550 TUMORS. 



peculiar star-shaped formations with a central nucleus-like body, from which 

 a number of spokes were seen to emanate. These spokes, after traversing 

 the alveolus, blended with its wall. The largest of the alveoli showed only 

 traces of delicate branching fibrillse, the main substance consisting, as in 

 colloid cancer, of the so-called colloid mass. 



Cystic cancer can easily be recognized by the naked eye. The tumor 

 shows a number of sacs, the size of a pin's head to that of a walnut, hold- 

 ing a sero-albuminous fluid. Under the microscope, epithelial nests were 

 found only at the periphery of the tumor. The cysts consisted of a wall 

 of connective tissue, and in the serous liquid contained in their cavities only 

 a few plastids were found. 



Vertical sections obtained from the thickened wall of the stomach affected 

 with cancer showed that the process of development had started from the 

 submucous and muscle layers. A number of epithelial nests, bounded by 

 smooth muscle-fibers, were found toward the periphery of the invading 

 growth. In the neighborhood of epithelial formations the connective tissue 

 had lost its fibrous structure and was transformed into finely granular 

 bioplasson, within which large, shining, yellowish lumps were irregularly 

 scattered. The bioplasson stage having thus been reestablished, the change 

 in the next consisted of an increase in size of the intersecting points of the 

 living reticulum; these were transformed into medullary corpuscles, and, 

 after having reached a certain size, became polyhedral by flattening each 

 other, and in this manner were transformed into epithelia. The same char- 

 acteristic changes took place in the smooth muscle-fibers. They were first 

 transformed into rows of small, shining lumps of living matter, and passed 

 by different stages of transition into epithelia. Groups of such epithelia 

 were surrounded by newly formed connective tissue, the framework of the 

 cancer. 



In sections from the central portion of the tumor all the stages leading to 

 a complete transformation into colloid cancer could be traced. Within the 

 alveoli, bounded by newly formed connective tissue, a varying number of small 

 medullary elements and a limited number of epithelia were observed; the 

 remaining space was filled with a hyaline, apparently structureless, substance. 

 Many of the alveoli were entirely devoid both of medullary elements and epi- 

 thelia, holding only a homogeneous substance with remnants of living matter. 

 Irregular clusters of epithelia could be seen here and there still attached to 

 the cancer frame. Some of the connective-tissue bundles were in part coarsely 

 granular and in part transformed into medullary corpuscles, giving rise to a 

 myxomatous basis-substance. (See Fig. 228.) 



In the most advanced stages of colloid change the field was traversed by a 

 coarse, irregular reticulum of connective tissue, within which, besides a homo- 

 geneous substance, a more delicate fibrous net- work with remnants of epi- 

 thelia were observed. Epithelia from these portions of the tumor, more 

 especially when but one was present in an alveolus, had lost their polyhedral 

 outlines, increased in size, as if by swelling, and had a globular or oblong shape. 

 Some of them had increased three times their natural size, and presented 

 the appearances of pale, dropsical, partly nucleated bodies. 



In specimens obtained from the colloid cancer of the large intestine it was 

 shown that the change had very uniformly invaded the entire tumor. Here 

 large alveoli, separated by coarse bundles of connective tissue, could be seen, 

 holding a very delicate fibrous reticulum, with isolated clusters of epithelia. 



