The pathology and surgical treatment of tumors . tubercles in carcinoma-tissue. section from which the illustration (Fig. 224) was taken was derivedfrom a testicle that had been tubercular for a long time and had onlyrecently commenced to increase rapidly in size. This specimen refutesthe assertion made by Rokitansky, that tuberculosis and carcinomaexclude each other. There can be no doubt in this case that the tuber-cular epididymitis was the primary and carcinoma the secondary affec-tion, Sutton has never seen a tubular carcinoma of the testicle. That CARCINOMA. 343 such a carcinoma occasion
The pathology and surgical treatment of tumors . tubercles in carcinoma-tissue. section from which the illustration (Fig. 224) was taken was derivedfrom a testicle that had been tubercular for a long time and had onlyrecently commenced to increase rapidly in size. This specimen refutesthe assertion made by Rokitansky, that tuberculosis and carcinomaexclude each other. There can be no doubt in this case that the tuber-cular epididymitis was the primary and carcinoma the secondary affec-tion, Sutton has never seen a tubular carcinoma of the testicle. That CARCINOMA. 343 such a carcinoma occasionally, although rarely, occurs is shown byFigure 225. Langhans never saw hard, but always soft, carcinomataof this organ. He believes that the tumor starts from the epithelialcells Hning the seminiferous tubules. He also calls attention to thetransformation of an adenoma of the testicle into a carcinoma. From a diagnostic point of view it is important to remember thattuberculosis almost always begins in the epididymis, and carcinoma in f^-.^*^.-. ^<&. m t*^. **. iff!* »fc.^ Af is*. *^». &-iKl^7^^ ifSM * Fig. 225.âTubular carcinoma of the testicle ; X 270 (after Karg and Schmorl). The tumor is composedof long, solid streaks of large epithelial cells {a). The nuclear structures cannot be seen, as the chromatinhas been affected by the hardening solution, Mullers fluid. The stroma {i) is scanty and is rich in cells. the testicle proper. As carcinoma of this organ is always soft, it isliable to undergo cystic degenerationâan occurrence which still furthercomplicates the diagnosis. The regional infection extends along thelymphatics of the cord and from the cord to the iliac fossa. The tumormay attain the size of an adults head. Early removal of the testicle with its envelopes and the cord as faras it can be followed is the only operation that promises a permanentresult. Kocher has observed cases in which the disease did not recurfor four and a half, eight and a half, and te
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectneoplas, bookyear1895
