The nature of the cancerous processes and the cancerous cachexia, and the relation of local irritation to each / by Roswell Park.

  • Park, Roswell, 1852-1914.
Date:
[1900?]
Catalogue details

Licence: In copyright

Credit: The nature of the cancerous processes and the cancerous cachexia, and the relation of local irritation to each / by Roswell Park. Source: Wellcome Collection.

    2/10 (page 290)
    attention to the frequency with which may be noted what he calls fragment¬ ation of these tumors, which consists in a more or less regular division and segmentation into small masses or nodules, either with or without mul¬ tiplication of tumor elements. Aoyama ( Virchow's Archiv., 1886) has main¬ tained that these are post-mortem changes, since the figures and changes described by Arnold may be seen in various inflammatory conditions. Another phenomenon observed by many, [to which Klebs and others have attached considerable importance, is that of leucocytic inclusions, i. e. the penetration of leucocytes into the in¬ terior of the neoplastic cells. This, of course, is a common phenomenon in the infectious granulomata, and re¬ ceives there a commonly accepted in¬ terpretation. No matter what im¬ portance there may be attached to it by others, it would seem to me that in a case of malignant tumor leucocytic invasion is equivalent to phagocytic, and can be viewed only in one light, i. e. as an effort at protection against invading organisms. The fact that the dead leucocytes are so often found in the tumor mass does not detract at all from the importance of such an ex¬ planation. Leucocytic aggregation and infiltration must here be regarded as a reaction from some form of irritation. Its recognition brings up again the constantly recurring question, Is can¬ cer due to intrinsic or to extrinsic causes? Leucocytic invasion, i. e. phagocytosis, is practically always a reaction against extrinsic causes. As observed in carcinoma, and even more often in epithelioma, where leucocytes are seen in the interior of the pearly bodies, it is more than a mere reaction / against the irritation of foreign bodies; it partakes of the significance of an active positive chemotaxis. Surely surgeons generally have not attached sufficient importance to the facts so beautifully elaborated by Cor-| nil and Ranvier, who have shown the wonderful freedom of communication between the minute terminal lymphat¬ ics and the. alveoli of cancerous tum¬ ors. The possibility of lymphatic in¬ volvement is, of course, everywhere recognized, but the mechanism of it is not generally made clear enough, | neither is the practical lesson to be de¬ rived from this anatomical fact. Metastatic foci seem to evidence predilection for certain organs, de¬ pending upon the character of the growth. Certain cancers, for exam¬ ple, generalize [themselves mainly through the osseous system, as, for example, in the cases; studied by Leu- singer (Die Knochenmetastasen bei?7i Krebs; Inaug. Diss. Zurich, 1896), who found that in cancer of the thy- • roid 20 to 25% of inetastases were found in the bones, in cancer of the breast about 14% and in cancer of the uterus only about 3%. Aside from the reports of individual cases by different observers, to which I could add several of my own, show¬ ing the tendency to osseous lesions in cancer of the breast, it is worth while to note Recklinghausen’s statement, that secondary cancer of the bone is particularly common in primary disease of the prostate. Secondary nodules in voluntary muscles at a distance are very rare, although Handford {Trans. Path. Soc., London, 1888) and Menetrier) Traite de path. gen. de Bouchard, Tome III., 2, p. 748), have published cases of mus¬ cle involvement after primary cancer ■ of the lung. In sarcoma, 011 the •?T^