Abstract
There are numerous sensory and vegetative nerve fibres found in the dermal tumors in RECKLINGHAUSENS's disease. This fact proves their origin as starting in peripheral nerve bundles. Since the proliferated SCHWANN's cells predominate widely over the increased connective tissue cells, the genetic essence of these tumors is thought to be due to a pathological proliferation of SCHWANN's cells.
As the tumor cells originate in SCHWANN's cells or the KOHN's so-called accessory cells, they seem to be endocrine in nature, and this fact, coupled with the luxuriance of newgrown blood vessels and the undermentioned special nerve supply leads to the conclusion that these tumors should belong to a sort of pathological endocrine organ morphologically resembling the paraganglia.
The tumors are liable to slow degeneration starting at the oldest parts but on the other hand neogenesis is continuously going on toward the proximal part of the affected nerve bundles.
The tumor cells go on proliferating and distributing toward the surroundings, to invest the hair follicles, the arrector muscles, sweat glands and other normal nerve bundles in their way, but they do not infiltrate into such tissues to damage them.
In the incipient stage of tumor formation, the nerve fibres run in approximately parallel but spaced courses, accompanied by many new grown branch fibres; the nuclei of the tumor cells comprise mainly elongated ones, but some ovoid nuclei formed by mitosis are also found sporadically. When the tumor formation is completed, however, only cells with ovoid nuclei are found in compact arrangement.
The vegetative fibres, both in the earlier and the later stages of tumor formation, pass over into the special vegetative terminal network after ramifying and anastomosing, as such fibres do in the various paraganglia. The sensory fibres pass over into rather peculiar formations. The unmedullated terminal branches are represented as stout fibres occasionally changing their size, which end in simple branched terminations, and sometimes in more complexly branched or glomerular ones. These sensory terminations presumably show the existence of the reflex path to the secretive action of the newly formed pathological endocrine organ.
As long as the tumor tissue remains undegenerated, the sweat glands, the hair follicles, the sebaceous glands, the arrector muscles, the nerve bundles and such formations entrapped in the tumor tissue retain their normal shapes and the vegetative termination supplying them is also in the form of normal terminalreticulum. The nerve fibres distributing in the tumors represent no pathological signs, too. But once the tumor tissue falls into degeneration, in the later stage of its formation, these nerve elements as well as the other tissues enclosed therein begin to suffer simultaneous degeneration.
The essence of the degeneration of the tumors consists in the collagenous degradation of the tumor cells based upon the appearance of stellar connective tissue cells and collagenous substances filling the intercellular interstices.
