MYELOPATHIC I'liDTI-:! WRI A 525 



It will be at once observed that the two typical hypcrnoi)hromas, Xos. 1 and 2, 

 show a marked resemblance to the normal adrenal in the proportion of fat and 

 lipoids. (The lower figure for lecithin in No. 1 probably is due to the fact that 

 this specimen had been preserved lon<;er than the others.) This was what was 

 to be expected from the microscojjic resemblance of these tumors to adrenal 

 tissue, and corroborates the results of Gatti's and Beebe's observations on iso- 

 lated cases. More surjirisinf"; is the fact that equally comparable results were 

 obtained in the hypernephroma (No. 3), which contained only cells free from 

 vacuolization and not at all resembling adrenal cells. From this it may be 

 concluded that in these tumors of adrenal origin the amount of fats and lipoids 

 present cannot be estimated from the degree of cytoplasmic vacuolization of the 

 cells, or the extent of necrosis; the fatty materials are an integral part of the cells, 

 present in them as an essential constituent and not as the result of degeneration. 



The results of analysis of two carcinomas and a sarcoma indicate that the 

 hypernephromas are peculiar in their close resemblance to adrenal tissue in respect 

 to fat and to lipoid content. The amount of all these constituents in these three 

 tumors is far below that found in the hypernephromas, although in the carcinoma 

 of the breast the amount of simple fats is relatively large, as might be expected 

 in view of the function of the cells from which it arose. It is interesting to note 

 that a carcinoma of the gall-bladder shows a rather high proportion of its fatty 

 material as cholesterol, for this observation may bear a relation to the well-known 

 tendency of the ei)ithclium of the gall-bladder to form cholesterol. The large 

 proportion of lecithin in the sarcoma of the liver may possibly be due to the in- 

 fluence of the soil upon which the tumor was growing, but we need more informa- 

 tion concerning the lipoid content of other malignant tumors arising in different 

 sites. 



Renal hypernephromas reproducing the adrenal cortex in struc- 

 ture do not contain epinephrine,^^ but tumors of the adrenal arising 

 in the medulla may do so.^* Microscopically, hypernephromas con- 

 tain much glycogen. The special tests for hypernephroma tissue 

 recommended by Croftan seem not to be specific. ^^ 



Melanotic tumors produce melanin, which seems not to differ 

 at all from the melanin found in normal pigmented structures. Hel- 

 man-° found as high as 7.3 per cent, by weight of melanin in melano- 

 sarcomas. (See also Melanin, p. 474, and Enzymes in Tumors, p. 505. 

 Concerning Chloromas-^ see p. 480.) 



Multiple Myelomas and Myelopathic "Albumosuria" 



Multiple mijelom.as are of particular chemical interest, because of 

 the appearance in the urine in such cases of the peculiar protein first 

 described as an albumose by Bence-Jones,^^ and now, because of lack 

 of grounds for its definite classification, generally known as the 

 '^ Bence-Jones body" or " Bence-Jones protein." Because of the ex- 

 tensive bone destruction there is also an excessive excretion of cal- 

 cium,-^ and sometimes metastatic calcification may occur. ^^ This 



1^ Greer and Wells, Arch. Int. Med., 1909 (4), 291; Brooks, Jour. Exp. Med., 

 1911 (14), 550; Ciaccio, Deut. Zeit. f. Chir., 1910 (104), 277. 



18 Wegehn, Verb. Deut. Path. Ges., 1911 (15), 255. 



19 Koerber, Yirch. Arch., 1908 (192), 356. 



20 Arch, internat. Pharmacodyn., 1903 (12), 271. 



2' Metabolism in chloroma does not differ from leukemia (Sakaguchi, INlitt. 

 Med. Fak., Tokio, 1914 (13), 198). 



22 For Hterature, see Rosenbloom, Biochem. Bulletin, 1911 (1), 161; Vance, 

 Amer. Jour. Med. Sci., 1916 (152), 693. 



23 Blatherwick, Amer. Jour. Med. Sci., 1916 (151), 432. 



24 Tschistowitsch and Kolessnikoff, Virchow's Archiv.. 1909 (197), 112. 



