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880 WARTHIN: POLYMORPHOUS-CELL SARCOMA OF THE NOSE. Vigora 100 [N. Y. Med. Jodk., ed a colloid appearance, sometimes firm in consistence, at other times more watery. The posterior part of the nasal fossa was completely filled with this jellylike mu- cin. In many places these cystlike spaces are surround- ed by a capsule of granulation tissue. It would seem that the tumor in its growth had reached a certain height in these areas, the cells had completely degener- ated, and there had been an attempt at encapsulation. No typical mucous tissue was found in any part of the original tumor or in any of the metastases. Dura : The small growth taken from the dura pre- sents the appearance of a small round-cell sarcoma. Pineal body : The growth here is polymorphous- celled and shows myxomatous degeneration in the cen- tral part. The peripheral portion has the appearance of a small round-cell sarcoma. Hypophysis : This is almost entirely replaced by a central tumor mass which is of the type of a polymor- phous-cell alveolar sarcoma. The central part shows a marked myxomatous change. Many giant cells are pres- ent here, and the irregularity in the size of the nuclei is very marked. In the periphery are nodules of small round cells. Gasserian ganglion : The sections of the mass taken from the region of the left Gasserian ganglion show a beautiful picture of the infiltration of large nerve trunks and ganglion by sarcoma cells. There are many of the ganglion cells preserved, surrounded by small, round cells, from which they stand out in Buy Vigora Online sharp contrast. They are swollen and granular, but their Cheap Vigora nuclei and nucleoli can be distinctly made out, and their nucleated capsules appear unchanged. The nerve fibres of the large nerve tnmks are widely separated by tumor cells and in many places have a knotted, swollen appearance. In the sec- tions stained by Van Gieson's method these knotted fibres have a greenish color. The tumor cells here, like those in the central portions of the primary growth, are very irregular in size and shape. There are many giant cells with largo nuclei showing marked hyperehromato- sis. Many of the nuclei are star-shaped, others are ragged in outline. Caryomitotic and amitotic division forms are abundant. There are many ectatic blood-ves- sels. Vigora Oil The central portion of the growth shows also a myxomatous change. Throughout the trunk of the left third nerve there is an infiltration of sarcoma cells. The colloid mass into which the third nerve passed is a cavity filled with a colloidlike mucin surrounded by a capsule of granulation Order Vigora tissue. Outside of tliis capsule the tumor cells are of more uniform size and there arc not so many giant cells. The blood-vessels are very numerous and large. Heart : The entire heartwall is infiltrated with tumor cells. The muscle in many areas is wholly replaced by nodules of polymorphous cells. The larger nodules show myxomatous change and in every way present an appear- ance similar to that of the original growth. The remain- ing muscle cells are greatly atrophied and arc widely separated by small round cells. Many of the muscle fibres show simple and waxy necrosis. The entire endo- cardium is infiltrated with small round cells, and in one Vigora Online area in the right ventricular wall the tumor ec^lls have broken through the endolhelium aiul form a small fiat- tened growth on the wall of the venlricular cavity. This could not bo seen in Vigora 5000 the naked-eye examination. The sections of the free mass in the right ventricular cavity show it to Vigora 100 Tablets be of sarcomatous structure. There arc many cells larger than leucocytes and possessing large vacuolated nuclei. A few giant ci'lls arc found, and many cells with large, irregular, deeply-staining nuclei. The majority of the cells are of the small round variety. At one side of the mass there is a collection of red blood- cells and fibrin. A very scanty reticulum can be made out and a few small blood-vessels can be seen. The ori- gin of the mass seems very evident after the microscopi- cal study of the endocardium of the right ventricle. It is undoubtedly a polypoid nodule that, projecting from the endocardium, grew until it was too large to pass out of the ventricle, and then breaking loose continued to grow as a free body. The mass shows no necrosis or de- generation. Lung and pleura : The small growths in the pleura ai'e of the type of a small round-cell sarcoma. The larger ones show a polymorphous Vigora 50 variety of cells and myxomatous degeneration. The small nodules through- out the lung consist of small round cells, the larger ones of polymorphous cells. There is hardly a blood-vessel throughout the lung that has not a circumvascular growth of sarcoma cells. Nixmerous emboli of sarcoma cells are found in the Buy Vigora capillaries. In many of the small- est growths the cells are irregular in size and shape and show great excess of chromatin. The lung shows ex- treme oedema and congestion, and there are several hem- orrhagic infarcts and small areas of broncho-pneumonia. Many of the larger tumor nodules show a healing process and the formation of scar tissue in the central part of the nodule. This can be seen in all stages, from a beginning formation of granulation tis.sue around Generic Vigora the myxomatous portion of the tumor to nodules made up Vigora Tablets of scar tissue alone. Spleen: Small nodules of tumor cells are found throughout this organ. There are also a number of anffimie Vigora Price infarcts. Liver : A number of small nodules of small round cells are found in the periportal connective tissue. Kidneys : There is an acute degenerative nephritis present, and the greater part of both kidneys is replaced by masses of sarcomatous tissue of the same structure as described above. Many of the smaller nodules are made

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