—The skin and subcutaneous tissue, the fasciae and intermuscular septa, the periosteum and the interior of bones, the eye, the antrum, the breast, and the testicle. Sarcomata consisting of an admixture in varying proportions ot round and spindle cells, or of cells of many different forms and sizes, are sometimes called mixed-celled sarcomata. To'the naked eye they present the same cha- racteristics as the round- and spindle-celled forms, and they may undergo the same developmental and degenerative changes. Seats of Predilection.—Chiefly the bones. 3. The Myeloid or Giant-celled Sarcomata consist chiefly of large elements formed of masses of protoplasm, containing two or more nuclei—up to twenty, or even fifty—Avith a varying number of round, spindle, or mixed cells. They usually spring from the interior, cancellous tissue of bones, and vary in consistence from that of jelly to almost that of muscle. A section appears smooth, shining, succulent, but presents no appearance of fibrillation, and is of a greenish or of a livid red or maroon color, varied by pink or darker red](https://iiif.wellcomecollection.org/image/b21217014_0263.jp2/full/800%2C/0/default.jpg)
