ON THE STUDY OF THE IMPLANTATION OF ASCITES TUMOR IN URINARY BLADDER

REPORT II. THE METASTASIS OF THE TRANSPERITONEAL IMPLANTATION

Abstract

Transperitoneal implantation of MH 134 hepatoma, Yoshida sarcoma and AH 130 hepatoma into the urinary bladder was performed in 57 rats and the spreading ways of the implanted tumor were examined. The results are as follows:
1) Metastasis were found in all cases. The growth of the metastasis was differed, according to the brands of implanted tumor cells as well as the experimental methods, although Yoshida sarcoma always showed pronounced metastasis.
2) In the early stage, spreading ways to the various organs were noted to be different. In the retroperitoneal lymph nodes, metastasis appeared in the cortical lymphatic sinus, especially in the marginal sinus. The internal genitalia were infiltrated directly from the bladder. In the liver, spleen and lung, metastasis developed chiefly in the vicinity of the blood vessels. In the kidney, both the renal calyces and the connective tissue surrounding the blood vessels in the medulla were involved. These different sites of the metastasis suggested the possibility of both hematogeneous and intracanalicular spread to the kidneys.
In the adrenal glands, stomach, intestine and pancreas, dissemination of the tumor cells took place from the ascites.
3) The most common sites of metastasis was the retroperitoneal lymphnodes. The lung, liver and kidneys followed next. The internal genitalia were less commonly involved. In the spleen, pancreas and adrenal glands, incidence of metastasis was differed in different brands of the implanted tumors. The adrenal glands were involved rarely, and involvement of both the stomach and intestine was further rare.
4) With lapse of time, the involved organs were increased in number and the metastasis became pronounced.
In 7 days after the implantation metastasis was found in both the lung and retroperitoneal lymphnodes. In 14 days the kidney, liver and spleen were also involved, in addition to the above mentioned organs.
In the fatal cases, died during this period, numerous sites of metastasis were found in the internal genitalia, stomach, intestine and pancreas.
In early stage, the tumor spread lymphogenously to the retroperitoneal lymph nodes and then, hematogenously to the lung. With lapse of time, blood borne metastasis appeared in the kidney, liver and spleen. Later, in the advanced stage intracanalicular metastasis occurred to the kidney and continuous extention of the tumor infiltration from the urinary bladder to the internal genitalia. The abdominal organs, such as the adrenal glands, stomach, intestine and pancreas, were invaded through the serosa by the tumor cell presenting in the ascites.