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F. S. BILLINGS. 
as well as in the reticulum, granular protoplasmic cells, about of 
hepatic cells 01 epithelial cells, which we find on the mucous membrane 
of the mouth. The cells contain 2-3 nuclei!, 0.003-0.006 m.m., and 
from 2-5 nucleoli. 
The blood and lymph vessels which we find throughout the normal 
interstitial tissue, are in many places obliterated, and the final ramifica¬ 
tions of the blood vessels often appear as continuous lines of spindle- 
formed cells. 
The patho-anatomical changes in the alveoloe and the excretory 
ducts depoit themselves as follows: The single lobules are contracted, 
and far more distant from one another than in the normal condition ; 
the alveoloe are distended cyst-like, through the obliteration of their ex¬ 
cretory ducts, partly atrophied, partly obliterated in such a manner that 
m their place rows of spindle-formed cells were to be perceived, which 
showed their origin through their connection with the membrana propria 
of the excretory ducts. 
These phenomena find explanation in the hyperplasia which has 
taken place upon the interlobular and interalveolar connective tissue, as 
well as in the great number of neoplastic nodules. In the partly ob¬ 
literated, partly varicose distended excretory ducts, we notice a strata of 
cylindrical epithelium, under which may be seen one or more strata of 
germinal epithelium in a strata of proliferation; further, thick fibers of 
connective tissue, which stand in connection with the surrounding con¬ 
nective tissue and the membrana propria. 
In this case we observe numerous nodules in the interstitial tissue 
of the mammary gland, which occasion through their development either 
distention or contraction of the alveoloe and excretory ducts. 
We look upon these nodules as connective tissue neoplasms for the 
following reasons : Their matrix is connective tissue, which indicates 
the piogiessive development of the neoplasm, and surrounding the ele¬ 
ments one finds extra-cellular products. In respect to the reticulum 
(which has already been described), of these neoplasms, together with 
the round elements and extra-cellular products found in it, I believe 
myself justified to consider these neoplasms as lymphosarcoma. 
It remains yet to be mentioned, that the giant cells found in these 
neoplasms, which is already known to many, are essential elements of 
the nodule. According to Virchow,'* giant cells form a constituent of 
' f 1S due t0 Virchow that we no longer look upon all caseous products as tubercles. Through 
his researches the comprehension of tubercle is sharply defined. He considers tubercle to be a 
group of lymphomatose growths of an unstable character, whilst he describes lymphosarcoma as 
well as perlknoten (nodule), as neoplasms, possessing a more permanent character. 
