The identification of living malignant cells in exudates.
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The clinical records and preserved specimens of 111 cases of primary malignant disease of the liver have been analysed. All were diagnosed in the Merseyside area, chiefly in Liverpool and Birkenhead, and all but nine were Europeans. Necropsy was done in 89. The tumours consisted of 108 carcinomas, two sarcomas, and one mixed tumour. Liver cell carcinoma was nearly four times more frequent than carcinoma of the intrahepatic bile ducts. Both types were commoner in males, the difference between the sexes being greater in the case of liver cell carcinoma. Predisposing conditions included portal cirrhosis, haemochromatosis, and cystic malformations of bile ducts. The gross and microscopic appearances are described and the pathological effects discussed. Liver cell carcinoma tends to invade and permeate veins within the liver but seems, nevertheless, to remain limited to the liver for longer than carcinoma of the intrahepatic bile ducts. Liver cell carcinoma is more characteristic microscopically. The commonest occupation among the male cases was seafarer.
Smears and sections were obtained from various labelled points on the mucosal surface of 25 freshly-excised stomachs, and the appearances were compared. Normal gastric mucosa, intestinal metaplasia, chronic gastritis, and carcinoma could generally be identified from the smears. In a few smears from the edge of peptic ulcers there were abnormal cells which might cause confusion with carcinoma. Conversely, tumour cells were seen which would be very hard to diagnose with certainty on cytological grounds.
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