Primary carcinoma of the veriform appendix : a critical study of 90 cases, with references to 123 cases / by Clarence A. McWilliams.

  • McWilliams, Clarence A.
Date:
[1908?]
Catalogue details

Licence: In copyright

Credit: Primary carcinoma of the veriform appendix : a critical study of 90 cases, with references to 123 cases / by Clarence A. McWilliams. Source: Wellcome Collection.

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    The blood vessels are distended with blood. There is a thrombus in one of the larger veins. This more or less active inflammation extends entirely around the appendix, although in the portion opposite the mesenteric attachment the inflam¬ mation is much less than on the other side. The mucous membrane of this portion of the appendix is normal and the sur¬ face is unbroken. The submucosa, the muscularis, and the sub¬ serosa are infiltrated with cells arranged in large and small masses in the tissue spaces (Figs. 1,2, and 3). These cells are polyhedral (Figs. 4 and 5); there is no connective tissue between the individ¬ ual cells; the nuclei are large and show well arranged chromatin network. Mitotic figures are scanty. None of the carcinoma¬ tous masses show any tendency to an alveolar formation, nor are there any high cylindrical or mucous cells. While the new growth extends up into the lymphoid tissue underneath the lining mem¬ brane of the lumen of the appendix, this epithelium is in no place broken through, nor in direct connection with the growth. The infiltrated tissue shows the usual evidence of chronic inflam¬ mation, and many wandering tissue cells of the type of plas- macytes and plasma cells are present in the muscle bundles near the new growth. The exact histogenesis of the tumor cannot be established from the specimen, as the entire appendix is not available for section; but the possibility of the tumor having arisen from the mucous membrane cannot be excluded. The diagnosis is carcinoma of the appendix, polyhedral cell type; acute peri-appendicitis. Case XXVI.—Operator, Dr. J. Wiener. A male, aged thirty- five years, was admitted to Mt. Sinai Hospital, New York, Dec¬ ember 8th, 1903. As a child, inflammation of bowels. Five years ago, indigestion for six months with nausea and belching of gas, appetite fair, but with no pain. One year ago, nervous prostration, which kept him from work for six months. Moderate smoker, but not alcoholic. Eleven days before admission, sud¬ den sharp, shooting pains in right lower quadrant. Next morning