Malacoplakia of the endometrium, a probable cause of postmenopausal bleeding.

A 60-year-old woman, 20 years post-menopausal, who had deforming rheumatoid arthritis of 7 years' duration and Sjögren's syndrome of 1 year's duration, had had postmenopausal bleeding for a month prior to admission to the hospital. A diagnosis dilatation and curettage was interpreted as showing acute suppurative endometritis. The patient was discharged, only to have recurrent vaginal bleeding. She was readmitted five weeks later, at which time results of another dilatation and curettage were interpreted as showing xanthromatous endometritis. Total hysterectomy with bilateral salpingo-oophorectomy was done. Examination of Epon-embedded endometrium 1 micrometer thick by light microscopy and subsequently by electron microscopy disclosed intracellular bacilliform organisms within phagolysosomes of atypical histiocytes, lamellar bodies, and various developing stages of calcospherites, Michaelis-Gutmann bodies. The curettings were then received and classic Michaelis-Gutmann bodies were identified in periodic acid--Schiff-stained sections.

Isoantigen ABH in cervical intraepithelial neoplasia.

The purpose of the study was to examine the relationship between the histologic findings and the presence or absence of ABH isoantigens in intraepithelial neoplasia of the cervix. After the lesions were graded by four pathologists, the Red Cell Adherence (RCA) test was done to demonstrate the ABH antigens, and the results of the two were compared. The correlation between the morphologic diagnosis and the results of the RCA test was limited. The percentages of tissues giving positive (+) or positive-negative (+/-) reactions were very similar in intraepithelial neoplsia (59.2%) and normal squamous epithelium (58.4%). The relationship of the RCA test results and behavior of the lesion was not studied.

Metastatic prostatic adenocarcinoma of male breast.

Three cases of metastatic adenocarcinoma of the male breast from prostatic carcinoma are added to the 15 well-documented cases reported in the literature. These 15 cases had received estrogen therapy for prostatic cancer and gynecomastia developed; 14 had clinically palpable breast nodules containing adenocarcinoma. Our 3 cases also received estrogen therapy but differed in that gynecomastia developed in only 1 patient clinically, and diagnoses were made at autopsy with no clinical symptoms related to breast metastases. Moreover, 1 cases also showed remarkable florid lactation-like changes of the breast almost indistinguishable morphologically from that seen in the female breast during pregnancy. The histopathologic differential diagnosis of metastatic prostatic carcinoma of the breast from primary cancer of the male breast is stressed. Its importance is obvious because of the differences in clinical treatment and prognosis. Microscopically, the differential points consist of duct hypertrophy and periductal fibrosis (gynecomastia), absence of any ductal involvement by carcinoma cells, frequent presence of cancer cells in lymphatics and vascular channels, morphologic similarity between the cancers in the breast and prostate, and finally, the usual presence of acid phosphatase in the tumors of the prostate and breast.

Periductal elastic tissue of breast cancer. Quantitative histologic study.

Using techniques of stereology, we estimated the relative volume of periductal elastic tissue in 60 infiltrating ductal carcinomas of the breast. Volume density of periductal elastic tissue in the neoplasm correlated with our own subjective histologic estimates of the amount of elastic tissue. Periductal elastic tissue had a significantly higher volume density in the neoplasm than in nonneoplastic breast, but the two estimates did not correlate with each other. Similarly, the volume density of elastic tissue in the neoplasm did not correlate with that of neoplastic cells or of stromal collagen in the neoplasm, degree of lymphocytic infiltration, lymph node metastasis, mortality, menstrual status, age, parity, or presence or levels of estrogen receptor protein in the neoplasm. On the other hand, parity correlated with the volume density of periductal elastic tissue in the nonneoplastic parenchyma of the breast. Our findings indicate that there are at least two separate elastogenic effects in infiltrating ductal carcinoma of the breast: that exerted by parity on nonneoplastic tissue and that exerted by cancer itself on the neoplasm.

Gaucher's disease associated with chronic lymphocytic leukaemia, gout and carcinoma.

A case report of Gaucher's disease associated with chronic lymphocytic leukaemia is described in a patient with gout and carcinoma of the sigmoid colon. This the first reported case of Gaucher's disease associated with chronic lymphocytic leukaemia.