Abstract
In an attempt to investigate the mode of cancer spread through extravascular fluid pathways, a histological study was made on 8 fatal cases of tumor including intraabdominal tumors.
In these cases the entire anterior portion of the chest wall including internal mammary lymphatics, the thoracic duct, parasternal nodes, and the diaphragm was removed and dissected. The peritoneal diaphragm which had been peeled at the level of the submesothelial connective layer and stained with May-Giemsa's method, Bielschowsky-Maresch's impregnation method clearly showed a typical pattern between cancer cells and macula cribriformis.
The most prominent feature of human autopsy materials was that macula cribriformis was densely packed with cancer cells.
Another prominent feature was that the fat tissues around internal mammary lymphatics were permeated with many cancer cells, occasio-nally with many cancer cells infiltrated into interstitial tissues of intercostal muscles and transversus thoracis muscles. It was conceivable that the involvement might result in a leakage through the wall of retrosternal lymphatics, disclosing physiologically their special function, i. e., leakage phenomenon.
Evidence from human autopsy materials supports a conclusion that cancer cells may pass through the pre-lymphovascular fluid path, but partly may deposit in macula cribriformis and that cancer cells dicharged into internal mamary lymphatics may have leaked from lymphatics leading to a proliferation of cancer cells.
