THE DIGESTIVE SYSTEM. 543 



not well defined, and it is possible that some of them are sarcomata. 

 Sarcomata of the stomach may be round-celled or spindle-celled and 

 mixed forms occur myxosarcoma, angiosarcoma, etc. ' 



Adenoma. It has been already mentioned that in some of the papil- 

 lary tumors of the mucous membrane there is a considerable growth of 

 tubules lined with cylindrical epithelium (Fig. 314). Besides these we 

 find in the submucous coat circumscribed tumors composed of tubules 

 irregular in form and lined with one or more layers of cylindrical epithe- 



FIG. 316. CARCINOMA OF THE STOMACH. (Pyloric Region.) 

 A large globular tumor mass projects into the cavity. 



Hum, like those of the gastric mucous membrane. (See Adeno-carcinonia 

 below.) 



Carcinoma of the stomach is usually primary, but is occasionally sec- 

 ondary to cancer elsewhere. It is, of relatively common occurrence, the 

 stomach in Welch's analysis of over 30,000 cases being next to the uterus 

 the organ most frequently affected. 



The situation in Welch's summary of 1,300 cases 2 was: in thepyloric 

 region, 791; lesser curvature, 148; cardia, 104; posterior wall, 68; in- 

 volving a greater part of the stomach, 61 ; greater curvature, 34 ; anterior 



l See Dock, Trans. Assn. Am. Phys., vol. xv., p. 165, bibliography; also Fenwick, 

 Lancet, 1901, vol. i., p. 463, bibliography. 



* Welch, Pepper's "System of Practical Medicine," vol. ii., p. 561, 1885. 



