Fibroids and allied tumours (myoma and adenomyoma) : their pathology, clinical features and surgical treatment . 914, page 390. By permission of W. S. A. Griffith.) vi = vaginal wall ; 5=cytogenous tissue which has undergone decidual change. This surrounds anddistorts a cystic space which is lined by flattened epithelial cells and is obviously a dilated gland-tubule. are instances of migrfltion by a process of extrusion. Theauthors words are : Contraction of the connective tissue andperhaps also the endeavours ot the uterine muscle to expelthe growth would account for the separation of the tum
Fibroids and allied tumours (myoma and adenomyoma) : their pathology, clinical features and surgical treatment . 914, page 390. By permission of W. S. A. Griffith.) vi = vaginal wall ; 5=cytogenous tissue which has undergone decidual change. This surrounds anddistorts a cystic space which is lined by flattened epithelial cells and is obviously a dilated gland-tubule. are instances of migrfltion by a process of extrusion. Theauthors words are : Contraction of the connective tissue andperhaps also the endeavours ot the uterine muscle to expelthe growth would account for the separation of the tumourtrom its endometrial connection. Finally they [adeno-myomas] may make their way into the broad ligaments oreven into the recto-vaginal septum. ^ Proc. Roy. Soc. Med. {Obst. and Gyn. Sect.), July 1914, page 389. 3^4 EXTRAUTERINE ADENOMYOMA chap. Leitch therefore agrees with Cullen with regard tothe origin of extrauterine adenomyomata, but he is moreemphatic than Cullen as to the mucosal origin ofthe septal growths. Cullen admits the possibility of anembryonic as well as a mucosal origin for these Fig. 216.—-Adenomyoma of recto-genital space adherent to the cervix of a pregnantuterus, showing that the cytogenous tissue has undergone decidual change. Thedecidual cells under high magnification are seen arrayed around a gland-tubule, theepithelium of which has not suffered so much from pressure as has the tubule shownin the preceding figure. (After W. S. A. Griffith, Bv permission.) Leitch does not. In the two cases above referred to,Leitch stated that the septal tumours became excessivelypainful during jnenstruation. In one, the lower part of the uterus was very hard andthickened, and there was a continuation of the hardness,along the tissue of the left utero-sacral ligament, but it II OF THE RECTO-GENITAL SPACE 365 stopped short of the rectal wall. The uterus and the back-ward prolongation were removed under the belief that thecondition was a carcinoma of the
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