. Modern surgery, general and operative. d destroying every struc-ture. Epithelioma usually affects lymphatic glands early, but such infectionmay be long delayed. Epitheliomatous glands break down in ulceration,making frightful gaps and often causing fatal hemorrhage. Dissemination isnot nearly so common as in other forms of cancer, but it does sometimes Epithelioma.—This form of growth takes origin fromstructures covered with or containing cylindrical epithelium, and it containscylindrical or columnar cells. It is composed of a stroma of fibers l^etweenwhich lie tubu
. Modern surgery, general and operative. d destroying every struc-ture. Epithelioma usually affects lymphatic glands early, but such infectionmay be long delayed. Epitheliomatous glands break down in ulceration,making frightful gaps and often causing fatal hemorrhage. Dissemination isnot nearly so common as in other forms of cancer, but it does sometimes Epithelioma.—This form of growth takes origin fromstructures covered with or containing cylindrical epithelium, and it containscylindrical or columnar cells. It is composed of a stroma of fibers l^etweenwhich lie tubular glands lined with columnar epithelium and containing massesof epithelial cells. Such tumors are found in the uterus and gastro-in-testinal tract, and may begin from the surface epithelium or from the cellsof tubular glands. In these tumors there is an acinus-like structure and thespaces are filled with proliferating epithelium. Cylindrical-celled cancers mayalso arise from the mammary gland, liver, and kidney. One of the most com-. FiGS. 211, 212.—Rodent ulcer (case of Dr. L. M. Raring, Denver, Colorado). mon seats of cyHndrical-celled cancer is the rectum. Cancer of the rectum tendsin many cases to occur at an earlier age than cancer elsewhere, being not un-common between the ages of twenty-eight and forty. Cylindrical-celled epithelio-mata are at first covered with mucous membrane, but they soon ulcerate andinvolve the submucous and muscular coats in the growth. They may grow ratherslowly, usually but not always cause lymphatic involvement, and finally dissemi-nate widely. They require in some regions from five to six years to causedeath. In the rectum, however, growth is much more rapid and few victimsof cylindrical-celled carcinoma of the rectum, if unoperated upon, live beyondtwo years, and many of them die long before this period. A rodent or Jacobs ulcer, epithelioma excdens or cancroid (Figs. 211,212, 213),wascalledby the older surgeons noli me iangere, because
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