520 THE CHEMISTRY OF TUMORS 



Proliferating cystomas contain the peculiar characteristic mucoid 

 proteins mentioned above. Usually the contents are fluid, but of a 

 pecuhar slimy, stringy character, due to the mucoid substance, and 

 often opalescent or slightly turbid. The specific gravity is generally 

 high — 1.015-1.030. The reaction is usually slightly alkaline to lit- 

 mus, and neutral or slightly acid to phenolphthalein. If hemorrhage 

 has occurred into them, the fluid is discolored, and may contain blood- 

 pigments in crystalhne and amorphous forms. Small cysts often 

 show a condensation of the proteins into a semisolid "colloid" ma- 

 terial, but sometimes their contents resemble those of a serous cj^st. 

 Often masses of proteins fall out of solution, forming yellowish floc- 

 culi or large deposits half filling the cysts. As with all stagnant 

 fluids of this type, cholesterol crystals are frequently found. The char- 

 acteristic proteins are members of the class of pseudomucins, wliich 

 are constantly present (Oerum). 



Intraligamentary papillary cysts contain a j^ellow, yellowish-green, 

 or brownish-green liquid, which contains little or no pseudomucin; 

 the specific gravity is usually high (1.0.32-1.036) and the fluid con- 

 tains 9 to 10 per cent, of solids. The principal constituents are the 

 simple proteins of blood serum (Hammarsten). 



According to the same author, the rare tubo-ovarian cysts contain a 

 watery serous fluid with no pseudomucin. 



Chemistry of the Mucoids of Ovarian Cysts. — Pseudomucin has the following 

 elementary composition: C, 49.75; H, 6.98; N, 10.28; S, 1.25; O, 31.74 per cent. 

 (Hammarsten). In common with the true mucins it yields a sugar-like reducing 

 body, which has been investigated by numerous chemists (Miiller, Panzer, Zan- 

 gerle, Leathes, Neuberg, and Heymann*'). Panzer considers that this reducing 

 substance is in the form of a sulphuric-acid compound, similar to, but not identical 

 with, chondroitin-sulphuric acid. Hammarsten, however, did not find this 

 substance constantly present. Leathes determined for the carbohydrate group 

 the composition C12H23NO10, named it " paramucosin," and considers it a reduced 

 chondrosin (which is the carbohydrate group of chondroitin-sulphuric acid). 

 Neuberg and Heymann established, however, that the reducing body must come 

 from chitosamin (CeHuNOs), and do not consider paramucosin a constant con- 

 stituent of ovarian mucoids. The amount of reducing substance varies greatly 

 in the mucoids found in different cysts; in some the mucoid yields but about 

 3 to 5 per cent., in others as much as 30 to 35 per cent., of reducing substance. 



Pseudomucin dissolves readily in weak alkalies, and differs from true mucin 

 in that it is not precipitated by acetic acid, and from the simple proteins in that 

 its solutions are not coagulated by boiling. With water a slinn', stringy, semi- 

 solution is formed, resembling in appearance the material found in ovarian cysts. 

 Leathes distinguishes two forms of ovarian mucoids: One, paramucin, occurs as 

 a firm, jelly-like substance, which is converted by peptic digestion into easily 

 soluble pseudomucin. Ovarian "coZ/oz'd" probably consists of a thickened pseudo- 

 mucin, often mixed with other proteins. Pfannenstiel*- considers the "colloid" 

 material as representing a modified pseudomucin, strongly alkaline and relatively 

 insoluble, which he calls " pseudo-mucin /i." He also describes a very soluble 

 mucoid found only in certain ovarian cysts, naming it " pseudo-jriucin y." 



The reason why these variations in the pseudomucins exist is not understood; 

 they cannot be explained as due to variations in tiie cell type in the ej'st wall, 

 although pseudomucin is probably the result of true secretion. The smallest 

 cavities of ovarian cystadenomas contain nearly pure pseudomucin, which presents 



•3 Hofmeister's Beitr., 1902 (2), 201 (literature) 



