Studies in pathological anatomy : especially in relation to laryngeal neoplasms / by R. Norris Wolfenden and Sidney Martin.

Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Studies in pathological anatomy : especially in relation to laryngeal neoplasms / by R. Norris Wolfenden and Sidney Martin. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    over regions of the mucous membrane which are not normally furnished with papillae; and though in these situations they are usually covered with stratified pave- ment epithelium, they have been known in a few cases to be invested with cylindrical ciliated epithelium (Morell Mackenzie). To the naked eye papillomata appear as single or multiple growths, sessile, or pedunculated, but it is often impossible to make out distinctly their point of origin. In colour they are pale, grey, or red, but when very vascular may be deeply injected (“Teleangectatic papilloma” of Ariza). Their size is very variable. They may be small as a millet seed, or so large as to block up the orifice of the larynx almost completely. Oertel has differentiated three varieties of papilloma which can be detected laryngo- scopically. 1. Rosy or deep red, warty tumours, situated on the free edge or surface of the vocal cords, or at the anterior com- missure, varying in size from a hemp seed to a haricot bean. Though usually single these may be multiple. 2. Greyish tumours of distinct papillary aspect, situated by a broad base upon the vocal cords, and surrounded by smaller groups of vegetations. 3. Grape-like, mulberry-shaped, or muriform tumours of soft consistence, more or less filling up the cavity of the larynx, springing from the ventricular bands and their neighbourhood, or from the epiglottis. Virchow describes the growth of papilloma from situations where there are normally no papillae (just as in other parts where papillae occur) by production of exuberant cell growth of the superficial epithelial layers, indicated first as a small roundish knob-like projection, or flat elevation. At first only very small, amorphous, granular buds, it is only later that cells become visible. They gradually increase by cell multiplication and form papillary processes. A process of connective tissue entering from below forms a stroma, into which projects a vascular loop. All parts then grow simultaneously. The epithelial growth may become so exuberant that actual granulation is developed. Naked eye appearances papilloma.