MALIGNANT EPULTS.—This is a much more dangerous variety. Beginning usually at the socket, it is characterized by the presence of irregular multinucle ated mass of giant-cells associated either with round or spindle cells, or both. It is really a myeloid sarcoma. It is exceed ingly vascular, purplish red, grows much more rapidly than the simple epulis, and is finally transformed into a spongy mass, which projects in various directions and bleeds upon the least contact with a hard substance.
Epulis regarded as a recurring tutnor of malignant character and tending to destroy life. It seems to be definitely settled that epulis belongs to the sar comatous group. It is a myeloid sar coma, composed of fibrous tissue and myeloid cells, the former predominating, and it would appear occasionally to exist almost to the exclusion of the latter, and rice vow?. The greater the preponder ance of myeloid cells, the greater the tendency to malignancy. Early removal means a cure. When neglected the tend ency is to destroy life. W. 13. 'Rogers (Memphis Jour. of Med. Sci., Apr., '90).
Myeloid epubs may ossify. I. Hutchin son, Jr. (Lancet, Apr. 5, '00).
Epulis is almost always a, giant-cell sarcoma, though it may be of either a Lard T sL ft ensist, y. The careful
ii t \ Animation of somo ,eyoll tas,s nstratul that the giant cells tut not 111,1,1), litlenth:. de% doped cells. as ' As bt, cerally honeyed. but are ti use. ii• or bliddin,.•, from the blood-yes st Is. NI ClItiotildit1111 thrt`Ctly C011 I "St..' With the protoplasm of the giant ..,11s. and the tapillaries from which the giant ct Ils sprang were not always cini but frequently tilled with blood. The second constitut nt of the epillis— N D.. the spindle-cell sarcomatous tissue is %cry frt quently seen to be connected ith the giant cells and at the other times ith the capillaries, so that the spindle cells also, N‘ithout doubt. develop fn. In the blood-vessels; indeed. it is probable that these cells are, in reality, collapsed cal illarics lying elos.ely against cne another. The blood-spaces found in eptilis are not lilemorrhages from tlie fre quent traumatism to which the growth is submitted, but are, in reality, venous sinuses, into which the arterial system sends capillary sprouts. Carl Ritter Phila. "Med. Jour., from Dent. Zeit. f. Chir.. Dec.. '99).