Gynecological diagnosis . er early. The squamous-celled varietyseldom spreads beyond the level of the internal os, but the adeno-carcinoma frequently reaches to the fundus. The cervix may bereduced to a mere shell by the necrosis of the latter form of cancerand yet the external contour of the cervix remains to the surrounding organs, the bladder and rectum, CAXCER OF THE UTERUS 269 takes place usually by direct extension of the growth. The iliacglands are involved sometimes early and sometimes late, as is thecase with the squamous-celled variety. Microscopically adeno-carc
Gynecological diagnosis . er early. The squamous-celled varietyseldom spreads beyond the level of the internal os, but the adeno-carcinoma frequently reaches to the fundus. The cervix may bereduced to a mere shell by the necrosis of the latter form of cancerand yet the external contour of the cervix remains to the surrounding organs, the bladder and rectum, CAXCER OF THE UTERUS 269 takes place usually by direct extension of the growth. The iliacglands are involved sometimes early and sometimes late, as is thecase with the squamous-celled variety. Microscopically adeno-carcinoma of the cervix is recognizee! as a proliferation of the cylindrical cells of the cervical mucousmembrane, these cells preserving their alveolar or glandular ar-rangement. There is distinct loss or crowding out of the inter-glandular stroma, the proliferating alveoli lying close to one Adeno-carcinoma of the body of the uterus originates in thelow columnar epithelium lining the uterine cavity and the glands. Fig. 112.—Early Adeno-Carcinoma of the Body of the (Jterui Cull. of the endometrium. It usually starts at the fundus or in onecornu as a circumscribed area of proliferation of the this point it may spread until it involves the entire uterine;cavity. The growth may proliferate, forming actual outgrowth*of endometrium into the uterine cavity, as well as invade theuterine muscular wall. The growth may ulcerate it- way throthe uterine wall and appear in the peritoneal cavity and formperitonea] metastases. This is generally a late process of aexisting cancer. The ordinary benign uterine polyp, I ereil by endometrium, may become carcinomatous. Adeno-carcin 270 DIAGNOSIS OF MALIGNANT DISEASES OF THE UTERUS of the body seldom extends beyond the internal os, although adeno-carcinoma of the body and cervix may coexist. Glandular metastasis from this form of cancer is late. Microscopically adeno-carcinoma of the body is recognized bythe proliferation
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