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up of the polymorphous cell type. Pancreas: The head of the voltaren 50mg diclofenac pancreas is voltaren xr 100mg almost en- tirely replaced by a sarcomatous mass, which is made up chiefly of small round cells, but contains also many poly- morphous cells. Stomach: The base of the round ulcer and tlie flat infiltrations of the mucosa consist of nodules of sarcoma. The \ilcer is apparently caused by the mucous degenera- tion of a large nodule projecting through the mucosa. The structure of these nodules in the wall of the stomach is the same as that found in the other tumors. Intestine: The small nodules in the serosa arc of the same type voltaren topical of sarcoma as that described above. Testis : The tumors here present the appearance of a small round-cell sarcoma. Areas of mucous degenera- tion are abundant, and the blood-vessels are very luimer- ous and ectatic. Prostate: The prostate contains localized areas of small round cells. Lymph glands: The cervical, peribronchial, mesen- teric, and retroperitoneal lymph glands contain largo nodules of polymorplious or small round-cell sarcoma. The majority of these show mucous degeneration. Summary. — All voltaren sr 75 mg tablet of the growths are of the nature of sarconui. The majority of the smaller nodules and the periphery of all the larger ones are made generic name for voltaren up of small, round, dce])ly-staining cells having but. little intercellu- lar substance and lying in intimate contact with the Jnne 24. 1809.] WARTBHf: POLYUORPBOUS-CELL SAhCOMA OF THE SOSE. blood-vessels. In the central part of all the larger nod- ules, and in some of the small ones, the cells are larger, polymorphous, and there is an increase in the intercel- lular substance, which is myxomatous voltaren xr 100 in character. In many of voltaren for sale the nodules the entire central part of the growth has undergone a mucous degeneration, and early stages of this degeneration are seen in all of the growths. The tumors are further voltaren generic name characterized throughout by the num- ber and size of the blood-vessels. From the structure of the growth the diagnosis of the tumor as a myxomatous polymorphous-celled sarcoma would seem most appro- priate. That the growth in the nasal fossa is the primary one there can be no voltaren ec 75 mg reasonable doubt. The history of the case, the development of the symptoms, the size and structure of the nasal growth all support this view. The exact site of origin can not be determined. The patient affirmed that it appeared first in the right nostril upon the right side of the saeptuni. ^loreover, the rela- tion of the sarcoma to the polyps stated to have been removed can not be settled in the absence of any definite microscopical evidence concerning their structure. The fact that the tumor everj'where shows a marked tendency to a mucous degeneration of its cells and the formation of a myxomatous intercellular substance might be takeu as an evidence of an inherited tendency on the part of its cells tending to show a descent from a myxomatous polyp. This, unfortunately, will not admit of further confirmation. The points of special interest in this case are the widespread metastases and the generic for voltaren intracardiac growth. Secondaries were found in the dura, pineal body, hy- pophysis, cavernous sinus, lungs, pleura, heart, liver, «picen, kidneys, pancreas, stomach, intestines, perito- niuum, testicles, prostate, and the cervical, bronchial, retroperitoneal, and mesenteric lymph glands. The richness of the growth in cellular element.", the scanty stroma, the numerous large thin-walled blood-vessels, the Bmallncss and shape of the cells, all contributed to till- facility of the rapid dissemination of the tumor, 'riie numerous metastases throughout both venous and arterial systems are easily explained by the above-men- tioned factors. The free sarcomatous body in the right ventricular cavity form.* the most important fenturo of the case. Intracardiac and intravenous growths arc very rare both ill carcinoma and sarcoma, but have been described in both, more frequently in the case of the latter. Kau- tluick * has dcscrilx'd a case of voltaren xr 100 mg carcinoma of the testis in which there was a metastatic mass u[)on the tricuspid valve extending tliroii;,'li the auricle into the inferior Venn cava and through (he tricuspid orifice into the cavity of the right ventricle. The origin of this seemed to have Im'cu from an intrnvcnous growth in the inferior vena cava, n fragment of which must have become sepa- rated and grafted upon the tricuspid vnlvc, where it con- voltaren in canada linnod to grow. The pnibai)lc origin in my cnso is Ihnt voltaren 75 sr sug;;csled (iliovc — namely, the breaking loose of n fwlypoid nodule * ./..Mr, voltaren sr 100mg 0/ PmA. ami flart , January, IHWH from the endocardium, its retention in the ventricle, and its subsequent growth. Microscopically the endocardi- um was infiltrated ^vith sarcoma cells, and in one place there was found the thin, flattened growth on the sur- face of the endocardium. This may have been the ori- gin of the mass, or, on the other hand, it may have arisen from a primary embolus of tumor cells retained in the heart cavity. The numerous emboli of tumor cells found in the lung vessels and the haemorrhagic infarcts of the lung may have resulted from voltaren in usa the breaking loose of portions of this intracardiac growth. The anaemic infarcts in the spleen were also probably caused by emboli of voltaren ec tablets 50mg sarcoma cells, as masses of these cells could be seen growing in dilated blood-spaces of this voltaren rapid 25mg organ. Another point of interest in the growth of this voltaren ec tumor is its tendency to self-healing. As mentioned above, this could be seen in all stages, from the begin- ning of the formation of a granulation-tissue capsule voltaren 100 mg retard around the area of degeneration to completely formed

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