An unusual pelvic tumor with benign glandular, sarcomatous, and Wilms' tumor-like components.

We present a pelvic tumor occurring in a 23 year old woman in which a Wilms' tumor-like element was predominant. The presence of a benign glandular component surrounded by small spindle and round malignant cells paralleled that encountered in adenosarcoma of the uterine body and cervix. The possible histogenesis is discussed. Clinically the recurrent tumor showed evidence of a response to chemotherapy. Treatment was complicated by petit mal seizures, for which adriamycin was responsible. The patient exhibited no evidence of disease 22 months after the first operation.

An unusual case of Hansen's disease (lepromatous leprosy) with circulating anticoagulant and macroglobulinemia.

A 42-year-old Mexican migrant laborer with a previous history of neurofibromatosis presented with a stuffy nose and chronic ulceration of his soft palate. Multiple subcutaneous nodules were found on his skin, and laboratory investigation revealed an elevated activated partial thromboplastin time (APTT). Further laboratory evaluation showed a lupus-like circulating anticoagulant deemed IgM by quantitative immunoglobulin studies. Although coagulation defects in lepromatous leprosy are rare, the preoperative preparation of a patient with leprosy may require a screening prothrombin time (PT), APTT and platelet count. Abnormalities in these values may indicate the need for specific factor assays and a search for circulating anticoagulant.

Detection of drug-dependent antibodies by the 51Cr platelet lysis test: documentation of immune thrombocytopenia induced by diphenylhydantoin, diazepam, and sulfisoxazole.

Sudden, severe thrombocytopenia developed in each of three patients receiving diphenylhydantion, diazepam, and sulfisoxazole, respectively. Recovery followed discontinuance of the drugs. An antiplatelet antibody requiring the presence of an appropriate drug for interaction with platelets was deomonstrated in each case by the 51Cr platelet lysis test using normal, paroxysmal nocturnal hemoglobinuric, or enzyme-treated normal platelets as target cells. These antibodies could not be detected by techniques that depend on clot retraction inhibition, complement fixation, or platelet factor-3 activation. Quinine-and quinidine-dependent antiplatelet antibodies in the serum of 16 patients who developed acute thrombocytopenia while taking either quinine or quinidine could be demonstrated readily with the 51Cr platelet lysis test and could also be detected by other methods employed.