THE REPRODUCTIVE ORGANS OF THE FEMALE. 



683 



eral infiltration of a whitish new growth. The cervix then appears large 

 and hard. Very soon the mucous membrane over the new growth de- 

 generates and falls off ; the superficial layers of the new growth undergo 

 the same changes. After this the formation of the new growth and its 

 ulceration go on simultaneously, producing first an infiltration and then 

 destruction of the cervix, and often of a part of the body of the uterus. 

 The growth frequently extends to the vagina, the bladder, and the rectum 

 with the same destructive character, so that we often find the cervix and 

 upper part of the vagina destroyed, and in their place a large cavity with 



ragged, gangrenous, cancerous walls 

 (Fig. 437). Less frequently the 

 pelvic bones are invaded in the 

 same way. Xot infrequently the 

 ureters are surrounded and com- 

 pressed by the new growth, so that 

 they become dilated. The dilata- 

 tion may extend to the pelves and 

 calyces of the kidneys. The new 

 growth may begin in the cervix 

 and extend uniformly over the in- 

 ternal surface of the cervix and 

 of the body of the uterus. The 

 entire uterus is converted into a 

 large sac, of which the walls are 

 infiltrated with the new growth, 

 while the internal surface is ulcer- 

 ating and gangrenous. In some 

 cases there is a considerable for- 

 mation of new, dense connective 

 tissue, so that the growth has a 

 scirrhous form. 



In rare cases the growth begins 

 in the upper part of the cervix or 

 in the body of the uterus, while the 

 lower part of the cervix is not in- 

 volved. In all of these cases the 



epithelial cells of the new growth follow more or less closely the type of 

 the epithelial cells of the part from which they spring. But it has been 

 observed that carciuomata developing from the mucous membrane of an 

 inverted uterus may be of the squamous-celled type. 



In still another class of cases, in which the new growth may be in the 

 form of nodules, or diffuse infiltrations, or polypoid masses, or may pre- 

 sent more or less extensive alterations, the cells are irregular, polyhedral 

 in shape, the tumor belonging to the class of glandular or medullary 

 carcinomata (Fig. 438). These also usually commence in the cervix, 

 and, according to the views of many writers, probably in the mucous 

 glands. 



FIG. 437. CARCINOMA OF THE CERVIX UTERI. 

 The infiltrating and ulcerating type. 



