EX I’E K I hI EN ’I’A I, STI J I> I ES ; 11S I hlilla TI! A4 0 KS An Investigation of the Histological Changes in the Subcutaneous Tissues of Mice during the Induction of Sarcoma by Carcinogenic Hydrocarbons, J. \V. ORR. J. Path. LY: lht. 49: 157-170, 1939. Orr studied the reactions around pellets of parafin wax (11i.p.46-52’ C.) and similar pellets containing 2 per cent of a carcinogenic hydrocarbon or a related non-carcinogenic hydrocarbon. The pellets were about 1 cm. long and of 5 nig. average weight and were implanted su1,cutaneously into mice, which were killed at intervals ranging from 1 to 387 days; the mice were not of a genetically pure strain. Pellets of wax alone evoked a mild foreign-body reaction and were enclosed in a capsule of firm collagen within two months, after which no further change occurred. Pellets containing non-carcinogenic hydrocarbons were similarly encapsulated, but the capsule was sometimes thicker and required a little more time for conipletion. The initial reaction about pellets contain- ing carcinogenic hydrocarbons was similar but the encapsulation was imperfect, the collagen being small in amount or loose in texture, with fibrinoid material on the inside. The presence of the fibrinoid material suggested that the carcinogenic hydrocarbons damaged the collagen in contact with them. At a later date cellular proliferations were found at a distance from the pellet and outside the thin collagen zone. The proliferat- ing cells were of histiocytic or lymphocytic type and were the cells from which sarcomata developed. hlethylcholanthrene, 3 : 4-benzpyrene, and 1 : 2 : 5 : 6-dibenzanthracene produced qualitati\dy similar changes but in descending order of intensity. Orr concludes that the cells from which the carcinogen produces tumors are not present until a comparati\.ely short time before the tumors appear; the cells then collect where they are outside the range of action of the carcinogen. “ It is suggested that the appearance of sarcoma in these cellular foci is the result of a progressively increasing rate of division in an effort to acconiplish the sometimes apparently impossible task of enclosing the carcinogenic niaterial in iin adequate fibrous capsule similar to that formed round other foreign Iwdies. It may well be that the only possible outcome of such a process is a malignant tuniour.” The paper is illustrated by 16 photomicrographs and includes a bildiography. L. FOULDS

Morphology of 160 Tumours Induced by Carcinogenic Hydrocarbons in the Subcu- taneous Tissues of Mice, G. hl. BONSERAND J. \\’. ORR. J. Path. Sr Bact. 49: 171- 183, 1939. This paper describes the histologic features of 160 niouse tumors; 145 were induced by subcutaneous injections of niethylcholanthrene in lard and 15 by subcutaneous wax pellets containing carcinogenic hydrocarbons as described by Orr (see preceding abstract). Sarcomata constituted 65 per cent of the tumors in female mice and 96 per cent of those in male mice. The majority were spindle-celled, though many contained poly- niorphous cells. ITsuallyit w;is impossible to decide the origin of the tumor; some all- peared to originate from entlomysiuni hit others niore probably arose from histiocytes. Giant cells were coininon, being either niultinucleated tumor cells or derived from damaged ti ntary inuscle cells. There were 23 adenocarcinomata, of which 14 were associated with other forms of growth. They were regarded as mammary tumors and since they occurred close to the injected material and were as frequent in IF and CBA mice, in which spontaneous mammary cancer had never been observed, as in other mice, they were attributed to the action of the Carcinogenic agent. Some of the tumors showed a tendency to squamous differentiation. Two early tiiniors had originated apparently by intraduct proliferation of epithelium. 277 278 ABSTRACTS

Squanious carcinoiiiata alone were present in 6 iiiice. 'I'hey tle\.eloped from the skill and associated structures, from the squaiiious lining of sinuses formed in connection with ahscess cavities and injection masses, or by nietaplasia from other types of tumors. In 13 mice adenocarcinonia of the breast was accompanied by spindle-celled areas. In 3 aiiinials there were two separate tumors regarded as independent sarcoma antl adenocarcinonia and in one mouse a sarcoma was inlading a carcinoma. The remaining 9 neoplasms were classed as carcinosarcoma; 5 showed squarnous nietaplasia. In 6 other mice there were carcinosarconiata consisting of sarcoma and squanious carcinoma, and in one mouse there was a combination of sarcoma, breast carcinoma, and sq ua inou s carcinoma.

L'nder the heading I' carcinosarconia " the authors include tumors of four different categories which were found in their series: (1) tumors composed of two independent elements of different origin, (2) pleoniorphic tumors derived from one cellular source, (3) independent tuiiiors-carcinonia antl sarcoiiia-oriRinating in separate foci and subsequently intermingling by mutual invasion, (4) tumors in which the spindle- celled tissue is an unusually active cellular stronia of a carcinoma and not a true tumor. The paper includes 14 photomicrographs and a bibliography. I-. FOULDS

Dibenzanthracene Mouse Sarcomas: Histology, \Y. H. I.EWIS. Ani. J. Cancer 37: 521-530, 1939. This is a histologic study of 50 neoplasms produced in pure strain mice by one in- jection, into the axilla, of 0.8 nig. of 1 : 2 : 5 : 6-dibenzanthracene dissolved in lard or olive oil. Sections of 22 of these were found to contain modified skeletal muscle filxrs, muscle giant cells, niyoblasts, spindle cells, and invaded host tissues. Sections of the remaining 28 consisted principally of spindle cells without modified muscle. On suc- cessive transplantation the modified muscle elements, with rare exceptions, disappear, and the sections are similar to those of the spindle-cell sarconias without modified muscle. This disappearance of the modified muscle elements in later generations suggests that they either dedifferentiate into spindle cells, which are malignant and indistinguishable from those of connective-tissue origin, or are lost or die out. Twenty photomicrographs are reproduced and references are furnished.

Experimental Production of Malignant Papillomata of the Lung in Mice with 1 : 2 : 5 : 6- dibenzanthracene, H. A. ~~A(.Nus.J. Path. & Bact. 49: 21-31, 1939. The author injected 0.5 C.C. of a0.4 per cent solution of 1 : 2 : 5 : 6-dibenzanthracene in olive oil twice weekly for six months into the stomachs of mice, using for the purpose a blunt vaccine needle connected with a syringe. Sixty-three mice out of 100 were alive after six months, antl 60 of these (95.2 per cent) died subsequently with lung tumors, the first eight months and the last twenty months after the beginning of the experi- ment. Five of the mice with lung tumors had tumors elsewhere and two others had lymphatic leukemia. In a control group 23 out of 25 mice were alive when the last of the experimental group died; one only of these had multiple lung tumors of benign type. Many of the lung tuniors closely resenitled the papillary cystadenoina of nian. It was shown that these tumors were large intrabronchial papillomata filling the lumina of dilated bronchi; the columnar cells of which they were composed resembled those found in the epithelium of the bronchial niucosa. It is concluded that the tumors originate from bronchial epitheliuni and not, as conimonly supposed, from alveolar epithelium. 'I'hese tumors were undoubtedly benign, but in 75 per cent of the mice the bronchial papillomata showed clear evidence of malignancy with metastasis in two mice. The malignant growths consisted of masses of undifferentiated epithelial cells or, in- frequently, of well differentiated adenocarcinonia. 'The origin of bronchial cancer in mice is conipared with the origin of cancer from niultiple polypi of the colon in nian. There were no differences between the induced tuinors and those which occur spontane ously in mice. The incidence of spontaneous lung tumors in the stock " market mice " used in the experiment is 4 to 8 per cent. lhere was no reasonable doullt, therefore, that the developnient of triinors in 95.2 per cent of the experinient;il mice was attril)iital)le to EXPERIMENTAL STUDIES ; ANIMAL TUMORS 2 79 the dibenzanthracene. It was shown in separate experiments that charcoal or carmine in olive oil injected into the stoniach in tlie saiiie way ;IS the dillenzanthracene was demonstrable in the lungs five niinutcs later. It was assuincd that small quantities of solution were aspirated into the lungs during the withdrawal or introduction of the needle and it was considered highly prd)able that aspiration of minute quantities of 1 : 2 : 5 : 6-dibenzaiithracene accounted for tlie production of the lung ttimors. ‘rumors were coiiipletely absent from the alimentary tract, Imhably because the Ii~drocarbon passed through rapidly. The paper is well illustrated by photographs and I’hotoiiiicrograplis, and a bibliog- raphy is provided. I.. FOULDS

Association of Carcinogenicity and Growth-inhibitory Power in the Polycyclic Hydro- carbons and Other Substances, .A. IIADDOWAND r\. hi. l

Inhibition of Growth of the Rat by Oral Administration of Methylcholanthrene, Benz- pyrene, or Pyrene, and the Effects of Various Dietary Supplements, J. \~’JIITEAND A. A. \\‘HITE. J. I3iol. Chem. 131: 149-161, 1939. The authors sullniit data to shoiv that the inhibition of growth induced by diets containing niethylcholanthrene, benzpyrene, or pyrene (\\'bite and \\'bite: Proc. Soc. Exper. Biol. & \led. 39: 527, 1938. ,Al)st. in :\in. J. Cancer 35: 560, 1939) is a nianifes- tation of the production of a specific deficiency in the sulfur-containing amino acids, probably by imposing on the organism an increased demand for organic sulfur for detoxication niechanisins. Dietary supplements of I-cystine or dl-rnethionine, for instance, were shown to cause a prompt stimulation of gro\vth in rats following retardation due to the incorporation of niethylcholanthrene, henzpyrene, or pyrene in the diet. ‘I’aurine, sodium sulfate, and glycine were ineffective in this respect. I)ailj, injections of glutathione also produced an increased growth rate in ariinials on the riietliylcliolanthrene-containing diet. The authors’ results (lo not eiiipliasize the difference in behavior between carrino- genic and non-carcinogenic hydrocarllons visualized liy Haddow and his colleagues (Haddow, Scott, and Scott: Proc. Koy. Soc. I.ontlon, ser. 13 122: 477, 1937. Abst. in Am. J. Cancer 31: 497, 1037). These workers showed that a single intraperitoneal in- jection of certain carcinogenic hydrocarbons in sesame oil retarded the growth of the rat, whereas similar injections of non-carcinogenic hydrocarlions failed to do so. The Whites point out that both t)‘pes of 1iytlrocarl)on retard growth if given with the diet in 280 ABSTRACTS

;~decliii~teaiiiounts. 'flie ;imount of a particular compound required to inhibit growth tlepentls on the sul)stance itself and varies widely from one compound to another. Consitlerably more of the non-carcinogenic hydrocarbon pyrene than of the carcinogenic hydrocarbons niethylcholanthrene and benzpyrene is required to produce the same retardation of growth. This fact, it is submittecl, may explain the differences observed by 1 laddow and his colleagues. A. F. \\'ATSON

Comparison of the Photodynamic Activity of Some Carcinogenic with Non-carcinogenic Compounds, I. DONIACH.Brit. J. Exper. Path. 20: 227-235, 1939. It was shown previously that certain carcinogenic hydrocarbons sensitize living cells to near-ultra-violet radiation (Rlottrarii and Doniach: Lancet 1 : 1156, 1938; hlottrani: ['roc. Roy. SOC.,ser. I3 126: 560, 1939. Absts. in Am. J. Cancer 35: 280, 1939: 37: 120, 1939). .A method of biological assay is now described which detects 3 : 4-henzpyrene and other carcinogenic hydrocarbons in dilutions of up to 1 in 100 millions. Cultures of paramecium were used as test objects. Colloid suspensions of hydro- carbon were added to the cultures, and the mixtures were exposed to a mercury vapor lamp; photodynaniic action was measured by the time taken to kill 95 per cent of the paramecia. The degree of sensitization was greatly increased by prolonged contact between benzpyrene and the paramecia in the dark, though there was no lethal effect. The water-soluble oxidation products of benzpyrene formed during several weeks' ex- posure to sunlight also sensitized paramecia to light, but the sensitization was not in- creased by contact in the dark. The carcinogenic hydrocarbons 1 : 2-benzanthracene, rholanthrene, and methylcholanthrene had about the same degree of photodynamic potency as 3 : 4-benzpyrene. 'The activity of some non-carcinogenic light sensitizers (acridinc, acriflavine, eosin, quinine sulphate) was much lower, and these substances were distinguishable from the carcinogenic hydrocarbons by their failure to increase sensitivity of paramecia by contact in the dark. It was not decided whether the photodynaniic action of 3 : 4-benzpyrene was due to the hydrocarbon itself or to its oxidation products. It is presumed that the hydro- rartlon links up with the cell protoplasm and that the linkage probably tlepends on an ;ilteration of the molecules, perhaps by osidation or hydroxylation. The testing of photo-oxidation products for carcinogenicity may help to decide if carcinogenic action is due to the piire hydrocarl)ons, to their oxidation products, or to the actual process of ositlation. I,. FOLJLI~S

Attempt at Cancer Prophylaxis by Treatment with Carcinogenic Polycyclic Hydro- carbons, H. ALAPY. Ein Versuch der Kre1)sprophylaxe durch Vorbehandlung mit krel~serregenden polycyclisclien I

Effect of Dibenzanthracene on the Liver, 11. GOERNERAND RI. XI. C~OERNER. ,4111.J. Cancer 37: 518-520, 1939. Intraperitoneal injections of tli1)enzanthracene in rats and rabbits caused loss of body weight and enlargement of the liver with evidences of fatty degeneration; the vitamin A content of the liver was greatly decreased but the vitamin C content showed little c1i;irige. 'I'he amount of glutathione per 100 grn. of liver tissue was moderately retlucetl. Thirty rats and 15 ralhits were used for these csperinients, with adequatc controls. lieferences are apl~en(letl. EXPERIMENTAL STUDIES ; ANIMAL TUMORS 281

Action of Carcinogenic Hydrocarbons on Tissue Cultures, I,. T. IARIONOW, N. G. IVACHENTZOVA, AND 11. A. TCHEHTKOVA. Sur I'action des hydrocarbures canchi- genes dans les cultures des tissus, I3ull. tle biol. et de mi.tl. espbr. 6: 113-117, 1938. The effects of the carcinogens on cultures in uitro of spleen and bone marrow of the mouse, bone niarrow of the rabbit, and chick fil)rol)lasts are recorded. Small quantities of colloidal benzpyrene and dibenzanthracene increased the growth of explants of spleen and hone marrow. A 0.002 to 0.005 per cent concentration of benzpyrene pro- duced a transitory stimulation of chick fibroblasts, while addition of 0.001 per cent of the hydrocarbon provoked degenerative nianifestations. Ijibenzanthracene appeared indifferent in cultures of fihrolhsts. hlalignant change was not observed in chick fibroblasts cultivated for two months in niedia containing 0.0001 per cent benzpyrene or 0.001 per cent dil)enzanthracene. [Since a longer time than two months is required to produce a malignant tumor, no change ~vouldbe espected in the culture in that time. --ED.] hllLTON J. EISEN On the Supposed Relationship between Cholesterol and Carcinogenic Agents, \\'. I~ERGMANN.['Iwr verniutliche Ikziehringen zwischen Cholesterin untl cancero- genen Stoffen, Ztschr. f. I

Malignant Tumors in the Digestive System Resulting from the Ingestion of Fats Oxidized by Heat, i\. I I. KOIWO. 'I'umeurs iiialignes d6veloppCes dans I'appareil digestif par I'ingestion de graisses ox)d(.es par chauffage, I3ull. Assoc. franq. p. I'btude du cancer 28: 556588, 1939. Also in 1301. Inst. de nied. exper. para el estud. y trat. d. clncer 15: 407-521, 1938, and Prensa ii1i.d. argent. 26: 619-648, 19.39. Roffo previously reported the production of tumors of the digestive system of rats by the administration ofcholesterol, or foodstuffs richin cholesterol, irradiated with ultra- violet light (Ztschr. f. Krehsforsch. 47: 473, 1938). He now records similar results in rats which received a diet of bread and milk with daily additions of animal fats or olive oil which had been heated to 350" for half an hour. 'I'he heating destroyed all the cholesterol as estimated by the digitonin method. The fats acquired ahsorption spectra resemhling those of phenanthrene, irradiated cholesterol, and the carcinogenic hydro- carbons, and the tiimors were attri1)uted to the action of carcinogenic oxycholesterol. I.I he stomach, cecuni, and liver were the most frequent sites of lesions. In the stomach, lesions occurred in I)oth sqriamotis and glandular zones; they comprised simple erosions, hemorrhagic erosions, acute ulcers, rtrund ulcers with papilloniatous edges, and neo- plastic ulcers. The first three forms of lesion were found only in rats which had received heated fats for short periods while the other, chronic lesions were usually found after more than a year of treatment. 'I'he di\.erse lesions in the stomach are considered to be different developmental stages in a single process which culminates in neoplasia after an average period of twenty-t\vo months. 'I'he liver tumors were spindle-celled sar- comas with numeroii~secondary de1)osits. Spindle-celled sarcoma of the lung with secondary deposits was ;ilso ohserved. The results of four experiments, each comprising SO rats, are taliulated and some of the lesions are described in detail and illustratcd l)y eight photographs of gross speci- mens and five pliotoniicrographs: other illustrations mentioned in the text are not discoverable. From the tables it aplmtrs that of the 200 rats, 6 had spindle-cell sarcomas of the liver, 2 had spindle-cell sarconiii of the Iring, 1 had papilloma and 5 had ulcers of the 282 ABSTRACTS

cecum, and 79 had lesions of various kinds in the stomach; 23 of the gastric lesions were apparently benign or malignant neoplasms. RoITo has not observed similar lesions in hundreds of thousands of rats which had not received special diets. He concludes that the results, obtained by the feeding of fats subjected to conditions which are daily encountered in human cookery, demon- strate the esistence of carcinogenic substances and emphasize the importance of fat metabolism in carcinogenesis, in which the oxidation of cholesterol is of unquestionable importance. L. FOULDS

Pigment Protection in Tarred Mice, A. I

Development of Metastases of Tar Cancers in Mice, A. KO~IR.Zur Entwicklungs- mechanik einiger Metastasen des hliiuseteerkrebses, Prirodoslovne Razprave 3: 161-166, 1937. I.yniph node, heart and lung metastases of tar cancers of the skin in mice are de- scribed. Photomicrographs are reproduced. ~~ILTONJ. EISEN

Metaplasia and Adenoma-like Changes in the Uterus of Rats Injected with Sex- Hormones, \'. Iestrogens might influence the metaplastic changes. They ha\.e continued their studies with large series of normal and ovariectoniized rats. The animals were injected for two to three and a half months with estradiol dipropionate or benzoate-butyrate (0.018-2.0 mg. per week) alone or simultaneously with male hormones (androsterone 7.5 mg., testosterone propionate 2.25-7.5 nig. and testosterone dipropionate 7.5 mg. per week). In one experiment progesterone (4.5 mg. a week) was given in addition to estradiol dipropionate and testosterone propionate. The results are summarized as follows. (1) The percentage incidence of the metaplastic changes may be the same in the rats injected with estrogens as in those injected with both estrogens and male hormones. (2) \I'ith the doses used, however, adenoma-like changes in the uterine glands and the most severe degree of squamous nietaplasia of the uterine epithelium were found only in the latter group of rats. (3) The addition of progesterone considerably decreased or in most cases prevented the inetaplastic changes. (4) The results add weight to the suggestion that disturbances of the ratio of the male and female sex hormones, simultaneously present in the organism of either sex, may be an important factor in the occurrence and development of some types of neo- plastic growth. A. F. \VATSON

Experimental Tumorigenesis with Subcutaneous Tablets of Oestradiol, A. LIPSCH~TZ AND I,. \'ARGAS, JR. I.anCet 1: 1313-1318, 1939. Twenty and 50 mg. estradiol tablets were implanted subcutaneously in castrated female guinea-pigs. Uterine and extra-uterine tumors began to appear after two and a half to three weeks, and the authors consider it probable that no female guinea-pig with a 20 or 50 mg. estradiol tablet in the body for more than two weeks escapes tumori- genesis. Large growths may occur in seven weeks. Tablets of estradiol produce effects EXPERIMENTAL STUDIES ; ANIMAL TUMORS 283 which are, in general, similar to those produced by repeated injections of estrogenic substances as recorded by the authors in previous publications (see Absts. in Am. J. Cancer 36: 123, 1939). The action, however, is more rapid and more intense.: 4 mg. of estradiol absorbed from tablets in seven weeks produced more growth than 5 mg. administered by repeated subcutaneous injections during fourteen weeks. The in- creased effect of the estradiol when administered in tablets is attributable to continuous absorption and continuous flow in the body fluids. The distribution of the tumors pro- duced by tablets differed from that observed after injections in some particulars; " tumoral seeds " on the spleen and in its neighborhood were rare, though frequent in the earlier experiments; " apical " myomatous tumors, originating in the mesosalpinx where the tube joins the uterus, were, by contrast, more conspicuous. Photomicrographs and a bibliography are included. L. FOULDS

'' Useful Hysterotrophic " Dose and Tumor-Producing Dose of Free Estradiol and of Free Estrone, A. LIPSCH~~TZ,F. RODRIGUEZ, AND L. VARGASFILS. Dose hysthro- trophe '' utile " et dose '' tumorigene " de I'oestradiol et de I'oestrone libres, Compt. rend. soc. de biol. 130: 939-942, 1939. The authors determined the minimum dose of estradiol which, injected thrice weekly, maintained the uterus of castrated guinea-pigs at the same weight as that of the normal

guinea-pig for about three months. This dose (I' dose hysterotrophe utile ") was about 5 gamma. The dose which, administered at the same intervals, was necessary to produce uterine or extra-uterine tumors was about twenty to thirty times the maintain- ing dose. The action of estrone on the uterus was equal or superior to that of estradiol. L. FOULDS

Sexual Specificity of Connective-tissue Tumor Reaction to Follicular Hormone, A. JEDLICKY,A. LIPSCH~TZ,AND L. VARGASFILS. La specificit6 sexuelle dans la rhaction tumorale conjonctive vis-8-vis de I'hormone folliculaire (caprylate et 17-benzoate-3-n-butyrated'oestradiol), Compt. rend. Soc. de biol. 130: 1466-1469, 1939. It was previously shown (Koref, Lipschiitz, and C'argas: Compt. rend. SOC.de biol. 130: 303, 1939. Abst. in Am. J. Cancer 36: 462, 1939) that the extragenital tumor reac- tion to estradiol benzoate was different in male and female guinea-pigs. Similar results were obtained with the monocaprylate and the 17-benzoate-3-n-butyrateof estradiol. The reaction in the male was characterized by disseminated tumor foci in the neighbor- hood of the spleen; a similar reaction in females was unusual. The reaction in the male was not affected by castration nor by increasing the dose of hormone to eight times that which had a strong tumor-producing action in females. Ligature of the spermatic cord favored tumor growth at the operation site. L. FOULDS Regression of Experimental Fibromyoma and Resistance of Epithelial Tumor Forma- tions in the Absence of Follicular Hormone, A. LIPSCHUTZ,R. IGLESIASAND L. VARGAS,FILS. Regression du fibromyome experimental et resistance des forma- tions tumorales hpithhliales, dans la carence hormonale folliculaire, Compt. rend. SOC.de biol. 130: 15361540, 1939. Three castrated female guinea-pigs after receiving injections of estradiol benzoate thrice weekly for eight months had palpable uterine tumors with diameters of about 1.5 to 4 cm. The administration of hormone was discontinued and after seven to ten weeks the uterine tumors had decreased greatly in size. Autopsies were carried out three and a half months after stopping the injections and revealed only small vestiges of tumors: the latter were replaced by adipose tissue or transformed into hyaline.or ossified fibrous tissue. The experimental fibromyomas thus showed changes comparable with those which occur in uterine fibroids in women at the menopause.. Two guinea-pigs, however, had adenoma-like proliferations of uterine epithelium after about three months' de- privation of follicular hormone. It seems that the epithelial overgrowths provoked by the hormone can acquire under certain conditions a tumoral autonomy. L. FOULDS 284 ABSTRACTS

Local Growths in Aninuls, Produced by Injection of Intercellular Wound Honnoner, J. R. LOOFBOUROW,A. A. CtTmo, D. \I'HALEN,AND MARY hl. LANE. Sature 144: 939-940, 1939. The repeated injection into rats and mice of intercellular wound hormones, pro- duced by injuring tissue cells with lethal ultraviolet irradiation, has been shown to produce local overgrowths. The wound hormones were prepared by mincing whole rat or mouse embryos, or adult rat spleens, washing the minced tissues and suspending them in isotonic salt solution, submitting the cell suspensions to lethal ultraviolet irradiation, and obtaining the intercellular fluids (containing the wound hormones) free from cells by centrifugation and Berkefeld candling. These fluids were injected subcutaneously over the abdomen in 0.5 C.C. quantities. In two experiments with mice, injections were made three times weekly; in a third esperiment, with rats, injections were made twice weekly. Six to eight weeks after starting the injections, all the animals developed hard tumor- like masses either near the site of injection or on the tails or feet. These persisted and usually increased in size until the animals were killed at the end of from ten to twelve weeks. A typical tumor removed at autopsy weighed 1.15 gm. Histologic examination of the overgrowths showed them to be composed largely of connective tissue and striated muscle. Control fluids, obtained from tissues treated similarly except that irradiation was omitted, led in some cases to the development of similar but much smaller and less persistent growths. It is pointed out that some wound hormone production might be expected even in the control preparations because of unavoidable mechanical injury to the tissues. .4 more detailed description of the esperiments is promised in a future publication. A. F. WATSON

AttempG to Trrnder the Jeruer! Rat Sarcoma by the Trrnrplantatioa of Regional . Lymph Nodor, 0. HUBNEk AND E. ~HAI~R.Versuche zur Obertragung von Jensen-Sarkom durch Oberpflanzung regionarer Lymphknoten, Ztschr. f. Krebs- forsch. 48: 553-556, 1939. In most cases the implantation of regional lymph nodes, from rats bearing the Jensen sarcoma, into castrated and non-castrated rats did not reproduce the tumor. The authors were unable to duplicate the high proportion of successful results in recently castrated rats described by Auler and Schilling (Ztschr. f. Krebsforsch. 47: 363, 1938. Abst. in Am. J. Cancer 35: 566, 1939). The few tumors that did arise are referred to metastatic cells rather than to some non-cellular agent. Wm. H. WOGLOM

Splenic Grafte in a Lymphourcomatour Strrin of Mice, L. ~IERCIBR. Creffe de rate chez des souris d'une IignQ ii lymphosarcome, Compt. rend. Soc. de biol. 130: 964- 965, 1939. ' Transplants of the spleen of mice of an inbred lymphosarcomatous strain persisted and grew to a varying extent in 11 out of 12 mice of the same strain. Transplants of spleen from mice suffering from lymphadenoma of the lung, in which disease the spleen . is not enlarged, persisted similarly and retained the structure of normal spleen; the spleens of these lymphadenomatous mice therefore contained no cancerous elements capable of producing transplanted tumors. Persistent splenic .transplants did not inhibit the development of spontaneous lymphosarcoma in the hosts. L. FOULDS

Local Effect of Zinc upon the Development of the Mush-Bdrlo Adonocarcinoma, F. BISCHOFFAND M. L. Lc~~IG,Am. J. Cancer 37: 531-535, 1940. In an experiment comprising 50 virgin mice of the Marsh-Buffalo strain the injection, at the age of two to three months, of two series of 0.05 mg. doses of zinc sulfate, in the area of the mammary glands, eignificantly delayed the appearance of mammary adeno- carcinoma, In the filteenth month of age 73 per cent of the controls but only 38 per cent of the zinc-dosed mice had developed tumors. In another experiment, comprising 44 EXPERIMENTAL STUDIES ; ANIMAL TUMORS 285 pairs of litter mates of the same strain, in which the injection was begun before the onset of sexual maturity, similar results were obtained. References are given.

Behavior of Lipoids of Transplanted Tumors in Animal Hosts, -1,LANC AND A. ROSEN- BOBM. Das Verhalten der Lipoide von Iinpftumoren im \Yirtskijrper, Ztschr. f. Krebsforsch. 48: 183-186, 19.38. The authors report analyses of the lipoid constituents of transplanted Jensen sarcoma fragments weighing. approximately 50 mg., and of the newly proliferated neo- plastic tissue. The latter zone was readily separated from the original implant after five days. The total cholesterol of the implants showed a pronounced increase during the first eight days after transplantation. The substance was present chiefly as free cholesterol. In the necrotic portion of old tumors the esterified form predominates. The quantity of phospholipids decreased. Neutral fatty acids increased in amount, but this was accompanied by a reduction in their iodine number. Newly proliferated neoplastic tissue in early stages contained lesser quantities of total fat, cholesterol and phospholipid, but after four days a gradual increase in these fractions occurred. MILTONJ. EISEN

Meta~taersfrom Transplanted Tumors, F. E. KOCH. Zur Frage der .\letastasenbildung bei Impftumoren, Ztschr. f. Krebsforsch. 48: 495-505, 1939. By transplanting lymph nodes from mice bearing the Ehrlich carcinoma a tumor strain was cultivated which metastasized extensively, not only to the nodes but to the lungs, kidneys, suprarenal glands, heart, and peritoneum. This observation contra- dicts the frequently expressed opinion that transplantable tumors are less malignant than the spontaneous neoplasms of man. The paper is accompanied by cuts and a bibliography. \VM. H. \I"GLOM

Lymph Node Metastases from Peritoneal Carcinomatoeis in the Moure, WERNER SCHMIDT.uber die Bildung von Lymphknotenmetastasen beim Ascitescarcinom der Maus, Ztschr. 1. Krebsforsch. 48: 506-519, 1939. The transudate from mice with peritoneal carcinomatosis elicited metastasis in the regional lymph nodes by the ninth day after subcutaneous injection. In some of the metastatic cells degenerative changes had been brought about by the lymphatic juices. Though a similar protective reaction is not definitely known to occur in the nodes of man, there can be little doubt that one does take place, and that late metastasis can be thus explained. The article is accompanied by photomicrographs and a bibliography. WM. H. \YOCLOM

Mehnophore Hormone Changes in the Blood and Hypophyds of Tumor Animals, W. RODEWALD.uber die das Melanophorenhormon betreffenden Veranderungen in Blut und Hypophyse \-on Tumortieren, Ztschr. f. Krebsforsch. 48: 165-168, 1938. Inactivator of melanophore hormone was constantly present in extracts of the Ehrlich mouse carcinoma, but was either absent or present only in small quantities in the blood plasma of tumor mice and of rats bearing the Jensen or Flexner-Jobling tumor. The inactivator was not demonstrable generally in normal blood. The melanophore hormone content of the pituitary gland in animals with transplanted neoplasms was unchanged. The hypophysis of female mice of a strain showing a high incidence of spontaneous breast cancer contained reduced amounts of active melanophore hormone before and after the onset of tumor growth. Melanophore hormone inactivator was present in the plasma of these animals and in extracts of the mammary tumors. The author has also studied the melanophore hormone content of the hypophysis in human beings with cancer (see .\bst. on p. 291). MILTONJ. EISEN 2 86 ABSTRACTS

Distribution of Radioactive Substances in Tumor Mice Following Injection of Thorium B Solutions, C. DITTMAR.Uber die Verteilung radioaktiver Substanzen im Korper von Tumorm&wen nach Injektion von Thorium B-haltigen Losungen, Ztschr. f. Krebsforsch. 48: 121-128, 1938. The concentration of thorium B in the tissues of mice bearing the Ehrlich carcinoma was determined with the aid of an ionization chamber six to sixty-eight hours following injection of the radioactive material suspended in phy3iological saline solution or ad- sorbed on colloids, as tumor extracts, serum, plasma or ascitic fluid of tumor mice, serum of normal rabbits or of animals injected previously with tumor suspensions, dyes, and colloidal preparations of various metals. Significantly larger quantities of thorium were found in the kidneys, liver, spleen, and skeletal system than in the tumor tissue, probably as a result of the deficient blood supply of the neoplasm. This confirms the older observation of Ehrenberg (Ztschr. f. Krebsforsch. 35: 348. 1932. Abst. in Am. J. Cancer 16: abst. p. 745, 1932) and indicates the futility of at- tempting to influence the growth of malignant tumors by means of blood'-borne radio- active substances. MILTONJ. EISEN Artlflcial Benignancy of Neopl.sm. III. The Metabolism of Sarcoma 180 Growing at Different Rates, J. MUUS,F. N. CRAIG,AND CI'. T. SALTER.Am. J. Cancer 37: 553-561, 1939.

Pedigreed albino mice, Bagg strain A, were " immunized " against sarcoma 180 and later inoculated with malignant sarcoma tissue from a single tumor. From this material subcutaneous sarcomata were selected, forming a graded series, ranging from tiny 'I benign " growths to large I' malignant " tumors. Although these tumors are known to vary seriatim in their respective mitotic activities, no clear difference in lactic acid or ammonia metabolism could be established by biochemical studies. Oxy- gen consumption, however, was low in 'I benign " tumors. Gaseous Metabolism in a Heteroplrstic Transplanted Tumor, C. SELLEI. Gasstoff- wechseluntersuchungen mit heteroplastisch transplantierten Tumoren, Ztschr. f. Krebsforsch. 48: 520-531, 1939. - The Putnoky tumor (the Ehrlich mouse carcinoma growing in rats) is a more vigorous growth than the original mouse carcinoma, as glycolpis is more active. The x-ray, like potassium cyanide, sodium fluoride, and mustard gas, reduced glycolyeis to within the limits for normal tissues. Many investigators are mentioned throughout the test but no references are given. WM. H. WOGLOM

Speciadty of Proteolytic Enzymes from Tumors, J. S. FRUTON,G. W. IRVING,JR., ANI) MAXBERGMANN. J. Biol. Chem. 132: 465-466, 1940. This is a study of the action of the proteinases obtained from extracts 61 Crocker Fund mouse sarcoma 180, Bashford mouse carcinoma, Brown-Pearce rabbit carcinoma, a human breast carcinoma, and a human sarcoma of bone. Cysteine was used as an activator in all experiments. The pH was 4.6 to 5.2. The carcinoma and bone sarcoma extracts scarcely acted upon I-leucineamide. The Bashford carcinoma extract was equally effective on 1- and d-leucineamide. The breast and Bashford carcinomas acted on carbobenzoxy-d-glutamyl-I-tyrosine,which contains what K8gl designates as an unnatural d-glutamic acid. The enzyme solutions obtained from carcinomas are much less stable than those of other tissue extracts and they also show a marked autodigestion at pH 4 to 5 in the presenceof cysteine. [It has been noted in tissue cultures that cancer cells have a very high digestive action on the fibrin supporting network of the medium, which is not found in the cultivation of normal tissues.--ED.] Effect of X-rays on the Glucose and Hexosephosphate Glycolpsis of Tumour Tissue, B. E. HOLMES.Proc. Roy. SOC.,London, ser. B 127: 223-237, 1939. Transplantable mouse tumor 113, in the form of a mash, was irradiated with large doses of x-rays (about 70,000r). ..2 dose of x-rays which inhibited the formation of EXPERIMENTAL STUDIES; ANIMAL TUMORS 287 lactic acid from glucose had no effect on the formation of lactic acid from hexose-di- phosphate, hexose-mono-phosphate (Embden ester) or glucose-I-phosphate (Cori ester). Irradiation of the brains of embryo chicks by gamma rays from radium decreased the activity of the lactic dehydrogenase system; the decrease was partly or completely pre- vented by addition of coenzyme I to the tissue. The selectivity of x-ray and gamma- ray actions on metabolic process is discussed. L. FOULDS Separation of Cathepain from Malignant and Horn1 Rat Tissue, MARYE. MAVER. J. Biol. Chem. 131: 127-134, 1939. Methods for separating and determining the activity of the catheptic enzyme from normal and malignant (Jensen sarcoma) rat tissue are described. For previous work on the same subject see Voegtlin, Maver, and Johnson: J. Pharmacol. & Exper. Therap. 48: 241, 1933, and Maver, Johnson, and Voegtlin: Nat. Inst. Health Bull. No. 164; 29, 1935. Absts. in Am. J. Cancer 20: 657, 1934; 27: 142, 1936. A. F. WATSON Tryptophane Content of Tumora, A. LANG. Der Tryptophangehalt von Tumoren, Ztschr. f. Krebsforsch. 48: 29-31, 1938. The tryptophane content of rat tissue, expressed in percentage tryptophane nitrogen of total protein nitrogen, varied from 0.86 per cent in the lung to 1.21 per cent in the kidney. The tryptophane nitrogen of healthy Jensen sarcoma was 0.81 per cent, of the necrotic portion 1.09 per cent, while that of a human cancer was 0.74 per cent. No differences were observed in the tryptophane content of the organs of normal and tumor bearing rats. [See following abstract.] MILTONJ. EISEN Tryptophane Content of Rat Organs and Tumors, A. ROSENBOHM.Der Tryptophange- halt in Rattenorganen und in Tumoren, Ztschr. f. Krebsforsch. 48: 117-120, 1938. The tryptophane content of rat tissue, expressed in percentage of total protein, varied from 0.83 per cent in the brain to 1.28 per cent in the liver and 1.35 per cent in the muscle. In three rat neoplasms the following quantities were found: Jensen sarcoma, 0.90 per cent; Walker tumor, 0.79 per cent, and a benzpyrene tumor, 0.77 per cent. Greater quantities of tryptophane were present in the necrotic central portion of the Jensen tumor than in the healthy peripheral zone. No differences were observed in the organs of control and tumor rats. Three human breast cancers contained 0.60, 0.61 and 0.69 per cent tryptophane respectively. [See preceding abstract.] MILTONJ. EISEN CODtributionr to the Photochsmtrtry of the Antilytic Factor in Cancer, B. BUCYI. Beitrage zur Photochemie des antilytischen Faktors im Krebs, Ztschr. f. Krebsforsch. 40: 227-234, 1938. Spectrographic studies are reported on cholesterin butyrate, the antilytic factor in cancer serum described by v. Christiani (Ztschr. f. Krebsforsch. %: 292,1937. Abst. in Am. J. Cancer 34: 292, 1938). Cholesterol, cholesterol propionate, and the biologically active butyrate ester prepared from ergosterol-free cholesterol have similar extinction curves for ultraviolet light. A comparable curve is also obtained with inactive choles- terol butyrate synthesized with the aid of pyridine. The butyrate inactivator in the latter case is probably an oxidation product of ergosterol. The extinction curve of the biologically active form containing ergosterol impurities reveals a specific increase in the absorption of ultraviolet light at 250 mp, probably as a result of the presence of vitamin D. The inactive ergosterol-containing synthetic ester is activated by radium and ultraviolet light following the production of vitamin D, the presence of which may then be detected by specific photochemical findings. MILTONJ. EISEN Filtration and Centrifugation of the Vhses of Rabbit Fibroma and Rabbit Papilloma, M. SCHLESINCERAND C. H. ANDREWES.J. Hygiene 37: 521-526, 1937. The authors estimated the size of the viruses of rabbit fibroma and of rabbit papil- loma by filtration through graded membranes and by centrifugation (see Bechhold and Schlesinger: Biochem. Ztschr. 236: 387, 1931; Schlesinger: Ztschr. f. Hyg. u. Infek- 288 ABSTRACTS tionskr. 114: 161, 1932). The diameter of the fibroma virus was estimated by the filtra- tion experiments to be about the same as that of vaccinia (125-175 mp), and by centri- fugation as 126-141 mp. The figures for the diameter of the papilloma virus were 23-35 mp in the filtration tests and 32-50 mp as determined by centrifugation. References are appended.

Retention of Immunizing Power by the Shope Papilloma after Exporure to Ultraviolet Radiation, W. H. WOGLOMAND J. WARREN. Am. J. Cancer 37: 562-565, 1939. Of 12 rabbits injected intraperitoneally with an ultraviolet irradiated extract of the Shope papilloma, 11 proved totally immune to subsequent inoculation with the virus of this growth and 1 virtually so, while all 7 untreated controls developed the tumor. References are appended.

A Comparative Morphological Study of the Mammary Gland in a High and a Low Tumor Strain of Mice, ELIEABBTHFEKETE. Am. J. Path. 14: 557-578, 1938. A comparative morphological study of the mammary glands of the Little-Murray dilute brown high-tumor strain and the C57 black low-tumor strain of mice, at intervals from birth to the first pregnancy and thereafter, showed that the glands of the high- tumor strain do not respond so uniformly to the endocrine influences that regulate the pragressive, functioning, and regressive changes of the gland as do those of the low- tumor strain. In the high-tumor strain groups of cells may persist in cell division, while all the others are already functioning; or fail to regress, sometimes continuing to func- tion while all the others have undergone regression. These abnormalities were first apparent during the second pregnancy. The persistent mitotic activity of groups of cells leads to early malignant changes. Twenty photomicrographs are included and a bibliography is appended. [Since this paper was published a study of the mammary glands of mice of varying susceptibility to spontaneous tumor development by Gardner, Strong, and Smith has appeared in Am. J. Cancer 37: 510, 1939. See following abstract.]

Mammary Glands of Maturd Female Mice of Strains Varying in SuMeptibiltty to Spontaneous Tumor Devqlopment, W. U. GARDNER,L. C. STRONG,AND G. M. SMITH.Am. J. Cancer 37: 510-517, 1939. . A study was made, at various periods following lactation, of the mammary glands of adult female mice of six strains, some resistant and some hjghly susceptible to breast cancer. Localized nodules of alveolar tissue were found in the glands of most of the high-tumor-strain mice but were only infrequently present in the low-tumor strains. The number of nodules tended to increase with age but was not related to the post- lactation interval or the stage of the estrous cycle. The authors believe that the tendency for the development of these small hyperplastic nodules may be considered to be due to factors passed from parent to offspring in association with other factors predisposing to cancer. Photomicrographs and references are included.

Chromoromal and Ertrachromo~~malInfluence ia Relation to the Incidence of Mun- morp Tumom in Mice, W. S. MURRAYAND C. C. LITTLE. Am. J. Cancer 37: 536552, 1939. From their genetic studies the authors reach the following conclusions. (1) Some extrachromosomal influence, which is ten times as powerful as any possible chromosomal factor, is instrumental in determining whether or not mammary cancer appears in the first out-cross generations. (2) This extrachromosomal influence becomes non-effective after eight generations of back-crossing. (3) Concentration of the chromatin of the high-mammary-cancer strain does not return the cancer incidence to that obtained in the first hybrid generation or that in the original cancer strain. (4) The tendency to have mammary cancer is not mendelian in nature. THE TUMOR CELL 289

The observations from which these deductions are made are presented in a series of tables. Frequency of Tumors in Cold-blooded Vertebrates and Their Rnrity in Venomous Species, A. PEYRON.Sur la frbquence des tumeurs dans les divers ordres de vertb- brbs B sang froid et leur raretb dans les esphces venimeuses, Compt. rend. Acad. de SC. 209: 261-263, 1939. Five hundred diseased cod fish were obtained from the fishing grounds of Newfound- land and Greenland and tumors were found in 350; these occurred in a total of about 500,OOO fish examined. The principal types of tumors are enumerated. In autopsies on 4000 vipers, no tumours were found though their occurrence is well established in other reptiles, nor were any found in 3000 toads (Bufo vulgaris) though they occur in frogs. The relative frequency of tumors in cod fish and frogs contrasted with their absence from vipers and toads suggests that the two latter species have an immunity, at least partial, against tumors comparable with their strong immunity against infection. The im- munity is perhaps the result of impregnation of the blood and tissues by venins or their antitoxins. L. FOULDS Cutaneous Schwannoma of Pacinian Type in a Dog, J. F. MARTIN,V. BALL,J. DE- CHAUME, AND P. COLLET. Schwannome cutanb B type paciniforme chez le chienne, Bull. Assoc. frans. p. l’btude du cancer 28: 689-692, 1939. Rounded bodies, having the appearance of pacinian bodies, were present in the midst of schwannoma tissue of the usual structure. The smaller bodies consisted of five or six lamellae of flattened cells and a central space occupied by a cytoplam or syncytium containing one or several nuclei; the larger bodies had up to twenty lamellae. The tumor also contained areas of cholesteatoma. The source of the material is not mentioned. One photomicrograph is included. L. FOULDS Gliomas in Animals: A Report of Two A6trocytomaa in the Common Fowl, E. JUNCHERR AND A. WOLF. Am. J. Cancer 37: 493-509, 1939. Reports are given of two astrocytomas of the cerebrum in chickens. Three other examples of glioma in the chicken have been recorded and the data on these are sum- marized here. They, too, are astrocytomas, differing only in minor respects from that type of tumor in man. The authors have reviewed the general subject of gliomas in animals and have tabulated the apparently authentic cases. Photomicrographs and references are included. THE TUMOR CELI- Cytology of Tumors, K. DECKNER.Cytologie der Geschwiilste, Arch. f. klin. Chir. 193: 549-553, 1938. Cytologic Studies of Cancer Cells, K. DECKNER.Cytologische Studien an Krebszellen, Ztschr. f. Krebsforsch. 48: 129-148, 1938. The author reports cytological studies on serial sections of 30 human cancers. No specific nuclear alterations indicating malignant transformation of the cell were ob- served. Chromosomal alterations and deviations from the normal course of mitosis were common, but similar cytologic phenomena occur in non-neoplastic lesions and in normal tissue following irradiation. Nevertheless, the changes are more common in cancer. Cytologically there is no indication that the basic alteration in the cancer cell is a chromosomal mutation. This does not, however, exclude the possibility of a muta- tion not visible as a cytologic change. The most striking alterations observed in cancer cells were as follows: increase in the number of chromosomes, which in one instance attained 300; formation of polycentric mitotic figures; multipolar mitosis, of which the tripolar type was most common; chromosomal aberration, clumping, rhexis, and abnormalities in the separation of 290 ABSTRACTS daughter chromosomes after division; absence of cellular division despite division of the nuclei, thus giving rise to multinucleated cells. Amitotic division of cells was never observed. The changes are illustrated by 23 excellent photomicrographs. MILTON J. EISBN Action of Rerpiratory Cahlprtr on Culture6 of Embryonal Tiuuer and Tumor8, C. SILVA-LAFRHNTZ.Die Wirkung von Atmungskatalysatoren auf Kulturen von Embryonal- uhd Tumorgewebe, Ztschr. f. Krebsforech. 48: 532-545, 1939. It is well known that the respiratory activity of a tissue is related to its cytochrome content. Thus this agent is not present in anaerobic organisms, whereas aerobic bacteria contain a large amount. As for the tumor cell, though the reports of different investigators do not agree, it i8 thought by many to be deficient in cytochrome. If abnormalities in this respjratory pigment are an important feature of the malignant cell, the experimental addition of cytochrome, or of hemin from which cytochrome could perhaps be synthesized, might correct the faulty metabolism. Other catalysts, also, such as lactoflavin [vitamin B,] might be of similar significance, for several investigators have stated that tumors are deficient in lactoflavin enzyme [the yellow ferment of Warburg]. It was found that explants of embryonic tissue, which resemble the tumor cell in their high aerobic glycolysis, were not influenced by either lactoflavin or cytochrome t. Neither was the Jensen rat sarcoma in droaffected by cytochrome G or hemin. Lacto- flavin, however, sometimes inhibited the growth of this neoplasm in vitro, damaging it so seriously that explants would not grow when inoculated back into the rat. This result was not constant, the cooperation of some still undetermined condition being essential, but at least the same preparation of lactoflavin never harmed embryonic tissues. The deleterious effect on earcoma was probably due to depression of its aerobic glycolysis, a source of energy which is of fundamental significance for the metabolism of any vigorously proliferating cell. The paper is accompanied by a bibliography. WY. H. WOGLOM Morphological Variation6 of Tumor C&, 0. SAPHIR.Am. J. Path. 14: 443-454, 1938. This study is based on a selected group of tumors derived from the routine material sent to the histological laboratory from the tumor clinic and the various departments of the Michael Reese Hospital. Those tumors were selected for study which in routine examination showed tumor cells of more than one apparent type. Fifty such tumors were studieg. Twenty uterine tumors were included, 11 cutaneous carcinomas, 2 melanomas, 11 carcinomas of the oral cavity and esophagus, and 6 rectal tumors. The morphological variations observed in particular neoplasms appeared to be chiefly due to the presence of deemingly different types of tumor cells derived from cells which under normal conditions are found in the location subsequently occupied by the tumor. This fact may have a practical value in tumor grading and determination of radio- sensitivity. A bibliography is appended and 10 photomicrographs are reproduced.

ETIOLOGY Oxygen Supply and Carcino enedr in Relation to Embryonal Blood Development, C. S. ENGBL. Uber die Besiehungen des Luftsauerstoffs zur Krebsbildung unter Berficksichtigung der embryonalen Blutentwicklung, Folia haemat. 59: 212-218, 1938. The author expounds his theory on the origin of cancer. On the basisof an hereditary general disposition to neoplasig, here termed regeneration lability, a dedifferentiation of cells occurs during the normal processes of cellular division and repair. The resulting cells of an embryonal type, inqtead of receiving the reduced amount of oxygen available to cells of the embryo or fetus, are supplied with the larger quantity absorbed in the body GENERAL CLINICAL AND LABORATORY OBSERVATIONS 291 during past-uterine life. Malignant alteration develops as a consequence of the dis- turbance in equilibrium of cell regeneration. [Tumors have been described, however, in the newborn.] MILTON J. EISEN

GENERAL CLINICAL AND LABORATORY OBSERVATIONS

Lymph Node Metrst~ieof Sarcoma, S. WARRENAND R. W. MEYER. Am. J. Path. 14: 605-620, 1938. In an analysis of 237 cases of sarcoma-exclusive of lymphosarcoma, carcinosarcoma, sarcoma of endometrial stroma and melanotic sarcoma-lymph node metastases, proved histologically, were found in 17, or 7 per cent. In 8 other patients there was clinical evidence of node involvement. In 14 cases the involved nodes were removed at opera- tion. In 5 a radical dissection was done and these patients survived for a longer period than those in whom simple excision only was done. One has lived six years. The authors conclude that, while the number of examples is too small to suggest that lyni- phatic dissection be done coincident with every excision, it does seem to allow the inter- pretation that such dissection should be carried out whenever feasible if an operation as aerious as amputation or radical excision is being considered. The literature is reviewed and details of the 17 cases of this series are given in tabular form. Thirty references and 2 photomicrographs are included.

E.tnrectrt Metartrtic Growths from Upper Abdominal and Munmary Cancer: Report of Seventeen Cares, H. E. BACON. J.A.M.A. 112: 808-813, 1939. The writer calls attention to the infrequency with which a correct diagnosis is made of metastatic tumors in the perirectal tissues originating from the upper abdomen and the breast. Seventeen of these puzzling cases are recorded, one of which was a fibro- sarcoma, neurogenic in origin and presumably originating in the retroperitoneal space. In the literature may be found records of patients with rectal symptoms due to metas- tases from the gallbladder, kidney, pancreas, and esophagus. The only method of differential diagnosis is careful visual inspection of the rectum and sigrnoid under good technical conditions, when, if the mucous membrane is found to be perfectly normal, search must obviously be made in some other organ for the primary source. Three figures are reproduced and a complete bibliography is given.

Changer in Mdanophore Hormone Content of the Hypophyds in Cancer Pitieate, W. RODBWALD.Uber die Veranderungen im Melanophorenhormongehalt der Hypophysen Krebskranker, Ztschr. f. Krebsforsch. 48: 161-164, 1938. Rodewald’s cancer test is based on the property of the serum of patients with malig nant disease to inactivate the hypophyseal melanophore hormone (Deutsch. med. Wchnechr. 63: 1271, 1294, 1362, 1937. Abet. in Am. J. Cancer 36: 317, 1939). Studies on the hormone content of the hypophysis of normal subjects and cancer patients are reported in the present paper. The total melanophore hormone was increased in cancer despite a decrease in the active type. The increase is chiefly accounted for by an excess of the inactive form as a result either of an increase in production or storing of the hormone. The quantity of melanophore hormone soluble in neutral and acid solutions was greater in the normal pituitary gland, whereas the alkali-soluble form was found in higher concentration in cases of cancer. The author has also studied the melanophore hormone changes in the hypophysis of experimental animals (see Abst. on p. 285). MILTONJ. EISBN

New Facb Concerning the Origin and Histogeneds of Embryomas, A. PBYRON. Faits nouveaux relatifs B I’origine et A I’histogbnbse des embryomes, Bull. Assoc. franc. p. I’Ctude du cancer 28: 658-681, 1939. Peyron recapitulates previous observations, by himself and his colleagues (see Abst. in Am. J. Cancer 36: 164, 1939, and references there cited), on the origin and 292 ABSTRACTS

histogenesis of embryomas and adds some new ones. He disputes the view that em- bryomas of the sacrococcygeal region are simple local or regional malformations. In these tumors he has identified an hypophysis, which demonstrates the presence of a median embryonic axis, a lumbar region, and two testes. The congenital embryomas, despite the frequent reduction or simplification of their structure, represent a distinct individual, the monozygotic twin of the host. The embryomas of the genital glands are distinguished by the occurrence of precocious stages of blastogenesis, polyembryony, extra-embryonic membranes, and the resulting physio- logical phenomena (pregnancy syndrome, etc.). The differentiation and develop- ment of the germinal cells are less advanced, but the embryonic buds previously de- scribed by the author in certaip tumors of the testis are true ova in a very early stage of development. Further homologies between the embryonic buds and stages in the development of normal ova of primates and of man are described. The buds are engendered by the neoplastic tissue. The initial proliferation probably starts from seminiferous tubules but the process of parthenogenesis apparently cannot recur; during the growth of tumors the successive or pluricentric genesis of buds is not observed. The buds have only a temporary existence; they multiply and are reconstructed by simple budding, by complete symmetrical division, or by processes of budding corresponding to those ob- served in the embryo of the armadillo. In some tumors the processes continue in- definitely at the periphery and are found in the interior of veins which are both injected with neoplastic emboli and invaded through their walls. The invading tissue produces chorioplacental masses identical with those which occur in intravascular extensions of uterine placentoma. Furthermore, new embryonic buds identical with those in the main growth differentiate and multiply intravenously. The neoplastic tissue has, therefore, not only the trophoblastic potentialities of uterine placentoma, but the potentialities of the ovum itself, since it continues to engender characteristic embryonic buds indefinitely. The migration of embryonic buds or polyvalent embryos accounts for the multiplicity of tissues in some secondary deposits of testicular embryoma. The formation of gonoblasts in the tumors is described and is held to provide a decisive confirmation of the process of polyembryonic parthenogenesis. The morphology of the twp groups of embryomas favors the conception of epigenetic development and confirms the independence of the two processes of germinal and somatic organization. The paper is illustrated by drawings. There is no bibliography. I.. FOULDS

Homologies between Embryonic Vesicles of the Human Ovum and Those of Putheno- genetic Embryomas, A. PEYRON.Sur les homologies entre les vesicules embryon- naires de I’oeuf humain et celles des embryomes parthCnogCn&iques, Compt. rend. Acad. d. sc. 208: 1353-1355, 1939. Peyron reproduces figures of early stages in the development of human ova and sets beside them figures of vesicles which he found in embryomas. He concludes that the teratological ova produced in series by a strain of neoplastic cells of male origin are morphologically identical with those of normal uterine gestation. L. FOULDS

Genital Glands and Region4 Organization in Embryomas of TtRin Origin, A. PEYRON, A. BONNABD,AND B. LAFAY.Sur la prCsence des glandes ghitales et I’organisation regionale dans les embryomes d’origine gemellaire, Compt. rend. SOC.de biol. 130: 1577-1519, 1939. A sacrococcygeal tumor Was removed from an infant aged two weeks. It contained multiple tissues of epidermal, endodermal, and connective-tissue types. Metanephric blastema and glomeruli were identified and also two testes whose structure was in most respects normal. Chorioplacental structures were absent. The paper is illustrated by one drawing. L. FOULDS DIAGNOSIS AND TREATMENT 293

DIAGNOSIS AND TREATMENT Polarographic Studies in Serum Protein and Their Significance for the Diagnosis of Cancer, R. BRDIEKA. Etudes polarographiques des protkines du serum et leur signification pour le diagnostic du cancer, Compt. rend. Soc. de biol. 128: 54-56, 1938. This is a brief account of the polarographic method, the application of which to cancer diagnosis was suggested by the author in Nature 139: 330, 1937 (Abst. in Am. J. Cancer 31: 122, 1937). For a fuller account see Brdicka’s paper in Acta Unio Internat. contra Cancrum 3: 13, 1938, and those by Heyrovskf and by Walker and Reimann, abstracted below.

Pohrographic Research on Cancer, J. HBYROVSKG. Nature 142: 317-319, 1938. During recent years Heyrovskc and his school in Prague have investigated the ap- plication of certain electrochemical methods to the serologic diagnosis of cancer (see Brditka: Nature 139: 330, 1020, 1937. Abst. in Am. J. Cancer 31: 122, 123, 1937). These methods are described as follows. “ A dilute aqueous solution of blood or serum is studied polarographically, which means that a direct current is passed through it under increasing voltage in order to record the current-voltage curve. The cathode consists of mercury dropping slowly from the mouth of a thick-walled capillary with a narrow bore; the layer of mercury at the bottom of the beaker serves as the anode. A few cubic centimetres of the solution are sufficient for carrying out the electrolysis. The applied electromotive force is increased from zero to about 2 volts whilst the current corresponding to the applied electromotive force is registered polarographically. The current-voltage curves which ensue in this arrangement are independent of the duration of electrolysis and may be repeated any number of times with great reproducibility, the current being determined by the voltage and the composition of the solution.” The apparatus automatically recording current-voltage curves is called the polarograph, the resulting diagrams polarograms, and this branch of electrochemistry, polarography. After some years of experience in the study of the polarographic effect of proteins, systematic researches on the serologic diagnosis of cancer were undertaken. The development of these methods is described. An analysis of 187 cases examined by BrdiEka and Novkk gave the following results. The polarographic diagnosis agreed in 102 out of 107 histologically confirmed cases of carcinoma, and in 11 out of 13 cases of sarcoma, while one of the 38 normal sera showed a positive polarographic reaction. Of the 29 non-carcinomatous diseases, 14 were polarographically positive and 15 nega- tive. A similar agreement was found at the Finsen Institute and Radium Station, Copenhagen, where among the positive reactions some cases of hepatic disorder were preent . In conclusion, it is believed that while there are many details still to be investigated, the polarographic method of diagnosis already offers substantial advantages over biological tests. It is automatically registered and perfectly reproducible; the chemical treatment is simple, and only 0.5 C.C. of serum is necessary. There are three charts and a number of references to original papers describing the methods and giving the results of their application in Czechoslovakian and Danish hospitals. A. F. WATSON

Polarographic Studies of Humon Blood Sera, A. C. WALKERAND S. P. REIMANN. Ani. J. Cancer 37: 585-595, 1939. Walker and Reimann describe the polarographic method of chemical analysis (see preceding abstract) and discuss its application to cancer diagnosis. The method is shown to be remarkably sensitive and reproducible, and the majority of cancer cases were found to give values outside of the distribution curve for normal serum. Many other factors are involved, however, and the practical application of the test must await their evaluation. References are given to BrdiEka’s work in this field. 294 ABSTRACTS

Study of the Fuche Reaction fbr Cmcer, 0. ROSENTHAL.Am. J. Cancer 37: 566584, 1939. The author tested the Fuchs cancer reaction by means of Minibeck’s technic in 14 cases of cancer and in 19 persohs with other types of disease. The results indicate that the principle of the test is correct but that it demonstrates differences between cancer and non-cancer sera only in a statistical sense, being without real value for diagnosis in an individual case. The chief diifficulty of the test lies neither in the technic nor in the preparation of the substrates, but in the fact that the selection of specific substrates of such an activity that the reactSon values are unquestionably beyond the error range is a matter of chance. The results of other investigators are tabulated and a bibliography of 67 references is appended. Effect of Electromagnetic W~veron the Freund-Kunjner Cancer Test, G. Fuc~s. Die Beeinflussung der FreundlKaminerschen Karzinomreaktion durch elektro- magnetische Wellen, Strahlentherapie 57: 636-642, 1936. When serum from cancer patients was treated with short waves or ultrashort waves its inhibiting effect on the cytblytic property of non-cancer serum-the so-called “ pro- tective reaction ” (see Lustig: Wien. klin. Wchnschr. 46: 1581, 1933. Abst. in Am. ]. Cancer 21: 683, 1934) was diminished to the extent that almost the normal amount of cancer cells was dissolved. However, the protective action could not be decreased below the norm. X-ray irradiation had a similar effect, which was more marked when the dose was increased from 250 to 350 1. Some references are appended. F. BURGHEIM

Equipment and Methodr in Vie at the ‘‘ Manaryk InskitUte for Tumors ” in Brunn, R. WERNER. Uber Einrichtungen und Arbeitsmethoden der “Masarykheilanstalt ftlr Geschwtllste, Haus dea Trostes “ in Brilnn, Strahlentherapie 57: 647-654, 1936. The Masaryk Tumor Institute in Brunn consists of a department for practical cancer therapy and another for exper/mentd research. The former includes, betides the radio- therapeutic rooms, equipment for x-ray diagnosis, endoscopy, and surgery, and also wards for 90 patients. The =search institute serves the clinical department by doing all the routine hematologic, serologic, and microscopic examinations, while the staff is, at the same time, engaged id research work on the metabolism of cancer tissue, the experimental production of tumors, and in biologic investigations of chemotherapy and organotherapy. Plans of the building and a photograph are includa. F. BURGHRIM THE SKIN Mode of Inception md ht Spread of Certain Squamour Cell Carcinomu: A Hint+ pathologic md Experim tal Study, A. BRUNSCAWIGAND D. TSCHETTER.Surg., Gynec. & Obst. 67: 715-73 1, 1938. Photomicrographs of early squamous-cell carcinomas and so-called precancerous lesions of the skin reproduce4 here show that the initial process involves a segment of epithelium and is not the resqt of changes arising in a single cell or small nidus of cells. At the margins of such lesiods are zones of direct continuity between cancerous and non-cancerous epithelium wwch are best explained by the hypothesis of progressive cancerization of the normal epithelium at the periphery of the initially altered segment. Microscopic examination of squamous-cell cancers induced in white mice by applications of methylcholanthrene showed appearances similar to those in man and are regarded as furnishing further support for this hypothesis. No evidence of infiltration of the normal epithelium by cords of maligqant squamous cells could be detected. If it is aasumed that such progressive cancerization occurs, it must be assumed, also, that the normal epithelium possesses a certain degree of susceptibility to malignant change. The fact that when a large skin surface is exposed to a carcinogenic agent the lesion8 are multiple, wattere& and discrete, indicates that in such surfaces there are regions of hypersusceptibility to carcinomatous degeneration surrounded by or alter- nating with regions which are less sensitive to such changes. When application of the THE SKIN 295 carcinogenic compound has been made for some time and the multiple lesions have for the most part become well established and spreading carcinomas, those regions of the skin which have not developed lesions may be regarded as highly resistant to such changes. This also was borne out by experimental studies. Sixteen photomicrographs are reproduced. Contact Roentgen Therapy of Sldn Cancer, KNIERER. Erfahrungen mit der Rbtgen- Nahbestrahlung an Hautkarzinomen, Rantgenpraxis 9: 27-30, 1937. The early results of low-voltage contact irradiation of skin cancers are recorded. The method is advocated only for inoperable growths. Operable tumors are treated surgically. A total dose of 2,700 to 5,600 r was employed, 50 to 300 r being administered as the single dose (60 kv., 0.1 mm. Cu or 2 mm. A], distance 3 or 5 cm.). Complete tumor regression occurred in all of 34 patients with relatively inoperable cancers, but it would be premature to designate these results as cures, since the time of observation was not longer than six months. One patient had a recurrence after five months. A satis- factory initial result was obtained in 1 of 7 patients with absolutely inoperable cancers. MILTONJ. EISEN Radium Treatment of Ho~u~~oIu~,H. ARETZ. Erfahrungen mit der Radiumbehand- lung der Hlmangiome, Strahlentherapie 57: 682-688, 1936. The results of radium therapy in 11 cases of naevus flammeus were so poor that the author has abandoned this treatment entirely. Excellent results were seen, however, in 86 cases of cavernous angioma, so that radium therapy is claimed as the method of choice for such lesions. The dose was 4 to 8 mg. element hours per square centimeter, filtered with 1.0 mm. of brass and 0.2 mm. of silver. Irradiation was repeated at in- tervals of two or three months for varying periods up to two years, depending on the degree of decrease after each treatment. F. BURCHEIM Treatment of Skh Cancer with Very Soft Roentgen Rap, E. EBBEH~J.Uber Versuche zur Behandlung von Hautkrebs mit sehr weichen Rantgenstrahlen, Strahlentherapie 57: 661-669, 1936. Two hundred and fifty cases of skin cancer were treated with grenz rays. For lesions less than a millimeter in thickness irradiation at 12 kv. was sufficient, a single dose of 20,000~being given. If the cancer was somewhat thicker it was scooped out with a sharp spoon and its bed was irradiated. Where the cancer penetrated to a depth of 5 mm., however, this procedure proved to be insufficient. Then a single dose of 5,600 Y at 25 kv., filtered by 0.19 mm. A1 and administered in eleven minutes, was effective. No coarse wars were noted after either of these methods. Both are particularly ad- vantageous in cases of carcinoma of the eyelid, as there is no risk of injuring the eyeball or even the conjunctiva, as sometimes occurs after radium therapy. The late results of treatment were not available at the time of the report. Nine photographs illustrate the article. F. BURCHEIM

Multiple Mummifled EpitheUomar in a Child, R. HUGUENINAND M. PERROT. Epithk- liomas momifib multiples chez un enfant, Bull. Assoc. franc. p. I'ktude du cancer 28: 627-635, 1939. A male child developed a small indolent tumor of the left cheek at the age of eighteen months and a second tumor appeared on the right lower eyelid at the age of two years. Both growths were excised. A year later two new tumors developed. One, in the right suborbital region, gradually disappeared; the other, on the right forearm, was excised. Histologically the tumor of the cheek was an epithelioma with mummification, calcifica- tion, and ossification; the palpebral tumor was apparently a basal-cell epithelioma; the tumor on the forearm was an epithelioma partially mummified but not calcified. It is concluded that the tumors began as undifferentiated basal-cell epitheliomas; mummi- fication occurred later and was succeeded by calcification and then ossification. The tumor which disappeared was, clinically, apparently of the same nature as the others, and it is probable that lesions of this type can undergo spontaneous cure. L. FOULDS 296 ABSTRACTS

THE ORAL CAVITY AND UPPER RESPIRATORY TRACT

Tumors of the Mouth and Jaws. Collective Review. K. H. THOMA.Internat. Abst. Surg. (suppl. to Surg., Gypec. & Obst. Dec. 1938) 67: 522-525, 1938. As indicated in the title, this is a collective review of the literature on tuniors of the jaws and oral cavity. The bibliography lists 125 references.

Caee of Tumor of the Narophrrpnx, S. A. USTEL. Ein Fall von Epipharynxtumor, RBntgenpraxis 9: 619-621, 1937. A squamous-cell cancer of the nasopharynx with cervical metastases is described in a thirty-year-old man. The patient died of pneumonia before completion of roentgen therapy. Radiologic evidence of invasion of the base of the skull involving the pyramid and sphenoidal sinus was verified at autopsy. Roentgenograms are reproduced. MILTON J. EISEN

THE SALIVARY GLANDS Sialography, Itc Technique rDd Application in the Roentgen Study of Neoplrsmr of the Parotid Gland, J. V. BLADYAND A. F. HOCKER. Surg., Gynec. & Obst. 67: 777-787, 1938. The authors describe the technic of roentgen examination of the parotid gland with the aid of lipiodol injections. They have applied this technic in the study of 76 parotid gland tumors. In the presence of an encapsulated mixed tumor the most consistent finding is a filling defect outlined by the displaced ducts surrounding the tumor. The duct system in these cases presents no irregularities or destructive changes. Each duct is visualized in its entirety, although its shape and configuration may vary with the degree of its displacement. The practical value of roentgenography lies not in the demonstration of the tumor, which is clinically obvious, but in the determination of its position in rela- tion to the gland and main duct, which will make possible an appropriate operative approach. The characteristic roentgen findings in carcinoma are a filling defect, absence of duct markings, irregularity in the outline of the ducts, and peculiar irregular filling defects in the gland substance itself, This picture was present in 62 per cent of 21 primary parotid gland carcinomas of the authors' series and is considered by them to be diagnostic of malignancy. The reason for failure to demonstrate these findings in a greater per- centage of cases is that the carcinoma arising in a minute focus of the encapsulated mixed tumor is still localized and has not yet infiltrated the gland substance. For a satisfactory result from 1.0 to 1.75 C.C. of lipiodol should be used. The latter amount should not be exceeded. The authors make it a rule to inject 3 to 5 times as much lipiodol as the initial amount producing discomfort and pain. This permits individual variation and still insures injection of a sufficient amount. Inpme instances they have found it desirable to perform two injections of the gland, one for a study of the duct system and the other to visualize the gland substance by over-injection. Normally the lipiodol disappears from the gland in one to three days. Roentgenograms and drawings showing the technic of injection are included. A bibliography is appended.

THE THYROID GLAND

Thyroid Cancer with Metutuir to Cranial Boner and Intmcrmi.l Hypertandon, S. DRAGANESCOAND E. FACON.Cancer thyroidien avec mhtastases osseuses craniennes (Syndrome d'hypertemrion intracranienne), Ann. d'anat. path. 16: 627- 635, 1939. A man aged thirty-three had painful tumors of the cranium, cervical vertebrae, humerus, and iliac crest, with spontaneous fracture of the last. Signs of increased intracranial pressure were also present, including severe headache, vomiting, deteriora- INTRATHORACIC TUMORS 297 tion of vision and bilateral papilledema, together with hemiparesis. At autopsy a small adenocarcinoma was found in the substance of the thyroid gland, and multiple secondary growths were present in bones, dura mater, and right adrenal. The unusual localization of growths in the cranial bones resulted in reduction of the cranial cavity and increased intracranial pressure. L. FOULDS

THE BREAST

Evolutionary Stages of a Cancer of the Breast, R. HUCUBNINAND H. GILLBT. Prob- lemes posds par les phases Cvolutives d’un cancer du sein, Bull. Assoc. frany. p. I’Ctude du cancer 28: 603-613, 1939. A mammary cancer with epidermal invasion of the Paget type in a woman aged sixty-three was treated by irradiation followed by radical mastectomy. There was no apparent extension beyand the primary growth and the patient remained well for nearly fourteen years. There was then a recurrence adjacent to the scar, and biopsy revealed epithelioma, again with epidermal invasion. Irradiation produced no appreciable change for thirty-five days and then resolution occurred within a month. At the same time pleurisy developed and, although it was relieved for a time by treatment, it caused death after a year. Autopsy showed that it was due to neoplastic invasion of the parietal and, to a less extent of the visceral, pleura. L. FOULDS

INTRATHORACIC TUMORS

Tumors at the Apex of the Chest, B. S. RAY. Surg., Gynec. & Obst. 67: 577-599, 1938. Pancoast in 1932 called attention to a clinical picture presented by certain chest tumors, including unilateral pain in the shoulder girdle and upper extremity, Homer’s syndrome, paresis of the hand, and an abnormal apical shadow in the roentgenogram. He designated the tumors presenting this group of symptoms as pulmonary sulcus tumors. Later reports indicate that these do not constitute a clinical entity but that any type of tumor in the thoracic apex may produce a similar picture. Five cases are recorded here and the observations on more than 50 examples from the literature are summarized. The majority of the recorded cases were carcinomas of the lungs primary at the apex. Other types included are squamous-cell carcinoma of branchial origin, sympathoblastoma, epithelial tumors of unascribed origin, and metas- tatic lesions. The author devotes special attention to the neurologic symptoms, which constitute the most important part of the clinical picture. The tumors recorded have all been malignant and the survival period is brief, but because of the severe pain chordotomy or multiple root section is indicated for the palliative effect. Other measures are useless. Photographs, photomicrographs, draw- ings, and roentgenograms are reproduced. A bibliography of 32 titles is appended.

A Case of Pancoast’s So-Called Superior Pulmonary Sulcus Tumor, N. TAKIZAWAAND H. YAMASHITA.Ein Fall von sog “ Pancoast’s Superior Pulmonary Sulcus Tumor,’’ Gann 33: 390-405, 1939. This report consists of the clinical history and pathological findings on the body of the late Professor S. Abe (1889-1939), Tokyo Imperial University. The authors conclude that the case is to be regarded as bronchial cancer originating from an old tubercular lesion in the upper lobe of the right lung. The growth infiltrated along the bronchus and bronchioles, invading the thoracic vertebrae through the adherent pleural membrane, pressing upon the subclavicular blood vessels and invading the cervical sympathetic and the brachial plexus. Clinically the patient complained of pain in the right upper region of the chest extending to the right arm, Homer’s syndrome, and atrophy of the muscles of the arm. Roentgen examination showed a shadow in the apical region of the right lung. Detailed clinical and pathological descriptions of the lesion are given. W. NAKAHARA 298 ABSTRACTS

Broncho-Pulmoauy Cancer rpld Syphib, G. CARRIBRE,F. VANDBNDOPP,A. VER- HAEGHE, AND J. PARIS. Cancer broncho-pulmonaire dbveloppb dans une lobite sclereuse retractile supdrieure droite chez un syphilitique, Bull. Assoc. franf. p. I'btude du cancer 28: 615-426, 1939. A man aged seventy-one had symptoms of pulmonary disease dating from an attack of bronchitis four years previqusly and accompanied during the last eight months by progressive emaciation. ClirJcal and radiologic examinations led to a diagnosis of pulmonary cancer, but doubt,was aroused by a positive Wassermann reaction. The patient died about six weeks litter. At autopsy, a bronchopulmonary cancer was found in the right lung and there wgs histologic evidence of syphilis in the lung and in the kidneys. L. FOULDS

Rerultr of Radiotherapy in Bronchial Cudnonu, H. ENCELS. Ergebnisse der Strahlen- behandlung des Bronchialkarzinoms, Strahlentherapie 57: 445-458, 1936. This report of the Radiotherapeutic Institute of the University of Frankfort-on- Main is based on the experiepce of eight .years, during which time 92 patients with bronchial carcinoma were irradiated. Of these patients, 78.3 per cent died within the first year after x-ray therapy qas begun, but in many instances distant metastases were present when the treatment wbinstituted. Between 7 and 8 per cent of those treated were free from symptoms for more than three years. Some of these latter cases were previously published by Holfelder (Strahlentherapie S4: 438, 1935. Abst. in Am. J. Cancer 30: 624, 1937); the histories of the others are briefly presented here. The technic employed was partly Pfahler's saturation method, partly a method with divided, slowly decreasing daily doses, applied for four to five weeks on 4 to 6 fields up to a total surface dose of 6,000 to 12,000 1. A favorable effect upon pain, shortness of breath and cough was in most cases noticeable very soon. The author stresses the fact that the prognosis of bronchial carcinoma is not absolutely hopeless. Fibrosis of the lungs as a result of x-ray therapy may be avoided by proper technic. The paper is illustrated by 11 roentgenograms. F. BURGHEIM

Endothelionu of the Pedcuqom, H. STOERK.Un cas d'endothbliome dbveloppb sur le pericarde, Ann. d'anat. path. 16: 660-665, 1939. A well encapsulated tumor, the size of a cherry, on the anterior wall of the parietal pericardium, was found by chance at autopsy on a woman aged seventy-nine. The tumor was rich in cells often arranged in interlacing bundles, whorls, or concentric bodies. The diagnosis was endothelioma. A lymph vessel penetrated the capsule and contained tumor cells in close relationship with the vascular endothelium. The ap- pearancee suggested an origin from the lymphatic endothelium ; they also suggested a recent accession of malignanqy in a previously benign tumor. It is concluded that benign endotheliomas of the $erosa, though extremely rare, do exist and may become malignant and that there are corresponding malignant tumors which may originate either from serosal cells or from the endothelium of lymph vessels. L. FOULDS

THE DIGESTIVE TRACT

Perfontion in Grrtric Cuciaoplr. A Study and Report of 133 Cues, R. W.MCNEALY AND R. F. HEDIN. Surg.,lGynec. & Obst. 67: 818-823, 1938. Among 3289 gastric carcin+mae seen in Cook County Hospital and Wesley Memorial Hospital (Chicago) in a period of twelve years, 133, or 4 per cent, were complicated by perforations. About half of the latter were of the so-called classical type, i.~.,giving clinical evidence of perforation into the peritoneal cavity. The remainder were of the obscure type, comprising thotie cases in which there was a localized abscess without diffuse extension into the general abdominal cavity. The condition was correct1)r diagnosed in 31.6 per cent of the cases. Free air in the peritoneal cavity as shown by fluoroscopic examination was found to be a valuable diagnostic procedure. THE DIGESTIVE TRACT 299

No region of the stomach is proof against perforation, but the lesser curvature, the prepyloric region, and the cardiac end were the most frequent sites in this series. The types of lesions in which perforation most often occurs were found to be adenocarcinomas and ‘I ulcerative carcinomas.” Perforations into the general peritoneal cavity occurred in 36 patients who came to surgery or autopsy. These cases, together with 17 cases proved by clinical evidence, bring the total to 53 cases, or 39.8 per cent of the total. Localized perigastric abscesses were found in 34 patients and gastrocolic fistulas in 15. Twelve perforations resulted in subdiaphragmatic abscesses. There were 2 examples of perforation into the lung. Operation was undertaken in 63 patients. Only 13 of these lived to be discharged from the hospital as improved and these were not followed up. A bibliography of 33 references is furnished.

LymphobrUtic Sucoma of the stontach, F. CABYAND L. GASNE. Sarcome lympho- blastique de I’estomac, Ann. d’anat. path. 16: 657-659, 1939. Partial gastrectomy was performed on a man aged sixty-six for an infiltrating lympho- blastic sarcoma of the stomach wall. For three or four months the patient had suffered from epigastric pain and rapidly progressive cachexia. After operation, which was followed by irradiation, he regained his health and was well four months later, but the authors have little hope of a long-term cure. L. FOULDS Acute Obstruction due to Cucinonu of the Small Intestine, B. HEJDUK. Zwei interes- sante FBlle von acutem Darmverschlass bei Karzinom des DUnndarmes, Zentralbl. f. Chir. 64: 295-301, 1937. The author calls attention to the rarity of carcinoma of the small intestine, stating that only about 88 cases were published up to 1937. He adds 2 new examples. In neither case was the diagnosis made before operation. In the first patient, a sixty- three-year-old man, obstruction occurred as the result of incarceration of an undigested piece of beef tendon in the narrowed lumen of the small intestine. The second patient, a forty-year-old man, was operated upon for a benign growth of the pylorus. After resection of the pylorus he ate a very large meal, which caused an obstruction at the site of a carcinoma hitherto unrecognized. The tumor in the first instance was a medullary carcinoma and in the second an adenocarcinoma. The first patient showed distant metastases after a year and a half, but at the time of the report was free of other symptoms. The second man was symptom-free four years after the operation. Reproductions of two x-ray films are included. While many names are mentioned in the paper, no references are given.

Solitary Neurinoma of the Small Intestine, F. CABYAND L. GASNE. Neurinome isole de l’intestin gr@le,Ann. d’anat. path. 16: 656-657, 1939. A neurinoma, 8 X 5 X 5 cm., situated on the free border of the small intestine about 80 cm. from the ileocecal flexure caused intestinal obstruction. The tumor was removed but the patient, a man aged fifty-six, died a few hours after the operation. L. FOULDS

Lipma of the Colon, J. P. LOCKHART-MUMMERY.Proc. Roy. SOC.Med. 32: 897, 1939. A lipoma growing from the submucous tissue of the pelvic colon and almost com- pletely filling the lumen was removed from a man aged forty-two who had symptoms of growth or obstruction in the pelvic colon. Four inches of the colon were resected and end-to-end anastomosis was performed. The patient made an uninterrupted recovery. L. FOULDS

Invaghted Slgmoid Tumor, H. REDONAND F. BERTILLON. Tumeur sur invagination sigmofdienne A eclipse. Fausse erreur de diagnostic, Ann. d’anat. path. 16: 652-653, 1939. A tumor not previously detected was palpated per rectum in a woman aged forty-two. A few days later it was no longer palpable but was found by means of the rectoscope. 300 ABSTRACTS

Laparotomy was performed and a carcinoma of the sigmoid, sitiated 3 or 4 cm. above the rectum, was removed. The patient was well three years later. The case is described to exemplify a “ false error ” of diagnosis; the physician might have been blamed, unjustly, for his failure to detect a growth by rectal examination. L. FOULDS

Abdomirul Resection for Rectal Cancer, E. G. MUIR. Lancet 1: 1094-1097, 1939. The author describes the abdominal resection of rectal cancer and discusses the indications. It is not claimed that the operation is more efficient than abdomino- perineal excision but abdominal excision can be carried out in many patients who are unfit for the combined operation. Abdominal resection should be reserved for growths in the upper third of the rectum; it may be used for early high growths when the ability of the patient to withstand a combined operation is in doubt as well as for advanced growths. It is of especial value in patients who would otherwise receive only pallia- tive colostomy. The operation entails less shock than the combined operation; con- valescence is smoother and the mortality is lower. Since the main direction of lymphatic spread from high rectal growths is upwards along the superior hemorrhoidal artery, as much of the important lymphatic field is removed in the abdominal as in the com- bined operation, and it is improbable that the ultimate prognosis is greatly different. The author has carried out 9 abdominal resections without an operative death, but the ultimate results cannot yet be assessed, since the longest time which has elapsed is two years and four months. L. FOULDS

Perhod Rxdeion for Cancer of the Rectum, J. P. LOCKHART.-MUMMERY.Surg., Gynec. & Obst. 67: 655-660, 1938. A detailed description, with illustrations, of the author’s operation for cancer of the rectum. It has been described in Am. J. Cancer 18: 1, 1933.

Early Carcinoma of the Rectum, R. W. RAVEN. Proc. Roy. SOC.Med. 32: 907-908, 1939. A woman aged sixty-two had slight bleeding per rectum for several weeks and an attack of severe bleeding one week before examination; there were no other symptoms. Sigmoidoscopy disclosed a small ulcer with a proliferating edge 10 cm. from the anal orifice. Perineal excision was carried out. The ulcer was t inch in diameter. Sections showed columnar-cell adenocarcinoma invading the submucous layer. A small group of tumor cells surrounded by small round cells evidently represented the base of a crypt in which the epithelium had undergone malignant change. A photograph of the gross specimen is included. L. FOULDS

Prickle-celled Carcinoma of Rectum, E. G. MUIR. Proc. Roy. SOC. Med. 32: 910, 1939. A prickle-cell carcinoma was removed by perineo-abdominal resection from a man aged thirty-four who had suffered some rectal discomfort and constipation for a fortnight. 1.. FOULDS

Intursusception Caused by Malignant Growth, M. SMYTH.Proc. Roy. SOC.Med. 32: 905-907, 1939. A woman aged seventy-five complained of intermittent abdominal pain for two and a half years, becoming more severe and colicky five days before operation. Intussuscep- tion of the cecum, appendix and a portion of the small intestine was found and resected. A large fungating growth, microscopically a colloid carcinoma, formed the apex of the int ussusception. The report is illustrated by two roentgenograms and two photographs of the gross specimen. L. FOULDS THE SUPRARENAL GLANDS 301 I. Diverticulitis of Caecum Resembling Carcinoma. II. Abdominoperined Excision of Rectum and Wertheim’s Operation. III. Small Carcinoma of Pelvic Colon with Perforation of Enonnour Growth into Rectum. IV. Double Carcinoma of Pelvic Colon and Rectum, L. ABEL. Proc. Roy. SOC.Med. 32: 901-902, 1939. . I. A man aged seventy-two had colicky abdominal pain, increasing in severity for four days, and absolute constipation for twenty-four hours. Radiologic examination after a barium enema indicated a probable carcinoma. Diverticulitis of the cecum was found at operation. 11. A woman aged thirty:six had a columnar-cell adenocarcinoma of the rectum invading the vaginal wall up to the posterior fornix. Combined abdominoperineal excision of the rectum and a Wertheim hysterectomy were performed. The patient was alive eighteen months later, with recurrence. 111. A large cauliflower tumor apparently on the anterior wall of the rectum com- municated directly with a typical carcinomatous ulcer of the pelvic colon which en- circled the lumen. Histologically the tumor was a columnar-cell adenocarcinoma. Abdominoperineal excision was performed and the patient was alive and well five months later. IV. Abdominoperineal excision of the lower two thirds of the pelvic colon, which contained a growth, and of the rectum, which was also the seat of a carcinoma, was performed on a woman aged seventy-five. Recovery was uninterrupted. L. FOULDS

Caw of Gas Gangrene of the Rectum Following a Local Removd of Polypoid Growth, E. J. RADLEYSMITH. Proc. Roy. Soc. Med. 32: 909, 1939. A woman aged sixty-four gave a history of blood-stained discharge per rectum for five years with a mass prolapsing through the anus. Under general anesthesia the anus was dilated and the tumor was pulled down through it and excised locally. The patient appeared to stand the operation well but the following morning she complained of severe pain, the abdomen was distended, and signs of acute toxemia developed. The wound was reopened, the post-rectal space opened and drained, and anti-gas gangrene serum was given, but death occurred less than twenty-two hours after operation. At autopsy the peritoneal cavity was found to contain purulent, foul fluid, while all the abdominal organs and extraperitoneal tissues contained bubbles of gas, B. welchii and anaerobic streptococci were cultivated from the peritoneal fluid. The catgut used in the opeiation was examined but no organisms could be cultivated. L FOULDS

THE SUPRARENAL GLANDS

Corticel Adenoma of the Adrends with Paroxyd Arterial Hypertension, P. RIMBAUD AND A. DELMAS. Adbnome cortical. des capsules surrhales avec hypertension arterielle paroxystique, Bull. Assoc. franc. p. I’Ctude du cancer 28: 682-688, 1939. A man aged fifty-seven had four paroxysms of arterial hypertension in the course of fifteen months; three attacks were relieved by bleeding but the fourth was fatal. Au- topsy was carried out. The heart was enlarged and the left ventricle hypertrophied. There was slight atheroma of the aorta, but the kidneys contained no notable lesions. The left adrenal weighed 19 gm. Its structure was completely disorganized by ab- normal proliferation of the zona fasciculata, the dominant appearance of the tumor being spongiocytic. The proliferation extended to the central vein and a medullary zone was not identified. The right adrenal, though of normal weight, was also dis- organized by proliferation of the middle zone; chromafine cells were not found. The authors found only one recorded case of similar paroxysms of hypertension associated with adenoma of the adrenal cortex (Plazy and Germain: Bull. et m6m. SOC. mbd. d. hap. de Paris 48: 891, 1932). Two photomicrographs are reproduced. L. FOULDS 302 ABSTRACTS

THE FEMALE GENITAL TRACT Rectal Ulceration Following IqadiatSon Treatment of Cudnoma of the Cervix Uteri. PlSudo-Cadnoma of the Fbctum. T. F. TODD. Surg., Gynec. & Obst. 67: 617- 631, 1938. This paper, devoted to late rectal reactions following irradiation of cervical carcinoma, is based on 24 examples seen by the author. [He has seen altogether about 50 cases.] The incidence of these late reactions as generally reported is about 5 per cent of the treated cases. The majority occur within a year of irradiation, though longer intervals may elapse. The reaction may be either intrinsic, i.e., strictly limited to the rectum, or extrinsic, appearing pre-eminently as a perirectal leeion. In either instance the resemblance to carcinoma is striking, and the author suggests the term pseudo-carcinoma as calling attention to this Characteristic feature. In the intrinsic lesions the initial symptoms are seldom severe, but later pain and rarely stenosis of the rectum may develop. The onset of the extrinsic type is similar but may be associated with constitutional symptoms. In the former type the entire lesion is quite mobile; in the lgtter there is massive induration producing a perirectal solidity that is extremely characteristic. The prognosis in the intrinsic reactions is good, gradual healing taking place over a period of months. The extrinsic lesions, while seldom fatal, may be complicated by rectal etenosis, severe hemorrhages, and recto- vaginal fistula formation, all of which call for appropriate treatment. The author has found overdosage in the vaginal vault to be the only proved etiologic factor in the intrinsic reactions. This may be due to retroversion of the uterus 80 that the intrauterine radium is brought into direct contact with the rectal wall or to a dislocation of the radium applicators from their original position. In the case of ex- trinsic reactions he submits the hypothesis that the lesion is essentially a gangrene following post-irradiation deprivation of blood supply to the posterior segment of the pelvis, rather than a local timye necrosis due to the direct action of the specific agent. This is borne out by the histologic evidence, for the only characteristic feature found in sektions taken through the nectal wall and adjoining tissues is thrombotic occlusion of most of the vessels seen, wi+ recanalization in a few. Treatment and prophylaxis are discussed. The latter calls for technical improve- ments to insure against slipping of the applicators, repeated roentgen examination during the course of treatment, the use of a special applicator during supplementary roentgen irradiation to guard against overdosage, routine blood counts, and proctoscopy both before treatment, to show the condition of the rectal mucosa, and whenever symptoms occur. References are appended and illustrations are included. Radium Treatment of MenoplMlml Hemorrhage Followed by Carcinoma of the Body of the Uterur Three Your Later, A. GORDONLUKER. Proc. Roy. Soc. Med. 32: 767-769, 1939. In a woman aged forty-eight complaining of menopausal hemorrhage curettage showed no hietologic evidence d disease. Radium element (50 me.) was inserted in the uterine cavity and left there for thirty-six hours. Three years later bleeding recurred and the uterus was enlarged. Hysterectomy was performed and histologic examination disclosed a columnar-cell carcipoma with wide and deep invasion of the uterine wall. The author inclines to the opinion that the carcinoma war, not due to the radium treatment . L. FOULDS Aechheim-Zondek Reaction Idd the Honnonrl Som-titration Method of Brindeau- in the Pnctlc~of O~OCO~OO~(19- R~eo~raey;hth~logicrl Reg- nancy; Hydatidifm Mol4; Malignant Chorionepithelioma), A. BRINDBAU,H. HINCLAIS,AND M. HINGLAIS.La reaction de Aschheim-Zondek et le dro-titrage hormonal de Brindeau-Hinghh dans la pratique gynbcologique. Grossease normale. Grossesse pathologique. Male hydatiforme. Chorio-bpithbliome malin post- mOlaire, J. de chir. 51 : 801-816, 1938. A review is given of the common qualitative methods now in use for determining the pregnant state. These methods are unsatisfactory, however, for ascertaining whether THE FEMALE GENITAL TRACT 303 a benign hydatidiform mole is degenerating into a malignant chorionepithelioma. For this purpose the authors have devised a quantitative method which depends on an accurate titration of Prolan B in blood serum, using the rabbit as a test animal. The results are expressed as rabbit units per liter of serum. One unit is defined as the amount of Prolan B injected intravenously into a selected rabbit, weighing about 2 kg., which is sufficient to cause the appearance of at least one hemorrhagic point in one of the ovaries. With the quantitative method it could be shown that the fertilized ovum invariably dies when the blood 'serum contains less than 500 units. The lower limit for normal pregnancy is about 2,000 units. In the toxemias of pregnancy values of 25,000 to 50,OOO are found. Under pathological conditions such as hydatidiform mole and chorion- epithelioma there may be 60,000 to 500,000 rabbit units. Serum titration after expulsion of a hydatidiform mole is of special value. It is well known that any residual mole tissue may degenerate into a malignant chorion- epithelioma. To detect this malignant transformation in its earliest stages, when it cannot be determined by clinical examination, may be life-saving. Regular daily and weekly values of the blood serum content of hormone are de- termined after the expulsion of the mole. A steady and rapid fall occurs up to the third week. If after this period the hormonal titer starts to climb again malignant trans- formation into chorionepithelioma has taken place. In 17 per cent of 80 patients in which such studies were made a rise was observed after the third week and in each instance hysterectomy revealed an early chorionepithelioma. The authors have previously described this procedure in Compt. rend. SOC.de biol. 118: 46, 1935 (Abst. in Am. J. Cancer 25: 226, 1935). WM. MENDELSOHN

Implantation Clrdnormr of the Tubd MUCOMSecondary to Carcinoma of the Ovary, J. A. SAMPSON.Am. J. Path. 14: 385-420, 1938. The author regards carcinomatous implants of ovarian origin on the tubal mucosa as resembling in pathogenesis, structure, form, and life history similar implants on the peritoneal serosa. He presents 13 case histories and 163 illustrations, mostly photo- micrographs, to support his thesis. Mucosal implants were found in 12 of 23 patients with carcinoma of the tubal mucosa metastatic from the ovary. In 4 patients they occurred in both tubes. In 14 of the 16 tubes involved the deposits were multiple. Frequently various stages in their development could be seen in a single tube. In 12 instances implants were present in the fimbria, which is to be expected since the fimbrial mucosa is especially exposed to cancer cells escaping from the ovarian tumor into the peritoneal cavity. Cancer cells may reach the lumen of the tubes by several routes: (1) from the peritoneal cavity of patients with peritoneal carcinomatosis, through a patent abdominal ostium of the tube; (2) from an ovarian carcinoma in a tubo-ovarian cyst through the patent tubal ostium; (3) from the portion of an ovarian carcinoma which has invaded the fimbria and subsequently grown through the lumen of the ostium into the lumen of the ampulla; (4) from invasion of the wall of the tube with subsequent extension; (5) from metastatic carcinoma of the tubal mucosa whether of lymphatic or implantation origin. Cancer cells escaping into the lumen of the tube by any route Seem to be alive. They apparently may not only live a long time in this situation, but also may increase in numbers, as shown by the presence of mitotic figures in some instances, just as they live and multiply in the lumen of a lymph vessel and in the peritoneal cavity. It is to be expected that these cells may become implanted on the tubal mucosa when a suitable soil is present. Favorable conditions for implantation are: (a) local prolifera- tions of the cells of the subepithelial tissues of the mucosa associated with a partial or a complete loss of the overlying epithelium and (b) granulation tissue of various types on the surface of the mucosa, usually in the form of sessile or pedunculated polypoid out- growths in some of which newly formed lymph vessels were detected. The author has not been able to ascertain the exact cause of the local reactions of the peritoneal setoaa and of the tubal mucosa which form a fertile soil for the implantation and growth of cancer cells, but considers it obvious that the cancer cells are in some way responsible. The mature mucosal implants are of three types: Carcinoma replacing portions of 304 ABSTRACTS the tubal epithelium as though grafted in it, and carcinoma either growin8 on or em- bedded in organized newly' formed tissue attached to the surface of the mucosa, usually in the form of sessile or pedunculated polypoid tumors. Sometimes implanted carcinoma 'dies. In other instances it grows slowly and apparently remains localized for a long time. Again conditions are found indicating that implanted carcinoma ha8 invaded the mucosal tissues beneath it, including the lymph vessels, just as a primary carcinoma invades and spreads. A differential diagnosis between mucosal implantation metastases and metastases to the tubal mucosa through the lymph vessels usually may be made easily in the early stages of these secondary tumors. However, in the advanced stages of either of these metastases a positive diagnosis of their pathogenesis may be very difficult or impossible. References are included.

Two Cams of Endometrioma of Ovary Suggesting the Transplantation Theory of Origin, J. WYATT.Proc. Roy. Soc. Med. 32: 769-770, 1939. The author describes briefly two cases of bilateral tarry cysts of the ovaty. The patients were aged forty-six and forty-one respectively. Endometrial tissue was demonstrated histologically. L. FOULDS

Report on a Care of Granulou+ceUTumour in a Girl of Eleven Years, M. MOOREWHITE. Proc. Roy. SOC.Med. 32: 773-774, 1939. A girl had a small vaginal hemorrhage at the age of nine and another at the age of ten. Seven months later hemorrhages of the nature of a menstrual period commenced, recurring monthly for five months. The breasts were full and rounded and axillary and pubic hair appeared. At operation the uterus was found enlarged to the size of a fourteen to sixteen weeks' pregnancy and displaced by a tumor 59 X 4) X 4 in. occupy- ing the right side of the pelvis. The growth was removed and proved microscopically to be a granulosa-cell tumor of the folliculoid type. The patient was in good health two years after the operation. The uterus returned to normal size. Menstruation began three months after operation and continued regularly. L. FOULDS

Granulou-ceUed Tumour of Ovary in a Child of Four Years, J. WYATT. Proc. Roy. Soc. Med. 32: 770-771, 1939. A child aged four and a half years had a blood-stained vaginal discharge for a month. The breasts and the labia majora and minora were markedly developed for the age and some pubic hair was present. Laparotomy was performed and an ovoid tumor 11 cm. long and 6 cm. in width, growing from the right ovary, was removed. Convales- cence was normal. There was a slight loss of blood one month after operation but none afterwards; the breasts retrogressed though, at the time of the report, they were still larger than normal. One photomicrograph is included. L. FOULDS

Brenner Tumor with Cirrhodr of the Liver and Endocrine Dirturbance, M. CHIRAY, G.ALBOT, AND BALMEZ.Tumeur de Brenner associbe A un syndrome polyendocrino- cirrhotique, Bull. Assoc. ftanf. p. I'etude du cancer 28: 636-645, 1939. The patient had been obese since an attack of typhoid fever at the age of eighteen. The menopause occurred at the age of forty-six and a year later there was a considerable increase in weight. There was an irregularly distributed infiltration of the skin produc- ing an appearance of elephantiasis, with loss of hair. Cardiac disturbance was present but there was no metrorrhagia. Death occurred six months after admission to the hospital. The autopsy findings included: Brenner tumor in the right ovary, sclerosis of the left ovary, annular cirrhosis of the liver and fatty degeneration of moderate in- tensity, sclerosis of the kidneys, sclerosis and congestion of the thyroid characteristic of an old thyroiditis and secondary involution. The case provides an example of the hepato-endocrino-myocardial syndrome described by others. The relationship of the Brenner tumor to the syndrome is not discussed. Two photomicrographs are included. L. FOULDS THE CENITO-URINARY TRACT 305

Argentrfsne Carcinoma (Carcinoid Tumour) Arising in Ovarian Terntomas: Report of Tno Cases, M. J. STEWART,R. A. WILLIS,AND G. S. W. DE SARAM.J. Path R Bact. 49: 207-212, 1939. The authors describe two argentaffine tumors arising in relation to intestinal epithe- lium in an ovarian teratoma; they found no previously recorded case. One tumor was removed from a woman aged sixty-eight who was free from recurrence three and a half years later; the other from a woman aged forty-eight, who was well a year later. Each tumor was locally invasive, like the corresponding growths of the appendix and small intestine, and was no doubt capable of more widespread dissemination. Invasion by the tumor caused hypertrophy of the teratomatous intestinal muscle as in primary appendiceal and intestinal tumors. The use of the name ‘‘ carcinoid tumor I’ is de- precated. The lesion is a genuine carcinoma and should be called argentaffine carci- noma or Kultschitzky-cell carcinoma. The paper is illustrated by photomicrographs. L. FOULDS Structural Malformation of the Ovuy with the Appearance of Tubular Adenoma of Testiculu Type, E. ABUREL,V. D. MARZA,AND V. DOBROVICI.Malformation structurale de I’ovaire ayant I’aspect de I’adbnome tubulaire a type testiculaire, Ann. d’anat. path. 16: 617-625, 1939. A woman aged twenty-two had never menstruated. She showed, however, no trace of virilism; the appearance was feminine and the external genitalia were normal. The ovaries were slightly enlarged. The uterus was represented by two thin cords inserted into the dome of the vagina. A fragment of ovary was removed at operation and showed, histologically, a close resemblance to Pick’s tubular adenoma of testicular type. The authors do not regard the case as a true example of Pick’s adenoma, how- ever, since there was no tumefaction. Photomicrographs are included and a bibliog- raphy is appended. L. FOULDS Specimen of a Bilateral and Subcutaneous Leiomyoma of the Crura of the Corpora Cavernom and of the Corpus Cavernosum from a Woman Aged Twenty-reven, L. WILLIAMS.Proc. Roy. Soc. Med. 32: 774-775, 1939. A bilateral tumor involved the whole of the crura of the corpus cavernqsum and extended towards the clitoris. The urethral and vaginal orifices lay between the two halves of the tumor and posterior to their anterior confluence. Microscopically the growth was a leiomyoma developing, apparently, from the crura of the corpus caverno- sum. There is a photograph of the gross specimen, which is believed to be unique. L. FOULDS

THE GENITO-URINARY TRACT Squamous Cell Carcinoma of the Renal Pelvis with Specid Consideration as to Etiology, A. A. KUTZMANN.J. Urol. 39: 487-505, 1938. A case of squamous-cell carcinoma of the renal pelvis is recorded, bringing the total in the literature to 81. It was typical in its insidious onset, its association with chronic infection, calculus, and leukoplakia, and its rapidly fatal course following operation. Squamous-cell carcinoma of the kidney pelvis is a patholo’gic entity distinct from other tumors of this site. The author believes that it is to be explained on the basis of a protective metaplastic response to long-continued irritation by a chronic infectious process or calculus. A leukoplakia on the renal pelvic mucosa results, and with con- tinued irritation malignant change ensues. Sixteen photomicrographs are included, as well as other illustrations. A bibliog- raphy is appended. Mixed Tumors of the Kidney. Report of a Case and Review of Literature, S. D. Wu. Chinese M. J., Supp. 2: 193-205, March 1938. A Chinese boy seventeen months old with an enormously enlarged abdomen died in the hospital the day following admission. The child had been apparently well until 306 ABSTRACTS the age of eight months, when the tumor was first observed. Autopsy showed a com- pletely encapsulated, multilocdar cystic tumor closely connected with a much compressed kidney. It was composed of numerous large and small cystic spaces, tined by cu- boidal epithelium and a fibrbus stroma in which were found striated muscle fibers, young proliferating spindle cells, irregular groups of glandular structures, and adipose tissue. The literature is reviewed, references are furnished, and photomicrographs are reproduced. Priaury Ureteral Neopl.sma, Report of Two Cam# md Review of Literature, C. RUSCHBAND S. K. BACON. J. Urol. 39: 319-340, 1938. Two examples of ureteral tumor are recorded, one a benign papilloma and the other a papillomatous tumor of a low grade of malignancy resembling in structure the transitional epithelium of the ureter. In each case a preoperative diagnosis was made by pyelo- ureterography. For the latter procedure the authors describe a special technic. A ureteral catheter of small caliber is used and withdrawn a few centimeters at a time from the pelvis to the bladder, a series of pictures being taken during the process. In the first case there was a recurrence of the papillomatous growth in the bladder, successfully treated by fulguration. The second patient was well and without symptoms three and a half years after operation. The literature on ureteral' neoplasms is reviewed. In 1932 Melicow and Findlay found 28 examples of benign ureteral tumors in the literature and recorded an additional case (Surg., Gynec. & Obst. a:680, 1932. Abst. in Am. J. Cancer 16: abet. p. 1173, 1932). Eleven new cases, including the authors', have appeared since that report and are tabulated here. A second table shows 27 cases of malignant neoplasm of the ureter supplementing the collections of Scott (Surg., Gynec. and Obet. 58: 215,1934. Abst. in Am. J. Cancer 23: 214, 1935) and of Lazarus (Ann. Surg. 99: 769, 1934. Abst. in Am. J. Cancer 23: 690, 1935). Two further instances of malignant ureteral growths are mentioned in the discussion by Wyman and Duncan, as well as an example of probable lymphatic infiltration of the ureter due to lymphatic leukemia. Roentgenograms, photogr$phs of the operative specimens, and photomicrographs illustrate the cases reported. A bibliography is appended.

Three Cber of Fibromyoma of the Bladder, F. CABYAND MLLE. A. DESYONTS. Trois cas de fibromyome de la vessie, Ann. d'anat. path. 16: 654656, 1939. Two of the tumors here described had produced no symptoms and were found by accident. One was a fibromyoma projecting from the outer wall of the bladder in a woman aged thirty-six; the other, in a woman aged forty, was anterior to the vagina [it apparently was not examlned histologically]. The remaining tumor was a fibro- myoma which had produced urinary symptoms including hematuria; the patient was a woman aged forty-four. The tumors were all removed surgically and the patients were well and free from recurrence after periods of two to twenty-eight months. L. FOULDS

Tenth Annivenup Report o! the Carcinoma Reg&try Committee of the American Urologid Auociation, 1927-1937, J. Urol. 39: 456-463, 1938. In the first decade of the Carcinoma Registry Committee of the American Urological Association (1927-37) bver 1800 bladder tumors were registered. Renal tumors, registered only since Dec. 1, 1936, number 67. Hypernephroid Appe.nnce of Certain Epitheliomaa of the Proatate, J. P. LAYARE,M. LARCET,AND P. ISIDOR. Aspect hypernbphrolde de certain8 bpithbliomae de la prostate, Ann. d'anat. path. 16: 785-787, 1939. The authors describe three examples of epithelioma of the prostate in which glandular epithelioma of the usual type was accompanied by columns and masses of polyhedral vacuolated cells cloyly resembling those of renal hypernephroma. Transitional forms between these cells and the glandular epithelioma cells were present. Two photomicro- graphs are included. L. FOULDS THE GENITO-URINJSRY TRACT 307

Primuy Cudnoma of the Urethra: Report of a Case. P. D. MELVIN. J. Urol. 39: 414-417, 1938. A man aged seventy-three had noticed, eleven years previously, a small painless lump on the under surface of the glans penis just proximal to the external urethral meatus. This had remained symptomless until a year before admission, when it began to enlarge. Recently it had become ulcerated and painful, especially on urination. Following a course of roentgen therapy the penis was amputated. The pathologic diagnosis was spinocellular carcinbma of the urethra, Grade 111. No follow-up account is given. References are appended, but there are no illustrations.

A New Incidon for the Radical Operation for Epithelioma of the Penis, F. P. JOHNSON. J. Urol. 39: 517-521, 1938. For removal of the inguinal nodes in epithelioma of the penis the author advocates three separate incisions: a midline incision beginqing about 2) inches above the base of the penis and extending downward to the circular incision for amputation, and 2 lateral incisions beginning about 1) inches lateral to the upper end of the median incision and extending downward and lateralward to a point just below the saphenous opening. By tunnelling from one incision to the next and by retraction, an excellent exposure is obtained, while the use of skin flaps is avoided and convalescence is hastened. Illustra- tions of the technic and references are included.

Dircusdon on Dingnoris and Treatment of Neoplaunr of the Testis, Proc. Roy. SOC. Med. 32: 663-670, 1939. The opening paper of this discussion, by G. Gordon-Taylor, is published elsewhere (Brit. J. Urol. 10: 1, 1938. To be abst. in Am. J. Cancer). W. M. Levilt advised the surgical removal of primary testicular neoplasms in every case, with subsequent irradiation. Eighteen patients with metastatic deposits were treated by x-rays during the years 1930-35, and 5 were alive in 1938, 3 of them after five years. Secondary deposits limited to the lumbar regions should always be ir- radiated. When multiple secondary deposits are present irradiation should be ad- ministered cautiously at first to avoid dangerous toxic effects resulting from the absorp- tion of breakdown products. Prophylactic x-ray treatment should always be given, after operation, to the pelvis, groins, and homolateral lumbar glands. It is possible, but not yet certain, that more extensive irradiation would be advantageous. Of 9 patients treated prophylactically after operation, in the years 1929-35, there are 5 alive and well. Irradiation was applied by the ‘I x-ray bath ” method. Radium should not be used. Most of the growths are so radiosensitive that doses of x-rays sufficiently high to cause their destruction can be applied to extensive regions of the body. It is not sufficiently realized that even advanced cases are often amenable to treatment. If the disease is radiosensitive, the prospect of relief by irradiation is sd great that it is un- justifiable to deny the patient this treatment. R. T. Payne also advocated orchidectomy followed by deep xiray treatment. He reported 38 cases treated by orchidectomy during the years 1920-33; 18 were well for five years or longer. Irradiation was used in 7 of the cured cases. Nine of the latter were teratomas and 9 were seminomas. Mistakes in diagnosis must inevitably occur but should be reduced by the use of biological tests. The two important facts concerning treatment are that surgery will cure a small but uncertain number of cases and that irradiation will control and even cure metastatic deposits. L. FOULDS

Value of Correlating Hormonal Tests with Histologic Sections in Tumor of the Testis, T. 0. POWELL.J. Urol. 39: 522-528, 1938. The author suggests a scheme for grading testicular tumors by correlation of their histologic and hormonal features, and applies this to 74 cases followed from two to four years, as follows: 308 ABSTRACTS

Gonadotropic hormone Results Grouping and number of cases in urine (mouse units per liter) Dead Alive I. Embryonal tumors Teratomata Grade 4: Chorionepitheliow 4 20,000-3,000,000 4 0 Grade 3: Adenocarcinoma' 6 2,~1,000,000 5 0 Grade 2: Differentiated (with carcino- matouo elements) 8 500-100,OOo 6 2 Carcinomata Grade 4: Undifferentiated 8 1,oO0-1o,o0o 5 3 Grade 3: "Seminoma" 9 Below 100 2 1 Grade 2: Differentiated 36 100-1,OOo 5 31 11. Non-Embryonal Tumors Adult teratomata .2 Below 100 0 2 I nterstitial-cell tumor 1 Excess estrin 0 1

The teratomata respond fairly well to irradiation, but the ultimate prognosis in all grades is poor. The embryonal carcinomata respond well to irradiation and the prog- nosis in the three grades is pwr, fair, and excellent respectively. The non-embryonal tumors offer an excellent prognosis. References are appended. There are no illustrations.

Two Caser of Embryom of tl$e Tertis, A. PBYRON,J. PATBL,G. POUMBAU-DBLILLE, AND GOZLAND.A propos de deux cas d'embryome du testicule, Bull. Assoc. franc. p. I'btude du cancer 28: 64b657,1939. The authors describe the histologic structure of two testicular tumors. The first developed in an ectopic inguinhl testis in a man aged twenty-three; it was removed but recurred in three months and the patient died after a further three months. The tumor consisted in part of tissues ordinarily present in embryomas but was remarkable for the extensive growth and polymorphism of malignant chorioma. The malignant areas comprised chorioplacental masses, pure chorioma, and microcysts corresponding to the initial ectoblastic vesiales of embryonic buds. Undifferentiated masses, pure chorioma, or chorioplacentoms were produced, at various points, by proliferation of primitive ectoblast. The placental differentiation was a secondary differentiation oc- curring especially in the neighborhood of blood vessels in the peripheral zone of the masses. The second tumor, in the tgtis of a man aged twenty-four, was removed; the patient died eight months later. This tumor, too, contained the usual structures of embryoma and also chorioma, less extenave and less polyrnorphous than in the first case. The remarkable feature was the pqrsistence of embryonic buds and polyembryony, repre- senting the initial stage in the development of parthenogenetic embryoma. The high malignancy, common to the two tumors, corresponds in a general way with the proliferation of chorioma. The seminiferous tissue in ectopic testes conserves the potentiality for development into either seminoma or embryoma. The microscopic appearances are illustrated by seven drawings. L. FOULDS

Dietiactive Chnracterr and Copximtence in the Hurarn Tertir of Seminiferous Epithe- lioma and Embryonu wiq Multiple Timer, A. PEYRON.Sur les caractbres dis- tinctifs et la coexistence dans le testicule humain de deux tumeurs differentes: Bpithblioma seminifere et embryome B tissus multiples, Compt. rend. Acad. d. sc. 208: 1946-1948, 1939. The author has studied 7 examples of seminiferous epithelioma and embryoma in the same testis. The relationship of the tumors to the testicular parenchyma and their respective ages indicated that the ernbryoma developed first and probably provoked the seminoma. The latter always originated at a distance from the embryoma but later THE GENITO-URINARY TRACT 309 the two might intermingle. The seminoma was always much less malignant than the initial embryoma. The author believes that the most probable interpretation df these observations is that products of secretion of the different organoid layers or of the trophoblast in the embryoma diffuse into the parenchyma of the testis and by an in- ductive action bring about proliferation in the tubules. L. FOULDS

Germiacll Segregation in Parthenogenetic Embryome, A. PEYRON.Sur la sbgrbgation germinale dans les embryomes parthhogbnbtiques, Compt. rend. SOC.de biol. 130: 1470-1472, 1939. Peyron describes and figures the segregation of gonoblasts in an embryoma of the testis. L. FOULDS

A Rare Occupational Cancer in an Algerian Native, MONTPELLIER,MBCHIN, AND LAFFARGUE. Un cas de cancer professionnel rare chez I’indighe Algbrien, Ann. d’anat. path. 16: 555-557, 1939. The authors describe a keratinized squamous epithelioma of the penis and scrotum in a circumcised Algerian native aged forty. The patient had been employed in loading anthracite since the age of eighteen. At the age of thirty he had a venereal sore which subsided under treatment but which recurred at the same site eighteen months later and developed into cancer. [The attribution of this cancer to an occupational cause is not convincing.] L. FOULDS

Primup Malignant Tumor of the Epididymie, J. A. LAZARUS. J. Urol. 39: 751-765, 1938. The author has found 39 accepted eximples of primary malignant tumors of the epididymis in the literature. He tabulates the essential features of.these and adds a further case in a man of forty-four years. Twenty of the previously recorded cases were designated as carcinoma, 17 as sarcoma, and 2 as malignant teratoma. Actually the majority would seem to be malignant teratomata with one or another type of cell predominating. The ages of the patients ranged from fifteen to eighty, with the highest incidence in the fifth decade. In 18 cases there was a history of pain, in 6 the testis was painless, and in the remainder no mention is made of this symptom. A history of trauma was obtained from 10 patients, 5 stated that there had been no antecedent injury, and in the remainder of the cases this is not mentioned. In only 5 cases is a positive preoperative diagnosis of epididymal tumor known to have been made. Metastasis occurs along the course of the inguinal and abdominal lymphatics and veins. Simple orchidectomy ap- pears to have given the best results. In a few of the more recent cases it has been sup- plemented by roentgen irradiation. The end-result is known for only.20 patients. Of these, at least 40 per cent were dead within two years of operation and 27 per cent within a year. One patient lived twelve years after operation and one was alive and well after nineteen years, but in his case the malignancy of the growth is somewhat doubtful. Photomicrographs illustrate the author’s case record. A bibliography is appended.

Primup Tumors of the Epididymis, B. FALCONER. Zur Kenntnis der primthen Neben- hodengeschwulste, Ztschr. f. Krebsforsch. 48: 243-245, 1938. Tumors of the epididymis are uncommon. Of 15 examples found among 5,OOO necropsy specimens of the male genitalia, 12 were malignant and 3 benign. In 10 instances the malignant tumor was an undifferentiated type extending from the testicle. In one case the growth was an adenocarcinoma involving the epididymis and testis, and in another a metastasis of a choroidal melanoma. The 3 localized benign forms were a mixed tumor similar to the type observed in the salivary glands, a fibromyoma, and an adenofibromyoma. A photomicrograph of the last mentioned tumor is reproduced. MILTONJ. EISEN 3 10 ABSTRACTS

THE NERVOUS SYSTEM Diagnodr of Bnfn Tumors by Meri~gnphy,G. OKONEK. Zur Artdiagnose von Hirntumoren durch Arteriographie, Ztschr. f. d. ges. Neurol. u. Psychiat. 158: 356-359, 1937. Preliminary general remarks on the value of arteriography in the diagnosis of cerebral neoplasms by direct visualization of the tumor (meningioma, ependymoma, blood-veeeel tumors), by signs of abnormal blood-vessel proliferation in the region of the tumor (glioma, malignant forms 6f meningioma), or by distortion of large vessels as a result of pressure by expanding growths. MILTONJ. EISEN

Reaction of the Boner of the Skull to Xn'hd Ledone, M. H. JUPE. Brit. J. Radiol. 11: 146164, 1938. A general discussion of the radiologic findings in intracranial tumors, illustrated by roentgenograms. References are appended.

Behavior of the Blood Preuure during Op~8tiOIl8for Brain Tumors, W. MORITZ. Uber das Verhalten des Blutdrucks bei Hirntumoroperationen, Deutsche Ztschr. f. Nervenh. 146: 232-249, 1938. In 35 cases of cerebral tumor blood-pressure readings were taken for days preopera- tively, every five minutes during the operation, and at frequent intervals afterward, The writer finds that the blood pressure gradually drops during operation [a conclusion which will not greatly surprise the neurological surgeon]. Case reports are included. EDWINM. DEERY

On the hcalhtion of Gliomrr~mdAngioomrs of the Cerebral Hemisphere, with Special Regard to the EvolutIonarj Conditionr, E. ASK-UPMARK. Acta med. Scandinav. 94: 392-406, 1938. The greater frequency of gdoma in the central portion of the convexity of the brain is explained theoretically on the basis of a predilection of the phylogenetically more recent structures for the dev opment of pathologic processes. Angioma or arterio- venous aneurysm is most com on in the parietal region and this is believed to be a result of the convergence of the1 three main arteries of the hemisphere in this region. Illustrative diagrams are included. MILTONJ. EISEN

Hirtopathology of Cerebral Gyomata during Fht Two Deader of Life, K. J. ZULCH. Zur Histopathologie der Grosahirngliome in den ersten beiden Lebensjahrzehnten, Ztschr. f. d. ges. Neurol. u. Psychiat. 158: 369-374, 1937. Seven examples of glioma, removed successfully from children, proved histologically to be ependymomata of characteristic morphology. Three photomicrographs are reproduced. MILTONJ. EISEN

Wrd Dlrturbmcer in Gliomdta, with a Hiqh Degree of Inted Hydmcephrlur and with Cerebrorpinrl Met88b80r, T. WERNER. Zur Frage des Visusverfalles bei Gliomen mit hochgradigem Hydrocephalus internus und Liquormetastasen, Deutsche Ztschr. f. Nervenh. 145: 2*274, 1938. Four rather sketchy case reports of verified tumors of the cerebellum. All four were fairly advanced and therpfore showed visual disturbances from papilledema and internal hydrocephalus. In the two cases of medulloblastoma, metastases were found on the walls of the ventricles. The other two cases were a fourth ventricle ependymoma and a glioblaatoma multiforme of the cerebellum. [Glioblastoma multiforme occurring in the cerebellum is a very rare tumor: it is characteristically a cerebral lesion.] EDWIN M. DBERY THE NERVOUS SYSTEM 311

Tumors of the Pons. I. Cue of Astrocytomr ,of the Pons, P. C. BUCY,0. FOERSTBR, 0. CAGEL,AND W. MAHONBY.Die Tumoren der Brllcke. I. Mitteilung. Ein Fall von Astrocytom der Brlicke, Ztschr. f. d. ges. Neurol. u. Psychiat. 157: 136-146, 1937. A man of thirty-five years complained of hoarseness, speech disturbances, diminished hearing, muscular weakness on the left side, and vertigo of twelve years' duration. Examination showed signs of paralysis of the motor and sensory branches of the tri- geminal nerve, the abducens, facial, cochlear and vestibular branches of the auditory, glossopharyngeal, vagus and accessory nerves, and partial paralysis of the oculomotor and hypoglossal nerves on the left side. Death occurred two days after an abortive attempt at surgical intervention. At autopsy an astrocytoma was found on the left side of the pons and medulla, extending from the upper cervical cord to the midbrain. Photographs of the brain and photomicrographs are included. MILTONJ. EISBN

Observations on the Histogenesis of Associated Multiple Meningiomrta and Pachy- meningitis Interna Hemorrhagica, A. PACIFICO.Associazione di meningiomi multipli e di " pachimeningite emorragica interna." Considerazioni sulla istogenesi dei due processi morbosi, Riv. di pat. nerv. SO: 299-325, 1937. A meningioma of the right occipital lobe and a second growth of similar nature in the left parietal lobe were found at necropsy in a man of eighty-four years who died of pneumonia. An associated pachymeningitis interna hemorrhagica involved the entire surface of the brain. Histologically the irregularly thickened dura showed cansiderable proliferation of the connective tissue and small blood vessels. The author considers the possibility of the latter process being a diffuse neoplastic reaction as a counterpart to the localized formation of meningiomata from arachnoid tissue. A photograph of the lesions, photomicrographs, and a bibliography are included. MILTONJ. EISBN

Silent Pansagittal Meningioma of the Parietal Lobe, C. M. BEHRENDAND E. SCHILF. Uber ein stummes, parasagittales Meningeom des Scheitellappens, Ztschr. f. d. ges. Neurol. u. Psychiat. 159: 158-162, 1937. A woman of fifty-three years had symptoms of increased intracranial pressure, as- sociated with evidence of abnormal psychic lability. Loss of vision was almost complete, but there were no localized neurological signs with the exception of some decrease in the sense of smell. Encephalography was attempted by the occipital route, but the ven- tricles were not visualized in the roentgenogram. On the other hand, radiologic study pointed to a destructive lesion in the sellar region. The findings appeared to indicate a tumor at the base of the brain in the anterior fossa. The brain was exposed without corroborating the diagnosis and the patient died five days later. A necropsy disclosed a parasagittal meningioma in the right occipital lobe. A photograph of the brain is reproduced. MILTON-J. EISEN

Cerebrospinal Fluid Block in Caser of Tumor of the Hemisphere, F. FL~~GBL.Liquor- blockade bei Hemisphlrentumoren, Ztschr. f. d. ges. Neurol u. Psychiat. 158: 355-356, 1937. Prolapse of the brain developed in the operative area following removal of a menin- gioma in the region of the left occipital lobe in a woman of thirty-seven years. Ven- triculography disclosed a hydrocephalus of the left lateral ventricle as a result of a block in the flow of cerebrospinal fluid. The posterior cranial fossa was exposed at a second operation and adhesions were separated in the region of the cisterna magna. A block in the aqueduct was eliminated with the aid of a rubber catheter inserted into the fourth ventricle. A postoperative recurrence of the cerebral prolapse was entirely relieved by several lumbar punctures. MILTON J. EISEN 312 ABSTRACTS

Pathology and Pathogenesis of Badlar Endothdioma (Maaiagioma), C. AMBROSETTO. Zur Kenntnis der basalen sog. Endotheliome (Meningiome). Ein Beitrag zur Pathologie und Pathogenese dieser Tumoren, Ztschr. f. d. ges. Neurol. u. Psychiat. 157: 743-761, 1937. Four cases of meningioma of the base of the brain are described. The first patient, a man of Efty-three years, gave a three-year history of increase of weight amounting to 28 kilograms, with loss of vision, anosmia, and signs of increased intracranial pressure, as papilledema and secondary optic atrophy. Necropsy disclosed a meningioma in the anterior fossa in the region of the lamina cribrosa. The tumor destroyed the olfactory nerves. Its proximity to the pituitary gland and tuber cinereum, with consequent pressure on these structures, probably accounted for the metabolic derangement. Histologically the tumor elements were arranged in characteristic whorls of spindle cells or as bands of cuboidal cells resembling a primitive endothelium. Focal areas of fatty degeneration were common. The second patient, a man pged forty-four years, had early signs of increased intra- cranial pressure of seven months' duration, a left-sided paresis associated with jack- sonian attacks, and a hyposmia limited to the right. Temporary amelioration followed irradiation of the skull, but She symptoms recurred after a short time. Operative intervention was carried out and a meningioma of the base of the right frontal lobe removed. The symptoms of the disease regressed completely after operation. The growth was composed entirely of cuboidal endothelial-like cells. The clinical records in the third and fourth cases were not available, but the post- mortem findings are described. In both the tumor was situated at the base in the anterior and middle fossae. In one a maw, consisting of cuboidal cells, involved the optic chiasm and left optic nerve, the hypophysis, internal carotid artery and gasserian ganglion, and infiltrated the neighboring cerebral substance and cavernous sinus. In the other the tumor was comfiosed of cells of fibroblastic type and cuboidal elements which irregularly infiltrated the internal layers of the dura. The author discusses the theories on the derivation of meningioma and is of the opinion that the tumor is of mesodermal origin. It arises most commonly in the arach- noidal lining cells of the pacchionian bodies or in areas of the arachnoid where these formations are absent. At times an origin in the cells lining the inner surface of the d Lira mater appears probable. Photomicrographs and a bibliography are included. [For an interesting aiscussion of the origin of meningeal tumors, see Weinberger: Am. J. Cancer 38: 1, 194.0.1 MILTON J. EISEN

Treatment of Certain Tumoum Occurring in the Region of the Optic Chiarm, H. C. TRUMBLE.M. J. Australia 1: 277-287, 1938. A series of 20 tumors occurring in the region of the optic chiasm and treated surgically is recorded. There were 9 patients with pituitary adenomas without evidence of hyperpitultarism. In 2 of thew a second operation was required for recurrence. Two others had been previously operated on elsewhere. All survived operation and results are described as very satisfactpry except where the growth was of excessive size. Six patients had pituitary qdenomas with acromegaly. In this group there was one operative death. Improvement was obtained in all the others. Two tumors arising in remnants of Rathke's pouch are included. One was an adamantinoma in a girl of fourteen. This was partially removed and death occurred two months later. The othef was a craniopharyngioma in a man of twenty-seven, causing loss of vision and mental symptoms. Following operation, at which the tumor was almost completely removed, vision improved, the mental symptoms cleared up, and the patient resumed his work gs a farmer. Three tumors of the series are unclassified. One of these may have been metastatic from a renal carcinoma, as the patient had severe hematuria postoperatively. Two patients in this group died following operation. The pathological aspects of these tumors are discussed by Willis (see following abstract). THE NERVOUS SYSTEM 313

Pathological Study of Tumourb of the Pituitary Region, R. A. WILLIS. M. J. Australia 1: 287-291, 1938. In this paper are recorded the pathological findings in the series of tumors presented in Trumble’s paper (abstracted above) and in 3 additional cases which came to autopsy without operation. These latter 3 include one adenoma without acromegaly, a fibro- sarcoma of the pituitary region, and one unclassified growth. Concerning the group designated as adenomas the author says: “ Many of these growths appear to be not genuine tumors, but hyperplasias or ‘ strumas ’ comparable with goitre. They present a wide range of structure, a prominent retiform mode of arrangement being particularly apt to cause difficulty in histological identification. All growths from acromegalic patients in this series contained eosinophile cells, but faint eosinophile characters were seen also in some of the growths from non-acromegalic patients.” The fibrosarcoma described here occurred in a patient with a history of previous syphilis and the symptoms were attributed to that disease. The tumor was discovered only post mortem. Nine photomicrographs are reproduced.

Case of Primrry Pinealom Arising froqthe Region of the Hypothalamus Infundibulum, H. AKAMATU.Ein Fall von primiirem Pinealom aus der Hypothalamus-Infundi- bulumgegend, Gann 33: 371-383, 1939. The primary brain tumors hitherto described under the name of pinealonia have all been of the pineal region, originating from the pineal body. The author found an interesting case of pinealoma, the origin of which was traced to the infundibulum region of the hypothalamus. The patient was a twenty-three-year old man underdeveloped physically, with deficient growth of hair, genital hypoplasia, chronic headache, polyuria, visual disturb- ances and drowsiness alternating with insomnia. Autopsy revealed a tumor in the region of the infundibulum of the hypothalamus extending thence to the optical chiasm. Histologically the growth completely agreed with Bailey and Cushing’s description of pinealoma. W. NAKAHARA

Cam of Synldneeia Associated with Tumor of the Cervical Cord, 0. MECO. Sopra una particolare sincenesia nell’ uomo. Studio della sincenesia a proposito di un caso clinic0 di tumore del midollo cervicale, Riv. di pat. new. 50: 326-353, 1937. The chief symptoms produced by a tumor of the spinal cord at the level of the second and third cervical vertebrae in a man of fifty-one years were intense pain in the upper extremities and paralysis of the right side. The growth gave rise to roentgen evidence of cerebrospinal fluid block. The author appends minute details on the development of protective reflexes as shown by the maintenance of the lower extremities in flexion and the upper extremities in extension, and on the presence of synkinesia or involuntary movements elicited in one area of the body by passive or active muscular effort in a distant portion. Thus, extension and pronation of the right arm and ex- tension and internal rotation of the right leg occurred after extension of the extremities of the left side. The tumor was removed surgically, but the postoperative course is unknown. Photographs of the patient and roentgenograms are reproduced. MILTONJ. EISEN

Maningionu (Endothelioma or Fibroblastom) of the Sphd Cord, R. FREUDENBERG. Zur Frage der Endotheliome bzw. Fibroblastome (Meningiome) des Ruckenmarks, Ztschr. f. d. ges. Neurol. u. Psychiat. 157: 393-417, 1937. Three examples of meningioma of the dorsal portion of the spinal cord in patients aged eighty-two, forty-six, and sixty-two are reported. Evidence of spinal cord com- pression culminating in the symptoms and signs of a transverse myditis varied from five to nine years in duration. No operation was performed on the first patient and the growth was discovered at autopsy. The second died two months postoperatively of a 3 14 ABSTRACTS pyelonephritis; in the third the tumor was successfully edtirpated. All tumors had the characteristic morphology of meningioma. ,The author surmises an origin from the inner surface of the dura, cell nests in the arachnoid, or the denticulate ligament. The latter structures, which are frequently in intimate contact with the growth, extend from the pia through the arachnoid to the dura on either side of the spinal cord. A photo- graph of a gross specimen, photomicrographs, and a bibliography are included. MILTONJ. EISEN

Spinal Tumour and Its Diagnosis, M. G. KINI AND P. KESAVASWAMY.Indian M. Gaz. 73: 286-287, 1938. A report of a meningeal tumor of the spine in a man of thirty-five, causing compres- sion paraplegia of both lower extremities. Removal of the tumor was followed by relief of symptoms and three years later the patient was well and carrying on his work as a farmer.

Case of Neurofibroma (von Recklinghausen’s Disease), A. E. COATES. M. J. Aus- tralia 1 : 855-856, 1938. This is a report describing a single tumor-a neurofibroma-removed from the buttock of a man of fifty-six. It had been present since infancy, at first as a small mole-like growth, eventually reaching huge dimensions. Its weight was 12 pounds. As complete removal of all the affected skin was impossible, the possibility of renewed growth is admitted. There had, however, been no evidence of this a year after operation.

Congenital Pseudo-arthrosis of the Leg. Bone Deformity in Neurofibromatosis, DUCROQUETAND COTTARD.Pseudarthrose congdnitale de jambe. Ddformation osseuse de la neurofibromatose, J. de chir. 53: 483-502, 1939. Pseudo-arthrosis and congenital bowing of the leg are analogous deformities and are often present at the same time in the same limb. They are associated with similar family histories and x-ray findings. Of 11 patients studied by the authors, 10 were found either to have early or established lesions of neurofibromatosis or to give a family history of the disease. This evidence supports the theory that pseudo-arthrosis is one of the manifestations of the von Recklinghausen syndrome. Surgical treatment is unsatisfactory, especially in the young. The results are more encouraging when operation is delayed until the patient is older. Short abstracts of the 11 case histories are included. These are accompanied by eleven pages of excellent photographs and roentgenograms. WM.MENDELSOHN

Multiple Tumors of the Sympathetic Nervous System. Report of a Case Showing a Distinct Ganglioneuroma, a Neuroblastoma and a Cystic Calcifying Ganglioneuro- blaatoma, H. R. WAHLAND P. E. CRAIG. Am. J. Path. 14: 797-808, 1938. A case of multiple tumors of the sympathetic nervous system in a twenty-eight- year-old Negro is recorded, with autopsy findings. The tumors were a ganglioneuroma of the sigmoid colon and pelvis; a neuroblastoma of the pelvis with metastases to the regional lymph nodes and to the bones: a ganglioneuroblastoma of the pelvis. The three tumors bore no direct anatomical relation to one another, but were derived inde- pendently from the lower end of the sympathetic trunk, representing different degrees of differentiation of the formative neurocyte. Associated with the ganglioneuroblastoma were cystic degeneration, secondary hemorrhage, and calcification, which are character- istic of such tumors. Nine photomicrographs and a bibliography are included.

THE BONES, MUSCLES, AND TENDONS

Results of Roentgen Therapy in Bone Tumors, G. SCHULTE. Rontgentherapeutische Erfolge bei I(nochentumoren, Strahlentherapie 57: 370-384, 1936. Some interesting cases of bone tumors are reported, such as multiple osteo-heman- gioma, osteo-epulis, chondroma, multilocular myeloma, and Ewing’s sarcoma. The THE BONES, MUSCLES AND TENDONS 315 value of fractional protracted roentgen therapy is pointed out, but the exact factors of the treatments are not mentioned. The paper is illustrated by 15 roentgenograms, a photograph and a photomicrograph, F. BURCHEIM

Malignant Giant Cell Tumor of Bone, F. W. STEWART,B. L. COLEY,AND J. H. FARROW. Am. J. Path. 14: 515-536, 1938. Following a comprehensive review of the literature on malignant giant-cell tumor, the authors present 7 cases in which they consider the malignant character of the process beyond the possibility of doubt. Roentgen evidence of pulmonary metastases and the death of the patient were accepted as proof of malignant character and autopsy con- firmation was not considered essential. Eight photomicrographs are included and there is a bibliography.

Primary Liposarcoma of Bone. Report of a Case, J. DUFFYAND F. W. STEWART. Am. J. Path. 14: 621-626, 1938. A primary liposarcoma of the bone is reported, being the 7th on record. [The other 6 are tabulated by Rehbock and Hauser (Am. J. Cancer 27: 38, 1936)., who include also one doubtful case (Fender).] A forty-nine-year-old man was first seen for a fracture of the left femur following a fall. Healing was imperfect and a second fracture occurred while the patient was lying in bed. Roentgenograms at this time showed a large soft tissue mass at the fracture site with evidence of calcification at the periphery. Amputation was done and nine months later an enlargement of the stump was observed. An aspiration biopsy led to a diagnosis of recurrent tumor and roentgen irradiation was instituted, 2,000 r being given through three portals. Regression occurred, but shortly afterward further evidence of disease was observed and more radiation was given. A subsequent biopsy showed absence of tumor, but necrosis developed and a disarticulation of the femoral stump was done. Roentgenograms of the lungs now showed a pulmonary metastasis, but this regressed following roentgen therapy. At the time of the report, five years after the patient’s first admission, he was in excellent condition. Both grossly and microscopic- ally the tumor bore some resemblance to medullary fibrosarcoma, but the location was not the usual one for the latter tumor and the tumor cells showed some differences. The histogenesis of the neoplasm was most evident in the irregular islands of tumor in the medullary portion of the shaft above the main tumor. Here was a low-grade inflammatory reaction in the marrow fat tissue characterized by diffuse and nodular lymphocytic infiltration, and fat cells both adult and young. In the midst of these fat cells were obviously neoplastic cells with vacuolated cytoplasm. As the cells became more atypical, this vacuolization was lost-and they could no longer be identified as of fatty origin. The authors believe that the tumor is traceable to inflammatory changes in adult fat and they describe it as a liposarcoma. Photomicrographs and references are included.

Fibroblastic and Endo-Epithelial Sarcoma of the Elbow Joint, G. ALBOT,F. THIEBAUT, P. BANZET,AND J. HERVY. Sarcome fibroblastique et endoCpithClia1 de l’articula- tion du coude, Bull. Assoc. franc. p. 1’Ctude du cancer 28: 589-602, 1939. A tumor was excised from the cubital region of a woman aged fifty-two; it recurred locally two months later and amputation, previously refused, was then accepted, but the patient died ten days later. There was no autopsy. The tumor apparently originated from the external and superior portion of the lower or annular cul-de-sac of the synovium of the elbow joint, and its extension was entirely outside the joint. Some portions of the tumor had the ordinary appearance of fibro- sarcoma, but towards the center it was riddled with cavities. Some of these were vascular spaces lined by flattened tumor cells and some were lacunae in the sarcoma; others were lined by cylindrocubical tumor cells in palisade arrangement, resembling epithelial cells except for the absence of a basement membrane and the presence of 316 ABSTRACTS transitions between them and the sarcoma cells. These cavities correspond to the classical descriptions of the synovial spaces of King. In one region there were gland- like cavities lined by cells tending to the cubical form but also showing transitions to sarcoma cells. The tumor thus combined ordinary fibrosarcoma and structures recalling the normal histogenesis of synovial tissues. The formation of cavities and the cubical transforma- tion of the lining cells were the result of degenerative liquefaction of certain tumor cells which thus retained capacitiee for forming spaces resembling those in normal synovial tissue. The terminology appropriate to this tumor and to similar tumors previously recorded is discussed. The authors consider that the tumor should be placed in a sub- group of the fibrosarcomas. They propose the term " fibroblastic sarcoma of endo- epithelial type " or " fibroblastic endo-epithelial sarcoma." The paper includes five photomicrographs and a bibliography. L. FOULDS

Oateoclretoma of Ilchlum axid Pubis Treated by Teleradium, K. I. NISSEN. Proc. Roy. SOC.Med. 32: 823-824, 1939. A woman aged thirty-seven had dull pain over the right tuber ischii for eleven months, followed by swelling in the buttock. Radiological examination showed a lesion of the whole of the ischium including the spine and part of the pubis. The biopsy diagnosis was osteoclastoma. The patient was treated by a 4 gm. radium bomb, the main tumor receiving 3,000 I in two months. Four months later the patient had returned to full work and x-rays showed early recalcification but slightly increased invasion of the pubis. Three roentgenograms are reproduced. Brief reference is made to four other osteoclastomata treated by irradiation. The author concludes that only a moderate amount, about 3,000 r, is needed to produce a healing reaction in an osteoclastoma, but the response is slow, calcification seldom being marked in less than six months. External radiation by radium bomb or deep x-rays has displaced the dangerous implantation of needles or seeds. L. FOULDS

The Plasmocytic Myelomas, F. BUSSERAND M. HUCUENY. Les myblomes plasmocy- taires (Plasmocytosarcomes de la moelle osseuse), Ann. d'anat. path. 16: 443-475, 1939. This review of the pathobgical and clinical features of tumors composed of plasmo- cytes and originating in bone is based on published reports of 61 cases. Two groups are distinguished: solitary and multiple. The difference is primary; the solitary tumors rarely disseminate to other bones and the multiple tumors are multiple from the first. The solitary tumors occur in relatively young patients, about one third being under forty. They are commonest in the limb bones, especially the femur, and are most frequently revealed by spontaneous fractute. The multiple tumors occur in older patients, being exceptional before the age of forty. Any bone may be involved but the commonest sites are femur, cranium, ribs, and sternum. The initial complaint is usually pain or tumor, and spontaneous fracture is unusual. The solitary tumors are sometimes curable; the multiple tumors are more malignant and have always recurred after treatment. Both types, however, have the same histologic structure and are radiosensitive. Biopsy is required for certain diagnosis but radiological examination is of great importance. A summary of each of the published cases is included and a bibliography is appended. L. FOULDS

Sarcomain Muscle, J. MEYER-MAYAND B. JOYBUX. Sarcome musculaire, Ann. d'anat. path. 16: 665-667, 1939. A tumor was removed from the left calf of a man aged thirty-four. It was surrounded by muscle, which was compressed but not infiltrated and which showed metaplasia and fibrous hyperplasia. Tumor cells were separated from the surrounding muscle by con- nective tissue. They were elongated cells and some contained myofibrils but there were no characteristics of tumors of striated muscle. Some of the cells had endothelial THE LEUKEMIAS, HODGKIN'S DISEASE, LYMPHOSARCOMA 3 17 properties. The authors' diagnosis is angiomyo-endothelial sarcoma originating from the middle and internal coats of the vessels in a striated muscle. L. FOULDS

Giant-cell Tumor of the Synovium of the Knee, GIRAUD,SALMON, AND PAILLAS.Tu- meur a mybloplaxes de la synoviale du genou, Ann. d'anat. path. 16: 548-555, 1939. A girl aged twelve and a half years had hemarthrosis of the knee; the joint was tapped but despite palliative treatment the condition recurred at intervals for three years before operation was permitted. The synovial membrane and an attached tumor were then removed. The patient was well two years later. The tumor was benign; it consisted of villous processes covered with high columnar epithelium and a dense mass joined by a thin pedicle to the synovial connective tissue. The solid tumor contained numerous multinucleated cells, histiocytes, fibroblasts, and xanthomatous elements. Blood pigment was distributed through the tumor but there was none in the giant cells. There was thus no evidence that the latter are phagocytic. Their derivation is discussed. Two photomicrographs and a bibliography are included. L. FOULDS

THE LEUKEMIAS, HODGKIN'S DISEASE, LYMPHOSARCOMA

Genetics of Leuhaemir in Man, S. N. ARDASHNIKOV.J. Hygiene 37: 286-302, 1937. Among the pedigrees obtained in 32 cases of leukemia, 3 showed a familial history of the disease. These are said to bring the total number of recorded examples of familial leukemia to 36, though the reliability of some of these is open to question. The ratio of familial cases of the lymphatic form of the disease to those of the myeloid form is 6 : 1. The author accepts as the most probable explanation a conditionally autosomal type of inheritance, especially in lymphatic leukemia, with great variation in the phenotype due to other genes or to external influences. The existence of different forms of leu- kemia in a family suggests some common etiologic factors. The recorded examples are tabulated and a long bibliography is appended.

Myeloid Leukaemia Treated by Deep X-ray Therapy, S. M. K. MALLICK,S. ALI, AND B. SINGH.Indian M. Gaz. 73: 19-21, 1938. Myeloid leukemia is by no means uncommon in India, where it is frequently con- fused with chronic malaria or kala azar. An example is recorded in which roentgen therapy, chiefly to the bones, brought about a fall in the white cell count, a diminution in the size of the spleen, and an improvement in general health. The patient was under observation at the time of the report, three months after treatment. Hodgldn's Disease of the Vertebral Canal, W. HOLLMANN.Lymphogranulomatose des Wirbelkanals, Zentralbl. f. Chir. 64: 345-352, 1937. This is a detailed clinical history of a thirty-three-year-old woman who about a year previous to examination was seized with severe pains running from the spine into the region of the right kidney and radiating in the abdomen. After about three months the pain stopped. Six months after the onset the pain again appeared and evidence of pressure on the cord developed. When examined, the patient was found to have only a series of obscure nervous symptoms with absence of the abdominal Walt reflexes and a positive Babinski on both sides; there was no generalized lymph node enlargement. It was thought that she had a tuberculosis of the spine and she was discharged. X-rays showed no lesions of'the bones and spinal column at this time nor later when the patient was again seen. The Wassermann reaction was positive. Subsequently enlarged axillary and cervical nodes were discovered. One of these was excised and the diag- nosis of Hodgkin's disease was made from this. A large Hodgkin's tumor was also found in the spinal canal. Death was due to bronchopneumonia. A detailed autopsy record is given showing that there was a Hodgkin's lesion in the spinal canal in the region of the eighth dorsal vertebra, which compressed the cord. A considerable discussion is appended concerning the difficulties of diagnosis, since as a rule Hodgkin's disease involves the bony structures and does not cause cord lesions, 318 ABSTRACTS while in this case the opposide was true. The positive reactions for syphilis in both blood and spinal fluid are attributed to the Hodgkin’e lesion, as no anatomical changes suggesting syphilis were found after a careful examination of the autopsy material. Two roentgenograms are rqproduced. There is no bibliography though many names are mentioned in the course of the discussion. Acute Path Exacerbation of 4 Lymphourcoma of Complex Structure, R. HUGUENIN, V. D. MARZA,AND H. GI$LET. Pou& dvolutive aigue mortelle d’un lymphosar- come de structure complerte, Ann. d’anat. path. 16: 765-777, 1939. Lymphosarcoma in a womkn aged twenty-four was controlled for a time by irradia- tion. Splenic puncture was qarried out to confirm the diagnosis, and was followed by widespread dissemination of +more in the abdominal cavity. These grew with great rapidity and the patient died, thirty-six days after the splenic puncture. The lesions contained cells of the granulqcyte series in addition to lymphocytic or lymphoblastic cells and there was a polynuclqoeis in the blbod. The bearing of the observations on the diagnosis and ,treatment of lypphosarcoma is diecussed. Three photographs of gr+ specimens and one photomicrograph are reproduced. A short bibliography is appended. L. FOULDS STATIST1CS

Cancer Mortality for 1931 4 EavUir, R. KOHLER. Krebsetatistik 1931 in Bayern, Ztschr. f. Krebsforech. 48: 252-282, 1938. In 1931 the total number of deaths from cancer in Bavaria was 10,522 (4,825 males, 5,697 females). The rate per 10,OOO inhabitants was 13.12 in men and 14.48 in women (average 13.82). It was high r in urban centers than in rural communities, being 15.02 in the former and 13.18 in t I! e latter (urban population, 2,681,571; rural population, 4,928,429). These statistics re based on actual place of domicile and not on temporary residence at the time of deatd Malignant disease was the cause of 11.3 per cent of all deaths. MILTONJ. EISBN

Cancer Mortality in Switzer d, E. FORTH. Der Verlauf der Krebssterblichkeit in der Schweiz, Ztschr. f. Kvsforsch. 48: 106-116, 1938. An analysis of the cancer mortality statistics in Switzerland for six-year periods from 1901. to 1936 revealed a contirjuous increase as in Austria (Ztschr. f. Krebeforach. 47: 24, 1937. Abst. in Am. J. Canc r 35: 325, 1939) and in Germany (Ztschr. f. Krebsforsch 47: 427, 1938. Abst. in Am.7 J. Cancer 35: 615, 1939). The total deaths from cancer rose from 25,287 (12.15 per 10,OOO inhabitants) in the period 1901-1906 to 35,826 (14.48 per 10,OOO inhabitants)lin the period 1931-1936. Comparison for each sex of the periods 1901-1905 and 1932-1936 showed an increase in total deaths for males from 10,420 to 15,583; for females krom 10,525 to 14,572. MILTONJ. EISEN I Cancer Statirtfcr for the Cityrof Xiel and the City and Provkrce of Gbttingea, MEYBR. Die Krebskrankenstatistiq in den Stlidten Kiel und Mttingen-Stadt und mttingen- Land, Ztschr. f. Krebsforakh. 48: 204-222, 1938. The number of cases of eoplastic disease in Kiel and G6ttingen is tabulated for different one-year periods. 1the city of Kiel 281 patients (113 males, 168 females) applied for treatment for canqer during the period of October 1, 1934 to September 30, 1935. From June 1, 1937, tq May 31, 1938, there were 110 cases’of cancer (36 males, 74 females) in the city of Gytingen and 77 (30 males, 47 females) in the province of mttingen, exclusive of the u ban population. The number of cases is obviously too limited to warrant detailed stltistical analysis. MILTON’ J. EISEN