Vascular spindle cell lipoma.

Spindle cell lipoma is a neoplasm of adipose tissue that primarily affects posterior necks and shoulders of men in their fifth to seventh decades. It consists of a mixture of adipose tissue and spindle-shaped cells that could be misinterpreted as sarcoma. A clinical and pathological study of two patients, both men, with vascular variants of spindle cell lipoma is presented. These tumors were unusual clinically, in that one caused pain on motion and the other was painful to palpation. On microscopic examination, their vascularity was augmented over previously described examples of spindle cell lipoma.

A modified Warthin-Starry procedure at low pH for melanin.

The Warthin-Starry argyrophilic silver stain peformed at pH 3.2 is a highly effective method for the demonstration of melanin in tissue sections. Eighty-five melanocytic tumors were studied using the Warthin-Starry and the Fontana-Masson procedures. The Warthin-Starry technic stained a greater number of cells in 68% of the tumors, with no loss of cellular detail. Twenty-three per cent of the tumors that appeared amelanotic on hematoxylin-and-eosin-stained sections were positive for melanin with the Warthin-Starry stain, but negative with the Fontana-Masson technic. The Warthin-Starry stain is more sensitive and specific for melanin than is the Fontana-Masson procedure.

Ultrastructure of the goblet cell type of adenocarcinoid of the appendix.

Two examples of the goblet cell form of adenocarcinoid were studied with electron microscopy. Mucin was present in the form of large and small vacuoles or small patches of denser mucin granules. A small population of cells had a complement of organelles similar to the more obvious goblet cells but contained little or no identifiable product. Enterochromaffin cells were similar to those seen in normal midgut and in conventional carcinoids of midgut derivation. Enterochromaffin granules and mucin were not mixed with one another. Cell types transitional between mucinous and enterochromaffin were not found. Although study of plasmalemmae was hindered to a degree by artifacts due to tengential sectioning and, possibly, insufficiently rapid fixation, we favor the interpretation that the goblet cell type of adenocarcinoid is composed of two separate classes of cells.

Adenocarcinoid, a mucin-producing carcinoid tumor of the appendix: a study of 39 cases.

Adenocarcinoid is a form of appendiceal carcinoid possessing features of both carcinoid and adenocarcinoma. There are two histologic types. Thirty patients had the goblet cell type, characterized by nests of large mucin-distended cells. Nine patients had the tubular type, characterized by small glandular structures lined by uniform cells. Despite abundant mucin and a goblet cell or acinar-like arrangement, a closer relationship to carcinoid than to adenocarcinoma is suggested by a concentration of tumor elements below the crypts of Lieberkuhn, a lack of evidence of neoplastic transformation of the appendiceal mucosa, and the demonstration of argentaffin or argyrophil granules in 88% of the lesions. Six tumors, all of the goblet cell type, metastasized and resulted in the death of the patients. One of the tumours that metastasized had a prominent tubular component. Most adenocarcinoids can be adequately treated by appendectomy, but hemicolectomy is recommended for those tumors showing atypical foci, a high mitotic count, or spread beyond the appendix.

Apocrine gland adenoma and adenocarcinoma of the axilla.

Apocrine tumors from the axilla of 12 patients were studied clinically and pathologically. Based on histologic features, two tumors were classified as adenomas and ten as adenocarcinomas. All of the neoplasms were characterized by a glandular arrangement of large cells with abundant eosinophillic cytoplasm and evidence of decapitation secretion. The cytoplasm of the tumor cells contained PAS-positive, diastase-resistant granules. Intracytoplasmic particles of iron were demonstrable in three of ten tumors. Follow-up was available for all 12 patients. The two patients with apocrine adenoma are alive and well. Two patients with adenocarcinoma died of unrelated causes shortly after diagnosis. Of the remaining eight patients with adenocarcinoma, three have died of disease, and one is living with skeletal metastasis. A correlation appears to exist between tumor differentiation and prognosis.

Leiomyosarcoma of the colon: report of a case and analysis of the relationship of histology to prognosis.

A case of primary leiomyosarcoma of the colon in a patient without gastrointestinal symptomatology who initially manifested a metastasis in the parotid region is described. Review of the literature indicates that mitotic activity is the most reliable histologic criterion for prognosis. Three of five patients with tumors manifesting high mitotic activity succumbed to widespread metastatic disease within four months of initial diagnosis. The prognosis is generally favorable for those patients whose neoplasms have low or moderate mitotic rates.