. Transactions of the Pathological Society of Philadelphia . on the left side of the neck. The wound never healed, andthe neoplasm progressively increased in size. In September, 1889, his condition was as follows: The tumor forma-tion had involved the whole sub maxillary region and had extendedperipherally to the left side of the face. It appeared like a large gran-ulating ulcer with protruding, fungoid vegetations, the edges of thewound being raised and infiltrated, and the tissues of the neck swollenand nodulated. The neoplasm had evidently extended to the oesopha-gus and the larynx, because
. Transactions of the Pathological Society of Philadelphia . on the left side of the neck. The wound never healed, andthe neoplasm progressively increased in size. In September, 1889, his condition was as follows: The tumor forma-tion had involved the whole sub maxillary region and had extendedperipherally to the left side of the face. It appeared like a large gran-ulating ulcer with protruding, fungoid vegetations, the edges of thewound being raised and infiltrated, and the tissues of the neck swollenand nodulated. The neoplasm had evidently extended to the oesopha-gus and the larynx, because the patient began to suffer from dysphagiaand dyspnoea, which continued until he died, October 20, 1889. For some time before death he had several severe hemorrhages fromthe throat, and obstinate diarrhoea. Pain was not a conspicuous symp-tom, except shortly before death, when at times it would be severe, and MISCELLANEOUS. 325 again, entirely absent. Appetite was always good until a few daysbefore death, which, for a day or two, was preceded by Tubular epithelioma of the nasal glands, X 300. The tumor now under considera-tion is of identical structure with the above : connective-tissue stroma forming spacesfilled with masses of small squamous, epithelial cells which form a few distinct, smallpearly bodies. (Formad and Blackburn.) Autopsy.—Body well nourished. Xothing peculiar externally exceptthe tumor of his neck as described above. The growth proved to haveoriginated in the sub-lingual gland, extending to the sub-maxillary andparotid glands. It involved all the structures at the base of the tongue,extending around the larynx and pharynx to the soft palate, upward tothe base of the skull, and penetrated the sphenoidal cells. It followedthe oesophagus downward, infiltrating its serous coat, the posteriormediastinal space, and extended all over the upper surface of the dia-phragm. The growth presented a continuous chain of flat, nodularmasses from the pharynx to t
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