. Tumours, innocent and malignant; their clinical characters and appropriate treatment. into the cavity asan exuberant fungating growth, or infiltrate its walls andspread directly into the subjacent hepatic tissue. Cancermay be localized to the fundus of the gall-bladder, and bud-like processes of growth will perforate its walls, and thecells from the surfaces of these buds give rise to generalcancerous infection of the peritoneum. It is not uncommon for the gall-bladder to be implicatedand infected with cancer of the liver, both primary and secon-dary ; it requires some care to discriminate b
. Tumours, innocent and malignant; their clinical characters and appropriate treatment. into the cavity asan exuberant fungating growth, or infiltrate its walls andspread directly into the subjacent hepatic tissue. Cancermay be localized to the fundus of the gall-bladder, and bud-like processes of growth will perforate its walls, and thecells from the surfaces of these buds give rise to generalcancerous infection of the peritoneum. It is not uncommon for the gall-bladder to be implicatedand infected with cancer of the liver, both primary and secon-dary ; it requires some care to discriminate between primary GANGER OF TEE GALLBLADDER 349 cancer of the gall-bladder infiltrating the liver and cancer ofthe liver implicating the gall-bladder. In some instances thedistinction cannot be made. The lymph-glancls in the portalfissure are early infected. The type of cells usually found in cancer of the gall-bladder is columnar or subcolumnar. When the walls of acancerous gall-bladder are firmly compressed on the containedcalculi, the cells of the mucous membrane flatten and assume. CALCULUS Fig. 168.—Gall-bladder with primary cancer of its neck extending into the cysticduct; a gall-stone is embedded in the growth. From a man aged 70 years.{Museum, Charing Cross Hospital.) the characters of squamous cells. Cancer in a gall-bladder ofthis kind is squamous-celled, and cell-nests abound. The most important feature connected with primary cancerof the gall-bladder is its almost constant association withgall-stones (Figs. 168, 169, 170, 171). Careful investigationshave been made on this point, and prove that in at least 95per cent, of the cases of cancer of this structure, gall-stonesare present also. Ten years ago cancer of the gall-bladder was considereda rare disease. The systematic examination of gall-bladders 350 EPITHELIAL TUMOURS removed in the course of operations for gall-stones provesthat it is a common affection. Physiological observation hastaught us that the liver, in
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectneoplasms, bookyear19
