Carcinoma of the right fallopian tube readily palpable through the abdomen / by Thomas S. Cullen.

  • Cullen, Thomas Stephen, 1868-1953.
Date:
[1911]
Catalogue details

Licence: In copyright

Credit: Carcinoma of the right fallopian tube readily palpable through the abdomen / by Thomas S. Cullen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    vessels are seen ramifying beneath the peritoneum. On section it is seen that the great increase in size is due in a large measure to a new growth. This has extended into the lumen of the tube, but at no point does it appear to have reached the outer surface. Where the tube is 5 cm. in diameter the growth completely fills the lumen. It is composed of a granular-looking new growth which presents a somewhat arborescent appearance. The growth apparently springs from all parts of the wall of the tube. Near the fimbriated extremity, where the tube is 10 cm. in diameter, for over fully half of its extent the walls are covered with a new growth. This in places reaches 2 cm. in thickness. At other points the tube seems to be free from the growth. The entire central portion of the tube has been filled with fluid that has undergone coagulation in the hardening fluid. In the fluid next the growth here and there are large blood clots. The gross picture leaves little doubt that we are dealing with a malignant growth. If it be malignant the reason why it has not extended outside seems evident, because the point of least resistance would be toward the center of the tube. The left tube, near the uterus, is 5 mm. in diameter, but on f2l] passing outward a short distance it is dilated to 4 or 5 cm. It likewise on section is found to be the seat of a similar growth. The tube is covered with adhesions. Histological Examination.—Sections from the growth of the right tube show in some areas little tree-like or teat-like projec- tions extending into the cavity. They remind one very much of the small folds noted where a hydrosalpinx exists. At other points the epithelium has proliferated forming gland-like areas. In more advanced portions over wide areas papillary outgrowths are seen. These present a distinct arborescent appearance and the projections are covered with one or several layers of very high, exceeamgly regular cylindrical epithelium. Over large areas there is not the slightest evidence of breaking down. In still other portions of the growth one sees nuclei two or three times the usual size. These stain somewhat deeply. In other portions cross and longitudinal sections of finger-like processes with large blood vessels in their interior are seen. Here and there the epithelium proliferated until solid masses of glands have been formed. Masses of epithelium without evidence of gland forma- tion are also noted. In only a few places is there evidence of breaking down. The growth is, without doubt, a carcinoma, but is characterized by a marked tendency toward gland formation and papillary out- growths, and by its stability instead of its tendency toward break- ing down. One might, with some propriety, claim that it re- (3)