Reproducibility of tumour typing of lung carcinomas performed according to WHO's recommendation.

Tumour sections from 139 patients with bronchial carcinoma were classified blindly by a panel of three pathologists according to the WHO recommendation of 1981. Only sections from resected specimens were included. There was agreement among all reviewers with regard to the main WHO tumour type of 71% of the specimens. For the remainder, two reviewers agreed upon 19% whereas the tumour classification differed substantially in 10% of all cases. About half of the original diagnoses were maintained when the latter group was re-evaluated blindly. Best agreement in the whole material was noted for squamous cell carcinoma. The main difficulty was differentiation between adenocarcinoma and squamous cell carcinoma with a high malignancy grading score. Despite the improvements of the WHO classification system, our group of diagnostic problem cases was not reduced when compared with earlier classification studies.

The angiographic features of tumor infiltration of the greater omentum.

The angiographic findings of a metastatic neoplasm of the greater omentum are presented, and a survey of the angiographic features of previously reported omental tumors, primary and metastatic, is given. The angiographic pattern seems to be quite uniform with no specific relation to the histologic origin of the tumors and angiography is probably at the present time the best diagnostic modality.

Glass fragments and other particles contaminating contrast media.

Microscopy of filtrates made from contrast media of routinely opened glass ampoules substantiates previous assumptions that small fragments of glass may enter into the ampoule and the medium with considerable frequency. Such glass fragments may cause embolic lesions on intraarterial injections of the medium; the lesions, however, are histologically non-specific consisting of proliferation of intima and small granulomas associated with dilated nephrons in a ray-like arrangement. A significant amount of plastic particles may be added to injectable fluids on usage of disposable syringes.

Survival in lung cancer after surgery.

In 1053 patients hospitalized for primary lung cancer the overall crude survival rate (5 years) was 15.5%. Prognostically favourable indices were: absence of clinical symptoms (27% survival) and a peripheral site of tumour in the lung (28% survival). Duration of symptoms, when present, had no consistent influence on prognosis. Resection could be done in 419 cases. In this group the 5 years survival rate was strongly related to the extent of surgery and the completeness of resection. Cases with a radical lobectomy had a survival rate of 52% against 9% only in patients with a pneumonectomy that might not have been radical. Of 33 cases of resected small cell anaplastic cancer, 10 survived more than 5 years. This unexpectedly high survival rate persisted after revision of the histological typing and may justify an active surgical attitude even in this group of patients. Although hardly decisive in this context, confusion between the comprehensive term small cell carcinoma and its subtype, oat cell cancer, should be avoided.

A striking deposition of mineral particles in the lungs of a farmer: a case report.

The object of this study was to analyze mineral particles in lung tissue from a farmer who underwent lobectomy due to a lung tumor and relate these analytical findings to occupational exposure and histopathological and clinical diagnoses. Despite no clear evidence of previous occupational dust exposure, heavy deposits of birefringent particles and slight pulmonary fibrosis were found during histopathological examination. Extracts from the lung tissue were analyzed by electron microscopy and X-ray microanalysis for mineral particles. The major components of the dust were identified as mica, talc, and silica. Minor components included asbestos fibers and rutile fibers. Some of these fibers were coated by ferroproteins. Mica, quartz, feldspars (plagioclase), and rutile fibers were found in the soil from the farmer's potato storehouse. Based on these findings it is assumed that the slight pulmonary fibrosis is probably caused by the different mineral particles deposited.