The pathogenesis of secondary tumors / by Henry Wile.

  • Wile, Henry
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: The pathogenesis of secondary tumors / by Henry Wile. 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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    tory change, the adventitia being thickened and filled with proliferating cells; the me- dia appears normal, while the intima of the vessel shows distinct thickening, also due to proliferation of its cells. In the lumen is seen the periosteum folded up and twisted, and in the interspaces formed by the folds of the periosteum and the walls of the blood-vessels are seen masses of an organ- izing blood-clot, which in some places are beginning to be absorbed. This organ- izing blood-clot evidently serves as a ma- trix for the embolus, the latter being de- pendent temporarily to a great extent upon the clot for its nourishment. The clot is always in direct communication with the intima, and is in turn nourished by the vasa vasorum of the mother vessel. Only in rare instances is the periosteum seen in contact with, and deriving its nourishment directly from, the vasa vasorum. At this place the intercommunication of blood-vessels between the embolus and'the wall of the blood-vessel is distinctly seen. The outer layer of the lamella of perios- teum, as seen in transverse section, is un- changed. The inner layer shows the begin- ning of ossification analogous to that seen in foetal intermembranous bone-formation. At this stage the inner periosteal layer is seen transformed into hyaline glassy cells, very imperfectly stained, and resembling most perfectly the tissue of callus which is produced during the process of healing of bones. This I will call osteoid tissue, designated by authors as the osteogenetic layer. It extends as a uniform belt par- allel to and bordering the outer layer of the periosteum. The inmost layer of this osteoid belt is made up of large cells, which in some places are seen distinctly to have undergone calcification. Some preparations made from experi- ments of the same duration show a some- what further development of the changes above detailed. Preparations from another of these fourteen days’ experiments present the following appearances. The belt of osteoid tissue presents a still more glassy appearance. The outlines of the cells are less distinct, and still did not take carmine staining. The lowest layer of cells has in places unevenly proliferated, forming larger and smaller heaps of cells of osteoid tissue, with distinct calcification ; but in the main it continues as a belt, and twists in a curved manner, describing an imperfect ellipse. Next to the osteoid tissue is seen a layer of cells of embryonic character, many of which are distinctly giant-cells, and this layer also is calcified in some portions. Attached to this layer is a third belt of tissue of very uniform width, and composed of large elongated rod-like cells or plates of uniform size, and arranged nearly parallel with one another, their long axes being per- pendicular to the other two layers, so that it presents an appearance similar to that of a lining made up of large columnar cells. This layer and the cells composing it cor- respond precisely, and have the appearance of what are described as osteoblasts. Within this last belt is a long, narrow space, which is filled with lymphoid cells, osteoclasts, etc., forming the elements of marrow of bone. This collection of cells is freely pierced by blood-vessels. Outside of this ossifying ellipse is seen the organizing clot upon which the em- bolus depends for some nourishment. But much of this clot is absorbed, yet enough is left to form a capsular fibrinous mass, being attached on the outside to the intima of the blood-vessel. It will be noticed that true, fully-devel- oped bone is not seen at this stage. Fig. 6. Transverse section of a pulmonary arteriole partly filled with organized blood-clot, enclosing a periosteal embolus, which shows the process of ossification, somewhat diagrammatic. (Drawing reduced to one-third.) a. Thickened intima (the other coats of the vessel-wall are not represented), b. Clot containing the embolus, c. Osteoid tissue, d. Layer of co- lumnar osteoblasts, e. Marrow-cavity filled with young cells. In experiments of nineteen days’ dura- tion the formation of true adult bone is beginning to become prominent. A la- mella of bone substitutes the belt of osteo- blasts described above, and the interior of the ossifying embolus is largely composed
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