Carcinoma of the stomach starts in the epithelial mucus-producing cells of the mucous membrane and grows outward from one or more focal points in all directions, i. e., into the lumen, along the gastric wall parallel to the lumen and toward the serosa. However, different tumors vary in the speed with which they grow in these various directions, and this accounts for the morphologic characteristics of the different gross types of gastric carcinoma. For instance, there is the fungating tumor, which grows chiefly into the lumen; there is the linitis plastica type, the growth of which runs parallel to the lumen in all of the gastric coats, and there are the ulcerated cancer and the cancer developing at the margin of a preexisting peptic ulcer, the growth of which is usually directed chiefly toward the serosa. In a little more than half of the resected stomachs, growth apparently occurred at