Gynaecology for students and practitioners . rior lip of cervix. , Posterior lip of these two points lies the cervical canal, which on the right sideshows an ulcerated area, the starting-point of the malignant growth. [SeeFigs. 270, 271, 272.) equally difficult to prove or refute. It has commonly been taught thatcancer of the cervix may be systematically distinguished as [a) cervicalcancer, which, arising in the squamous epithelium of the portio is asquamous epithelioma, and (6) endocervical cancer, which arising in thecolumnar epithelium of the cervical endometrium, is th
Gynaecology for students and practitioners . rior lip of cervix. , Posterior lip of these two points lies the cervical canal, which on the right sideshows an ulcerated area, the starting-point of the malignant growth. [SeeFigs. 270, 271, 272.) equally difficult to prove or refute. It has commonly been taught thatcancer of the cervix may be systematically distinguished as [a) cervicalcancer, which, arising in the squamous epithelium of the portio is asquamous epithelioma, and (6) endocervical cancer, which arising in thecolumnar epithelium of the cervical endometrium, is therefore anadenocarcinoma. Careful examination, however, of a large series ofcervical carcinomata has demonstrated that this simple, and appa-rently logical classification breaks down; in fact ; it is often impossibleto decide either by naked eye or (in advanced cases) by histological CANCER OF THE CERVIX 519 examination, whether a cancer started in the epitheliumof the portio vaginalis or in the columnar epithelium of the cervical. Fig. 270. Sagittal Section of Specimen shown in Fig. 269. x 4 showingA Squamous-CELLED Cancek starting in the Cervical , Corporeal endometrium. B, Cervical endometrium. C, Malignant ulcera-tion of cervical endometrium. D, Fibro-muscular tissue of cervix free fromgrowth. E, Healthy surface of portio vaginalis ceriicis. The microscopiccharacters of the growth are seen in Figs. 271, 272. endometrium. The disability to prove the site of origin in cases ofcancer of the cervix is due to the marked disposition of the epi-thelium of the cervix to undergo metaplasia. This change is very liable 520 GYNECOLOGY to occur in the case of the columnar epithehum, not only in cellsalready cancerous, but also in what may be called the pre-cancerousstage. In cases of cervical catarrh and cervicitis, with or withoutectropion of the cervical mucous membrane, the columnar epitheliummay be seen assuming the characters of squamous epithelium. In thesam
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
