Undifferentiated primary hepatic non-Hodgkin's lymphoma in childhood.

This report describes a case of primary non-Hodgkin's lymphoma occurring in the liver of an 11-year-old boy. Preoperative imaging established a large mass confined to the right lobe of the liver; complete removal was effected by right hepatic lobectomy. At presentation, there was serological evidence of active hepatitis B infection, which was confirmed histologically in the nonneoplastic portion of resected liver. The right lobe of liver was virtually replaced by a multinodular tumor mass that histologically resembled small-cell lymphoma. No evidence of either a B- or T-cell lineage could be established by immunophenotyping. However, immunohistochemical staining for panleukocyte markers demonstrated membrane staining. Gene rearrangement studies were not available. The patient remains well with no evidence of disease 2 1/2 years after surgery.

Corynebacterium pseudotuberculosis is a cause of human necrotising granulomatous lymphadenitis.

Corynebacterium pseudotuberculosis is a well recognised pathogen of farm animals, particularly sheep and goats. Human infection is a rare occurrence. This report describes suppurative lymphadenitis occurring in an adolescent boy who had contact with farm animals. The histological differential diagnosis of suppurative granulomatous lymphadenitis is discussed, and the importance of lymph node culture is stressed.

Traditional tests and job simulations: minority and majority performance and test validities.

Performance of 565 minority and 414 majority job applicants on traditional paper-and-pencil tests and on a telephone simulation that measured similar constructs was assessed. Models of the measurement characteristics of these 2 test batteries indicated larger subgroup mean differences on the traditional tests than on the simulation. Correlations between traditional tests were lower in the majority sample than in the minority sample, and the variance of the minority candidates' scores on the traditional tests was much larger than the variance of majority applicants' scores on the same measures. The validity of the simulation was lower than the validity of the traditional tests. This study replicates previous laboratory research that has indicated smaller subgroup differences on simulations than on paper-and-pencil tests and extends this research by providing evidence of the relative validity of these 2 types of measures.

An open technique of pleural biopsy in the diagnosis of tuberculous effusions.

To assess an open technique of pleural biopsy as an aid to diagnosis in pleural disease 107 African patients with radiological evidence of pleural effusion underwent biopsy. In 87 there was radiological evidence of an effusion but not of underlying lung disease; 73 patients (84%) in this group were ultimately diagnosed as suffering from tuberculosis and of these 56 (77%) had a positive pleural biopsy. There was a heavy male predominance of tuberculous infection (male:female ratio approximately 5:1) and half of the patients were aged 21 to 30 years. In the 20 patients with radiological changes in the lung a diagnosis was established by biopsy in 13 cases. Four of these were tuberculous and a further two cases of tuberculosis were established on clinical grounds.

A study of the services provided by the women's health nurses in a Sydney Area Health Service.

OBJECTIVES: To describe the client characteristics and nature of services provided by women's health nurses and to examine whether the goals set for the service are being met. DESIGN: A retrospective study of women's health nurse (WHN) records from 1987 to 1991. SETTING AND SUBJECTS: All women attending the women's health nurse in the Southern Sydney Area Health Service, 1987 to 1991. Older women and women of non English-speaking background are specific targets for this service. OUTCOME MEASURES: Pap test and breast self-examination practices were examined in relation to age and ethnic background. Use of general practitioner services was examined for all women attending the women's health nurse in 1991. RESULTS: Forty-five per cent of clients were aged over 50, and 29 per cent were from a non English-speaking background. Older women were more likely to return for subsequent visits to the women's health nurse. The practice of breast self-examination increased significantly between visits among all women. Forty-one per cent of women had not had a Pap test for at least three years, 93 per cent of these women were screened at their first visit. Eighty-seven per cent of women on their first visit and 86 per cent of women revisiting the women's health nurse had seen their general practitioner within the previous year. CONCLUSION: Women's health nurses are meeting the goals set for their service in relation to health promotion and the screening of women. Their services are perceived by their clients as complementary to those provided by their general practitioners.

Solar keratosis can be distinguished from superficial basal cell carcinoma by expression of bcl-2.

Criteria for the histological diagnosis of solar keratosis (SK) and superficial basal cell carcinoma (SBCC) are well defined. On occasion, however, the distinction can be difficult, particularly when evaluating small-punch or superficial shave biopsies in which the overall global architectural pattern of the lesion is not represented. As bcl-2 expression has been established in basal cell carcinoma, this study was undertaken to determine whether it could be employed as a basis for distinguishing SBCC from SK. Ten cases each of typical SBCC and SK were studied. Every example of SBCC showed strong uniform expression of the bcl-2 gene product Bcl-2, whereas all examples of SK were uniformly negative. It is suggested, therefore, that this simple technique is a reliable method for distinguishing these two closely related but disparate lesions.

Rhabdomyomatous mesenchymal hamartoma of skin.

A case of a solitary mesenchymal hamartoma occurring on the chin of a newborn infant is presented. The skin nodule exhibited an abnormal arrangement of dermal mesenchymal elements and, in particular, there was prominence of skeletal muscle. This lesion, which appears to be unique, has been termed rhabdomyomatous mesenchymal hamartoma of skin.

A study of the value of closed bone marrow biopsy.

Percutaneous microtrephine bone marrow biopsy by the Jamshidi-Swaim method was employed in the investigation of selected patients during a 1-year period. Data obtained from the study confirm the importance of this procedure as a method of diagnosing bone marrow lesions characterised by altered architecture or malignant infiltration. Common examples of such lesions are aplastic anaemia, myelofibrosis, Hodgkin's and non-Hodgkin's lymphoma and carcinomatosis. Bone marrow aspiration is frequently not helpful in the diagnosis of these diseases, but it is important that both aspirated and biopsy material be examined together, since the two methods are often complementary.

Bone marrow changes in neuroblastoma.

Bone marrow examination at the time of diagnosis of neuroblastoma was performed in 48 new cases prior to instituting therapy. Bone marrow involvement by neuroblastoma was present in 20 patients (approximately 42%). In this study the trephine biopsy was a more reliable technique than marrow aspiration in establishing the presence of metastatic disease, but in a single case the trephine biopsy was negative with metastatic cells present in the aspirate. Myelofibrosis secondary to metastatic neuroblastoma was a frequent finding, being the predominant feature in 6 cases. Bone marrow involvement by neuroblastoma was usually associated with the presence of a primary adrenal tumor and occurred only infrequently with extra-adrenal primary origin. Bone marrow involvement was usually present at the time of presentation in case where the primary tumor was located in the adrenal gland.