A practical guide for making post-mortem examinations : $b and for the study of morbid anatomy, with directions for embalming the dead, and for the preservation of specimens of morbid anatomyThomas, A. R. (Amos Russell)
Science
A practical guide for making post-mortem examinations : $b and for the study of morbid anatomy, with directions for embalming the dead, and for the preservation of specimens of morbid anatomy
Thomas, A. R. (Amos Russell)
Anatomy, Pathological; Autopsy -- Handbooks, manuals, etc.
Chronic encysted abscess, so closely simulates various tumors in this
situation, as to render a diagnosis in some cases very difficult during
life. It usually commences as a result of pregnancy; sometimes as a
consequence of lacteal inflammation; but usually without any injury or
other direct local cause. An indolent, indurated swelling forms, and
this may gradually soften in the centre, although fluctuation may for a
long time be very indistinct, and even absent, owing to the thick wall
of plastic matter that is thrown around the collection of pus. It is not
unfrequently attended with retraction of the nipple.
Syphilitic ulcers are also found affecting the nipple; while eczematous
and erysipelatous inflammation in this situation are of frequent
occurrence.
Morbid Growths.
The mammæ are frequently the seat of adventitious growths, presenting
the characters of non-malignant and malignant formations. The most
common of the benignant tumors is, perhaps, the
=Adenoid Tumor or Adenocele=. This is most frequently met with in young
women under thirty years of age, seldom commencing at a later period
than forty. It may remain stationary for years, or it may slowly
increase or grow very rapidly to a great size. It has frequently been
mistaken for cancer, but the otherwise good health of the patient, the
mobility of the mass, the absence of all implication of the skin or
glands, the want of hardness and its circumscribed character, are points
of diagnostic value.
On removal, it appears irregularly lobulated, is encapsulated, and its
cut surface has a bluish or grayish-white color, which, on exposure to
the air, assumes a rosy tint. On pressure, drops of thick, creamy fluid
will often exude. According to Birkett, the microscope shows it to
consist of imperfectly developed hypertrophy of the glandular tissue,
the terminal cells of which are filled with epithelial scales. This
tumor sometimes simulates malignant disease by its extreme rapidity of
growth, especially where it developes later in life. It then, after
section, presents a lobulated, glistening appearance, somewhat
resembling a mass of rice or sago jelly, often having cysts interspersed
throughout its substance containing fluid or semi-solid glandular
tissue.
In rare cases, the adenocele may return, even after extirpation of the
entire mammary gland.
=Cystic Tumors.= These may occur as the unilocular cyst, or as the
cysto-sarcomatous tumor.
_Unilocular cysts_ usually occur as a small, thin sac, of about the size
of a filbert, containing a clear, serous fluid, imbedded in the
glandular structure of the breast, and movable under the skin. As they
increase in size or become multiple, their contents may assume a
greenish-brown or blackish tinge from effused blood. According to
Brodie, they are originally formed by a dilatation of the lactiferous
tubes.
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