American practice of surgery : a complete system of the science and art of surgery . andfibro-adenomata, according to the relative proportions of the two elements present(Fig. 107). Pure adenomata of the mamma are somewhat rare. In someinstances the newly formed glandular tissue results in the production of newterminal acini, associated together in groups, and lined with cubical epithelium,resembling somew^hat closely the structure of the normal functioning gland. Inothers the growth is erratic, presenting irregular tubules lined with cubical andcylindrical cells. The various tubules and acini
American practice of surgery : a complete system of the science and art of surgery . andfibro-adenomata, according to the relative proportions of the two elements present(Fig. 107). Pure adenomata of the mamma are somewhat rare. In someinstances the newly formed glandular tissue results in the production of newterminal acini, associated together in groups, and lined with cubical epithelium,resembling somew^hat closely the structure of the normal functioning gland. Inothers the growth is erratic, presenting irregular tubules lined with cubical andcylindrical cells. The various tubules and acini are bounded externally by adoubly refractile basement membrane. The recognition of this structure is im-portant, for so long as it remains intact the growth is benign. Should the gland-ular elements proliferate irregularly and appear outside the basement membranethe tumor would be called a carcinoma. Many carcinomata of the breast origi-nate in a simple adenoma and are hence called adeno-carcinomata, though thereis no doubt that some arise directly from the glandular Fig. 108.—Foetal Adenoma of the Thyroid. Winckel No. 3, without ocular. (From the authors collection.) Adenomata of the kidney are well-defined, rather soft, growths, of whitish col-or, which may be microscopic in size or may attain that of a walnut. Histolog-ically, they are tubular, acinous, or papuliferous. The epithelium resemblesmore or less closely that of the secreting tubules. Some of the renal adenomata,however, have been shown to originate in misplaced suprarenal rests (benignhypernephromata). The adenomata of the kidney may become malignant. Glandular benign tumors of the thyroid are of three types, swiple, foetal, and 348 AMERICAN PRACTICE OF SURGERY adenomata. The siini)lo adononia consists of follicles filled ^vith col-loid, resembling those of the normal thyroid. The ei)ithelium lining the folliclesis cuboidal or somewliat flattened. In the supporting stroma can be see
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