. Diseases of the stomach : including dietetic and medicinal treatment . fice, or as an annular tumor in the central i)art of the scirrhous carcinoma one fre(|uently sees small tumor nodules of theserous covering of the stomach, and in the ])(Titoneuin. PATIIOIJHIY 217 jMicTuscopically, one finds the xarioiis coats (jf the stomach thickenedand very rich in connecti\e tissue, wliich occurs especially in irregularlybranching septa of varying thickness. Scattered through the coats,but occurring especially in the thickened submucosa and along theconnective-tissue septa in the muscularis
. Diseases of the stomach : including dietetic and medicinal treatment . fice, or as an annular tumor in the central i)art of the scirrhous carcinoma one fre(|uently sees small tumor nodules of theserous covering of the stomach, and in the ])(Titoneuin. PATIIOIJHIY 217 jMicTuscopically, one finds the xarioiis coats (jf the stomach thickenedand very rich in connecti\e tissue, wliich occurs especially in irregularlybranching septa of varying thickness. Scattered through the coats,but occurring especially in the thickened submucosa and along theconnective-tissue septa in the muscularis are found small nests of sphe-roidal and atypical epithelial cells. These may occur in small tubules,but more often as solid plugs or strands of cells along the septa, orpenetrating between the muscle bundles. They may be more or lessdegenerated, making it very difficult to tell whether they represent aneoplastic growth or not. The mucosa generally shows the changesof chronic productiNe gastritis, often with ulceration. It may be in-vaded bv the tumor tissue. Fig. 37. Medullary carcinoma (spheroidal cell) on posterior wall of the stomach at the pylorus. The of the typical cauliflower appearance. There some superficial ulceration at X. P, pyloric ring;T, tumor mass, sharply circumscribed. A piece of tissue has been removed at 1 for sections. Mechdlary {Soft) Form.—These growths appear typically as cauli-flower-like excrescences of soft, exuberant, succulent tumor tissue,attached to the stomach wall by a broad base. They are grayish whiteto pale pink in color, generally show varying degrees of irregular ulcera-tion, have a dirty looking surface or one discolored by hemorrhage,and generally extend deeply into the stomach wall. They grow rapidly,are often the seat of hemorrhage, and form early metastases. Onaccount of the resemblance of the tumor tissue to brain substance thistype of growth has been called encephaloid. As a rule these tumors 218 CANCER OF THE STOMAC
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