. Diseases of the stomach : including dietetic and medicinal treatment . Iceration is \ery common, at times being so extensive that only ahowl-shaped ulcer, with raised, ()\erhangiiig, or gradually slopingborders, remains (Aschoffs soft, ulcerating type). Not infrequentlyone finds other smaller, flat tumor nodules in the \icinity of the largeulcer. These may also form sui)erficial ulcers. Occasionally, medullary carcinoma infiltrates the walls of the stomachdiffusely, causing thickening of the various coats and a hypertrophyof the mucous membrane, which is thrown into firm folds andridges. rAT
. Diseases of the stomach : including dietetic and medicinal treatment . Iceration is \ery common, at times being so extensive that only ahowl-shaped ulcer, with raised, ()\erhangiiig, or gradually slopingborders, remains (Aschoffs soft, ulcerating type). Not infrequentlyone finds other smaller, flat tumor nodules in the \icinity of the largeulcer. These may also form sui)erficial ulcers. Occasionally, medullary carcinoma infiltrates the walls of the stomachdiffusely, causing thickening of the various coats and a hypertrophyof the mucous membrane, which is thrown into firm folds andridges. rATiioLoav 219 Micr()sc()i)i(all\ the i)i(tur( is (|uit( the reverse of the scirrhous stroma is scanty, the cell richness great. The alveoli are large,irregular, tortuous, and numerous, and they are filled with oval orspheroidal cells. The mucous meml)rane is the seat of widely growingtumor tissue of the same type. It shows early ulceration. It is alsonoticeable that the deepest layers of the stomach wall are infiltratedl)v the growtii at an early date. Fig. 39. Adenocarcinoma of the stomach. M, mucosa showing considerable infiltration, with mononuclearwandering cells at X; MM, muscularis mucosse, with infiltration of the carcinoma, as at .4;S, submucosa and muscularis, with extensive carcinomatous infiltration. Cylindrical-cell Carcinoma (Adenocarcinoma).—This type is repre-sented by a large, red fungus outgrowth from the mucosa of thestomach, having a broad base and a villous-like surface. While softin consistence, these tumors are firmer than the medullary cancers, andthey are more superficial. They are moderately succulent, very proneto hemorrhage, and often the seat of extensive ulceration. Occasionallythey occur in girdle form about the central portion of the stomach,or near the pylorus. Like the other varieties, adenocarcinoma may 220 CAXfER OF THE STOMACH infiltrate the stoinacli walls diHuscly. In this form the jnlorus isusually thiekened and rigidly ])atent ra
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