THE REPRODUCTIVE ORGANS OF THE FEMALE. 697 



material filling these cysts is sometimes called colloid, and the cysts are 

 frequently called colloid cysts. 



Numerous secondary changes are liable to occur in these cysts. The 

 cells may peel off, the walls of the cysts atrophy or become calcified. 

 Suppurative inflammation, perforation into the peritoneum, bladder, 

 vagina, or rectum; haemorrhage, gangrene, etc., may occur. As a re- 

 sult of chronic productive processes, the cyst walls may become thick- 

 ened and extensive adhesions may form. Carcinoma may develop from 

 these tumors. 



Papillary Cystadenoma. This type of cystadeuoma was formerly re- 

 garded as but a variety of the form above described a variety charac- 

 terized by papillary outgrowths in cauliflower-like tufts from the w r alls 

 of the cysts, which often in large degree fill the cyst spaces (Fig. 452). 



FIG. 453. MULTIPLE PAPILLARY CYSTS OF THE OMENTUM, SECONDARY TO A SIMILAR GROWTH IN THE 



OVARY. 



The papillary outgrowths are themselves becoming softened at their centres, forming accessory cysts. 



There appears, however, to be sufficient evidence, both anatomical and 

 clinical, to justify the separation of the papillary from the glandular 

 form of cystadenoma. 



The papillary cystadenomata are not, as a rale, as large as the gland- 

 ular form. The cysts are fewer and they do not contain colloid material. 

 The papillary outgrowths often break through the cyst walls, and may 

 be transplanted to the peritoneal or other surfaces in the form of multiple 

 cystic or papillary tumors (Fig. 453). The papillse and cyst walls may 

 be lined by cylindrical and often by ciliated epithelium. 1 



Follicular Cysts of the Ovary. The Graafian follicles may be dilated so 

 as to form cysts. This may occur in one or both ovaries, and the cysts 

 may be small or large, single or multiple (Fig. 454). They are usually 

 found after middle life, but may occur during youth, childhood, or 



"' For reference to bibliography of these ovarian cysts see Russell, Johns Hopkins 

 Hosp. Bulletin, vol. x., p. 10, 1899. 



