Gynaecology for students and practitioners . ntain a large amount of innocent-looking fibrous tissue arranged instrands which enclose groups of spindle-ceUs with large nuclei. Thelatter show multiple chromatin-granules, and vary in size and shape. In endeavouring to decide whether a hard cellular connective-tissuetumour of the ovary is an innocent fibroma or a malignant sarcoma,stress must be laid upon the characters of the nuclei of the cellularelements ; variation in shape and size, a rich supply of chromatin, andevidence of mitosis, are all points in favour of malignancy. But aswe have stat
Gynaecology for students and practitioners . ntain a large amount of innocent-looking fibrous tissue arranged instrands which enclose groups of spindle-ceUs with large nuclei. Thelatter show multiple chromatin-granules, and vary in size and shape. In endeavouring to decide whether a hard cellular connective-tissuetumour of the ovary is an innocent fibroma or a malignant sarcoma,stress must be laid upon the characters of the nuclei of the cellularelements ; variation in shape and size, a rich supply of chromatin, andevidence of mitosis, are all points in favour of malignancy. But aswe have stated in connection with fibroma, there is room for error in MALIGNANT CONNECTIVE-TISSUE TUMOURS 685 attempting to form an opinion as to malignancy solely from the micro-scopic examination of these connective-tissue growths. The microscopic characters of the soft or round-celled sarcoma aremuch more distinctive. The small round cells have a deeply staining, relatively largenucleus, centrally situated in a clear cytoplasm. Multinucleated giant-. FiG. 389. Sarcoma of the Ovary. Both ovaries were the seat of sarcoma, and secondary deposits were removed from the peritoneum of the utero-vesical pouch. The dark areas are cysts filled with blood-coagula. The microscopic characters are seen in Figure 390. cells are common amidst the small round cells. There is an intercellularstroma which ramifies between the individual cells, and by which thelatter are often arranged in pattern. The vessels areembryonic, having only an endothelial coat ; their lumina may beseen to be filled with sarcoma-cells. Free hsemorrhages are often seensurrounded by areas of degeneration. The round-celled sarcoma isvery malignant ; metastases are found early, and masses of sarcomatousgrowth occur on the peritoneum together with ascites. Melanosarcoma occurs both primarily and secondarily in the ovary. Endothelioma. This is a type of sarcoma in which the origin of theproliferating cells can be traced to
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
