LIPOMATA. 169 



intraorbital connective tissue. From this point of view the 

 lipomata may be regarded as overgrowths of the normal layers 

 of fat, excrescentiw memhrancu adiposce (^Morgagni) ; and if w^ 

 choose to regard these layers as a connected system of adipose 

 tissue, and not as a certain quantity of connective tissue infil- 

 trated with fatty matter, we may claim for lipomata, together 

 with polysarcia, the quality of hyperplastic tumours. For my 

 own part, I look upon polysarcia as a fatty infiltration of pre- 

 existing connective tissue, and on lipoma as a fatty infiltration of 

 a growth of independent origin and development. 



§ 134. The lipomata, like the papillomata, at first increase 

 slowly, their growth proceeding in an accelerating ratio. They 

 may attain a very considerable size. Tumours as large as a 

 man's head and larger, are by no means rare. Moreover their 

 central mode of growth involves their speedy emergence from 

 the surrounding soft parts, and their protrusion towards the 

 nearest free surface ; they push the skin before them, and finally 

 project above the surface as tuberous or polypoid excrescences. 



The greater the size of a lipoma, the greater the probability 

 that farther metamorphoses have taken place in its interior. We 

 not unfrequently find a chronic inflammatory overgrowth and 

 fibroid transformation of the interstitial connective tissue. In 

 consequence of this the clusters of fat- cells perish en masse ^ the 

 remaining lobules being separated by broad bands of fibroid 

 tissue (Fibroid Lipoma, Steatoma Midler t). Retrograde changes 

 are more commonly met with. Calcification of the fibrous 

 matrix of the clusters stands foremost among these. It results 

 in the formation of a spongy calcareous framework with exceed- 

 ingly fine meshes, which permeates the entire tumour, or large 

 sections of it, making it very hard and heavy. Yet more remark- 

 able is the mucous transformation of the tissues of a lipoma, 

 and the consequent possibility of a fatty tumour being converted 

 into a myxoma. In persons who arc much emaciated, who have 

 been exhausted by lingering disease, we often find the adipose 

 tissue about the heart deprived of its fat, and in a peculiarly 

 swollen and oedematous state, which, on minuter examination, 

 proves to be due to mucous infiltration. Precisely the same 

 phenomenon is met with in lipomata, and especially in the larger, 

 pedunculated lipomata of the skin. The tumour acquires a 

 transparent and colourless aspect; it becomes tremulous and 



