Operative gynecology : . f cancerous disease are found in the cervix uteri—epitheli-oma and adeno-carcinoma. To make a diagnosis in the early stages of carcinoma of the cervix, it isnecessary for the clinician to send the pathologist a wedge of the suspiciousportion, which should be at least 1 cm. in depth; this may readily be removedwithout pain after injecting a few minims of a 4 per cent solution of cocaindeep into the cervical tissue, when two or three catgut sutures may be passedto close in the wound. Where the cervical disease is far advanced the ordinarycurettings will be sufficient for
Operative gynecology : . f cancerous disease are found in the cervix uteri—epitheli-oma and adeno-carcinoma. To make a diagnosis in the early stages of carcinoma of the cervix, it isnecessary for the clinician to send the pathologist a wedge of the suspiciousportion, which should be at least 1 cm. in depth; this may readily be removedwithout pain after injecting a few minims of a 4 per cent solution of cocaindeep into the cervical tissue, when two or three catgut sutures may be passedto close in the wound. Where the cervical disease is far advanced the ordinarycurettings will be sufficient for the diagnosis. CARCINOMA OF THE CERVIX. 595 Epithelioma.—The surface of the cervix is covered by several layers ofsquamous epithelium, which, however, can be seen penetrating the stroma inthe form of finger-like or branching masses of cells; many of these brancheswhen cut transversely or obliquely appear as round, oval, or irregular groupsof cells lying deep in the stroma. On other parts of the surface of the tissue. d a c h Fig. 328.—Squamous-celled Carcinoma of the Cervix Showing the Depressions on the SurfaceFilled up with Pus Cells and Detritus, a. b indicates the typical cells; at c the nuclei are enlarged and stain deeply; at d giant cells are protoplasm is increased and the nuclei, four or five in number, are bunched in the center of the cells;e is the stroma and shows moderate small-celled infiltration as indicated by /; at g small isolated clustersof carcinomatous cells are present in the stroma. (T. S. Cullen, Cancer of the Uterus, 1890.) slight elevations are found which consist of a central blood vessel surroundedby little or no stroma and covered externally by numerous layers of squamousepithelium, indicative of an outgrowth of blood vessels and stroma with a dis-proportionate increase in the epithelial layers. The cervical glands are usually normal, except that in some cases thesquamous epithelium may be found projecting into the lumen of the gland
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
