Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

    102/902 page 86
    II. EriBLASTIC AND IlYrOIiLASTIC TUMOUE.S. Tumours of the type of epil](eliul iiasucs [Carcinoma). Caroinojiata, or C'.vncers, are malignant growtlis consisting of epithelial-like cells contained in an alveolar stroma. The individual cells are not siuToundod by any intercolkilar substance as in the sarcomata, and the vessels run in the stroma, and not among the cells. Tliey are derived from pre-existing epithelium, and are hence spoken of as tumours of epiblastic or hypol)lastic origin. The epithelium is believed to proliferate and break through the wall of an acinus or duct, or the basement membrane of the skin or mucous membrane, and invade the siui'oundiiTg or underlying connective tissue, where it is supjiosed to enter the l;smiphatic spaces, and thence, sooner or latei, pass into the lymphatic vessels, and so, finally become disseminated. The cells in carcinoma, though varying in their character, retain tlie type of the epithelium from which they spring. Thus, they are more or less squamous when derived from the skin, sipiamous or columnar when derived from a mucous memlirane, spheroidal when derived from a gland. The alveoli in which the cells are contained are by many regarded as the lymphatic spaces natural to the affected tis.sue dilated hj the invading epithelium. Thej comnuiuicate with one another, forming a kind of cavernous tissue tlirnughout the growth. The stroma surrormding the alveolar spaces at first consists of the connective or other tissue of the invaded ]iarts, infiltrated more or less with small round cells. Tliis small-cell infiltration is nscrib(Ml to the irrita- tion of the epithelial invasion, and from it is believed to be later derived the fibrous tissue constituting the dense stroma, of some foi'nis of carcinoma. The blood-vessels, which run in the stroma, are nume- rous in the more rapidly-growing tumours, nnd_(>si)ecially in the rircinii reveutial parts, but are much fewi'r in number in tlie more chronic forms, and in the ceiilral ]>arls ef the lattei' y bo oldilerated by the growtli of the fibrous tissu<'. Hence the rre(|uency with Avhich fatty degeneration of the ci'lls, and breaking down {iilcrrdiion) o\' older ]ia_rts of the tniiioiir neeur. In tlie softer or rajjidly-growing forms, in which the stroma, is scanty and the supjiort that the vessels receivi^ from it consequently but slight.
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