Medical Officers of the Army of India.
23
granulation-tissue which projected upwards into the papillæ and formed a conti
- n u o u s l a y e r b e n e a t h t h e m . T o w a r d s t h e l a t e r a l p o r t i o n s o f t h e s p e c i m e n t h i s
tissue gradually diminished in amount, disappearing from the papillæ, and
occurring beneath them in isolated patches only. In the more advanced central
portion of the tumour, the neoplasm appeared entirely to replace the normal
dermal tissue in the area which it had invaded.
This continuous stratum of neoplasm beneath the papillary layer in its
thickest portions was about 0.06 of an inch deep, and from this it gradually thin
- n e d o u t l a t e r a l l y i n b o t h d i r e c t i o n s . I t s i n f e r i o r m a r g i n w a s i n s o m e p l a c e s f a i r l y
even; in others, on the contrary, it presented a series of irregular processes pro
- j e c t i n g f o r v a r y i n g d i s t a n c e s i n t o t h e s u b j a c e n t d e r m a l t i s s u e a n d t h e r e b e c o m i n g
continuous with a system of irregular masses of similar composition scattered
throughout the interspaces of the fibrous bundles. In some cases these pro
- c e s s e s c o u l d b e r e a d i l y r e c o g n i s e d a s s p e c i a l l y r e l a t e d t o h a i r - f o l l i c l e s o r t o t h e
ducts of sweat-glands.
The complete continuity of the subpapillary granulation-tissue in its more
developed portions was only interrupted by the bundles of muscular tissue
belonging to hair-follicles which had completely disappeared. In less advanced
portions hair-follicles in various stages of degeneration and disintegration were
also recognisable.
Immediately beneath this continuous stratum of neoplasm was one of modi
- f i e d d e r m a l c o n n e c t i v e t i s s u e i n c o u r s e o f i n v a s i o n b y t h e g r o w t h . D u e t o t h e
presence of abundant masses of unaltered connective tissue in it the sections of it
stained with picrocarmine presented a conspicuous deep, bright red colour, con
-trasting strongly with the pinkish yellow of the granulation-tissue above it. Inter
- p o s e d b e t w e e n t h e b u n d l e s o f c o n n e c t i v e t i s s u e t h e r e w e r e e v e r y w h e r e m a s s e s
of granulation-tissue of various sizes and the most irregular outlines. In some
cases these were specially related to hair-follicles, sweat-glands, or the adven
-titia of the larger vascular trunks, but in most they were quite irregularly distri
- b u t e d a n d a p p e a r e d a s i t w e r e t o f o r m a n a t u r a l i n j e c t i o n o f t h e l y m p h a t i c s p a c e s
of the normal tissue. The appearances seemed to indicate that where hair-fol
- l i c l e s h a v e b e c o m e i n v o l v e d i n m a s s e s o f t h e n e o p l a s m t h e y a r e c o m p a r a t i v e l y
rapidly disorganised and soon disappear. The same would appear to be the
case with the straight portions of the sweat-tubes, but the convoluted extremit
- i e s , o n t h e c o n t r a r y , i n m a n y i n s t a n c e s s e e m t o p e r s i s t u n a l t e r e d e v e n w h e r e
entirely buried in masses of the growth (Plate III., Fig. 3).
The extent to which the fibrous tissue of the dermis was broken up and, as
it were, dissected by the interposition of these masses of the new growth varied
greatly in different parts of the tumour. Towards the centre masses of the
neoplasm were present in very great numbers and tending more and more to
become confluent with one another. Well-stained sections very clearly demon
- s t r a t e d t h e v a r i o u s s t a g e s i n t h e p r o c e s s o f s e p a r a t i o n o f t h e b u n d l e s f r o m o n e