268 



THE DISEASES OF THE HYPOPHYSIS 



chromophilic cells are sometimes very few, this would not militate against 

 the applicability of the above-mentioned postulate, 1 as in malignant tumor 

 there frequently sets in an anaplasia of the cells, as Fischer correctly points 

 out. Again cases of acromegaly have been described, in which the sec- 

 tions indeed disclosed tumors proceeding from the glandular part of the 

 hypophysis, which tumors, however, were cystically degenerated, and 

 showed but very little glandular tissue. Here it is indeed remarkable how 

 rapidly after extirpation of the part of the tumor, in the cases thus far operated 

 on, the manifestations of acromegaly ameliorate. These cases, however, 

 are fresh ones; in very old cases with acromegaly they perhaps would not 



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FIG. 50. Adenocarcinoma of the hypophysis made up, in great part, of eosinophilic cells. 



ameliorate so rapidly. Finally the cases with colloid struma of the hypo- 

 physis have been brought as evidence against the postulate, in that in 

 acromegaly such strumas may be found without proper adenomatous forma- 

 tion, and on the other hand there may be found typical strumas with small 

 adenomata without acromegaly. As example of the first type I mention 

 the case of Widal, Roy, and Froin. Here there existed typical acromegaly 

 in a sixty-six-year-old man, and atrophy and sclerosis of the gland substance 

 which was permeated with colloid cysts; in spite of the atrophy there could be 

 found rather numerous chromophilic cells. As example of the second type 

 I refer to the cases of Zack and Cagnetto. The case of Cagnetto was that of a 



1 z. e., that in every typical case of acromegaly the anterior lobe of the hypophysis shows 

 adenoma or adenocarcinoma. Editor. 



