Page:A Handbook of the Theory and Practice of Medicine - Volume I - Frederick T. Roberts.djvu/307

CANCER.

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2. Eneephaloid, modiillai'y, or soft cancer. Assuming' the form of tumours, or being- infiltrated, eneephaloid increases with great rapidity, forming considerable masses, which are more or less lobulated. The substance is soft and brain-like, and on section presents a pulpy appearance, especially towards the centre of a growth, varying in colour from white to crimson according to its degree of vascularity, and not uncommonly presenting small ex- travasations of blood. A large quantity of juice can be expressed. This form of cancer may produce very vascular fungous growths, being then termed fungus hcematodes. All grades are met with be- tween the eneephaloid and scirrhus forms of carcinoma.

3. Colloid, alveolar, or gelatiniform cancer. Many regard this variety of malignant growth as merely one of the other forms which has undergone colloid degeneration. It generally infiltrates tissues, but sometimes forms lobulated masses, which have a tolerably firm and uniform consistence. On section roundish spaces or alveoli are seen, having fibrous walls enclosing the colloid substance, w-hich is of more or less glue-like consistence, glistening and translucent in appearance, and either colourless or greyish-yellow.

4. Epithelioma, epithelial cancer, or cancroid. Generally observed in connection with the skin or a mucous membrane, epithelioma commences either as a hard nodule, or as a small excoriation or ulcer. The latter has indurated edg-es, with an irregular, grey or bloody surface, which is often papillated and villous, or nodulated. The consistence is generally firm, but may be soft and friable. The cut surface is greyish-white, or presents numerous opaque specks and white lines of fibrous tissue; a small quantity of milky granular fluid can be expressed, which will not mix with water.

Other varieties of cancer which have been described are named melanotic, which contains much pigment, the growth being most commonly of an eneephaloid character; cystic, where cysts are developed; chondtoid or cartilaginous; osteoid ox hony ; and villous, which affects mucous surfaces, presenting villous processes.

General and microscopic structure. All the forms of cancer con- sist of cells, enclosed in the meshes of a fihroics stroma, these elements differing greatly in their relative proportions in the different varie- ties. The ceils are of large but very variable size ; present di- verse and curious forms; and contain one or more nuclei, as well as usually a number of fat molecules. Each nucleus is large, clear, and well-defined; eccentric; round or oval in shape; and it encloses one or more nucleoli. Abundant free nuclei are often present. The expressed juice

Fig. 12

C;«'ls from a mammary cancer, magnified 300 diameters. (After Billroth).

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