A demonstration of specimens illustrating cysts of the female appendages / by Arthur Keith ; with notes, by Alban Doran.

  • Keith, Arthur, Sir, 1866-1955.
Date:
1910
Catalogue details

Licence: In copyright

Credit: A demonstration of specimens illustrating cysts of the female appendages / by Arthur Keith ; with notes, by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Wolffian duct or “ horizontal tube of the parovarium ’’ (Fig. 2). What is it? Most likely it is a pronephros, as in My.xine, rather than a prolongation of the mesonephron or Wolffian body. Two or three pedunculated cysts, instead of one, are not rare at this point, and are known as Kobelt's tubes. A junction between the anterior part of the Wolffian duct and a process from the Fallopian tube is sometimes observed, as in this specimen prepared by Mr. Alban Doran, and figured in his Tumours of the Ovary, Fallopian Tube and Broad Ligament (Fig. 3). The process is of the t^'pe called by some writers a ‘‘ Paratube.' The significance of this junction will be discussed presently. A pedunculated process at the ostium of the Fallopian tube, the ^‘hydatid of Morgagni ” (Fig. 1, 11) is simply an exaggerated fimbria (see Fig. 6). Small cysts require close scrutiny as to their origin, for it is not certain that pathologists are correct about the starting point of broad ligament tumours. Dr. Keith examined 34 appendages bearing small broad ligament cysts, and in no less than 28 there was no evidence that they were of TVolffian origin. On the other hand, in the 6 remaining specimens, the small cyst could be seen arising from the Wolffian body. Mr. Doran’s specimen here exhibited and figured in his treatise (Fig. 4), is undoubtedly Wolffian or “parovarian.” It is, however, quite small, and Dr. Keith observed that cysts of this type could never be traced upwards, through series where the cyst grew larger and larger, to the common thin-walled broad ligament cyst, a kind of tumour very well known to the surgeon. With another type of minute cyst it is otherwise. In 20 per cent, of all subjects a minute cyst is found, connected with the ovarian fimbria. By comparing the male and female genital gland. Dr. Keith finds that the fimbrial cyst is developed from homologues of the rete testis. It is really in ovarian (hiluml tissue; the histology of the ovarian end of the ovarian fimbria has been already alluded to; that end is the representative of the rete testis. In the male, the tubuli seminiferi are continued as the rete testis in the border of the genital gland, and pass on through the old kidney, mesonephron or vasa efierentia to the vas deferens. In the female, there are tubules, which tend to become cystic, in the neighbourhood of the ovarian fimbria. They correspond in position to the rete testis. As in the male, these cystic tubules are quite distinct from the mesonephron, that is to say, from the “ vertical tubes of the parovarium” (Fig. I, T). The vertical tubes pass on to the “ horizontal tube of the parovarium ” ^Fig. I, 5, 5), which is the beginning of the Wolffian duct, the homologue of the vas deferens. Thus the parovarium or Wolffian body, though closely associated with the cysts (Fig. 5), so often detected at the ovarian termination of the ovarian fimbria, is not the parent of that type of cyst. On the