A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
History
A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
Medicine -- Practice
The diagnostic value of the theory above-mentioned is rather negative
than positive. With rare exceptions, a tumor cannot be epithelial in
character if its origin is from an organ or a part in which epithelium
is absent. The possible exceptions admit theoretical explanations
which present considerable degrees of probability, and are also based
upon the existing views of the development of tissues.
A tumor whose origin from the connective tissues is determined
partakes of the characteristics of its matrix, and is a
connective-tissue tumor. Its development from fibrous tissue is more
likely to result in a fibroma; from fat tissue, a lipoma, or a myxoma;
from cartilage or bone, a chondroma or osteoma.
Tumors developing at certain periods of life in certain parts of the
body are more likely to belong to one than another of the histogenetic
groups. Tumors of the connective-tissue series are stated by Lücke as
more prevalent before the age of thirty-five years, while those of the
epithelial group are more likely to occur after this age, and cancer
of the lip is of special frequency in old age. The fibro-myoma is of
most frequent occurrence in the uterus, and rarely attains a large
size till the approach of the climacteric.
The rapidity of growth of tumors is also associated with their
genesis. It has previously been stated that the more rapidly growing
tumors are those whose cells are most abundant and in the closest and
most {120} intimate relation to blood-vessels. The type of such tumors
is the sarcoma with its scanty intercellular substance, while the
other (histoid) tumors in the same series, as the fibroma, lipoma,
chondroma, etc., are of relatively slow growth. Tumors of the
epithelial series are of slow growth, from the constantly increasing
distance of the new-formed cells from the vascular connective tissue
which provides their nourishment. When, however, the growth of the
epithelium advances into the connective tissue, pushing out in all
directions and coming in contact with new series of vessels, the
opportunities for nutrition are favorable. In like manner, when the
new formation concerns the connective-tissue stroma, as well as the
epithelial sprouts, vascularization proceeds with the development of
the tumor, and favorable conditions for rapid growth are presented.
Large epithelial tumors may thus arise within organs, but, as the
surfaces are reached, the sources of nourishment become farther
removed and the degeneration of the epithelium favors its detachment
and the formation of ulcers. Hence the tumors whose advance is
associated with ulceration belong rather to the epithelial than the
connective-tissue group.
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