A common species of tumour is that which is attached to a mucous
surface, and is called POLYPUS. Polypi vary in structure and
disposition; some are simple and benign, others are most malignant.
The simple mucous polypus has a shining appearance, being invested
by an extremely delicate membrane, in some degree resembling the
mucous, and moistened by a fluid similar to the mucous secretion; it
is of soft consistence and homogeneous structure. They are generally
light brown, sometimes greyish, and in some degree diaphanous. They
are connected to the mucous membrane by a narrow pedicle; generally
occur in clusters, and are of pyriform shape; one or more are often
suspended from one narrow base, and they seldom attain a large size.
They possess but little vascularity, though occasionally minute
vessels are seen ramifying pretty freely on their surface, and may be
considered as almost devoid of sensibility. The malignant polypus,
on the contrary, is always attached to the mucous membrane, and also
to the subjacent parts, by means of a broad base; and its form and
structure vary according to the particular action which it has assumed.
Most frequently it is encephaloid, of an irregular form, and often
presenting a cauliflower appearance, its surface being studded with
numerous excrescences of medullary consistence and colour. Such tumours
will be afterwards treated of, as occurring in different situations.
OF ENCYSTED TUMOURS.
Along with these have been classed the enlargements of bursæ, sheaths
of tendons, &c., but with equal propriety might we include hydrocele
and other collections in natural cavities. Encysted tumours are
almost always situated superficially. The skin is distended, seldom
inflamed, and often contains enlarged bloodvessels, which give it a
streaked appearance. They consist of an external cyst, which is in some
instances extremely thin and delicate, in others dense, of considerable
thickness, and composed of fibrous looking substance, occasionally
it is almost cartilaginous; the internal structure may be said to be
almost always more or less fluid, but varies much in consistence. The
tumour is surrounded with condensed cellular substance, which is of
greater or less thickness and strength according to the size of the
tumour. Some of these tumours are supposed, and on good grounds, to be
mere enlargements of the natural mucous follicles, in consequence of
obstruction in their ducts, by hardened and vitiated secretion; the
cyst, therefore, will be at first thin and delicate; its contents will
resemble the natural secretion of the follicle, and in many cases may
be readily squeezed out. There is a black point on the most prominent
part, marking the obstructed orifice of the follicle, and the sac is
found at this point to adhere firmly to the skin. Even after all other
marks of its original formation have disappeared, the situation of the
orifice is sometimes indicated by small dark spots, by depression, or
by a minute ulcer.
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