[Diagnostic image (84). A woman with persisting perianal fissures]. / Diagnose in beeld (84). Een vrouw met persisterende anusfissuren.

A 63-year-old woman had perianal fissures, which were caused by an amelanotic melanoma of the anus.

Dysmenorrhea related to gallstone spilling after laparoscopic cholecystectomy.

A 28-year-old woman is presented with severe dysmenorrhea since a previous laparoscopic cholecystectomy for cholelithiasis. Spilled gallstones were embedded in the Douglas cavity and the visceral peritoneum of the genitalia interna. Dysmenorrhea was treated successfully by laparotomic hysterectomy and removal of all gallstones.

[Detection of Mycobacteria in tissue sections]. / Opsporing van mycobacteriën in weefselcoupes.

A study of 31 patients with Mycobacterium infection was performed. The results of Ziehl-Neelsen(ZN) and auramine-rhodamine(AR) staining techniques were compared with the results of cultures. This study demonstrates that the AR method is more sensitive than the ZN method, but they complement each other and when used in combination allow fast and reliable screening for organisms. The culture is important for classification of Mycobacterium species and drug susceptibility testing.

Estrogen synthesizing rare malignant Brenner tumor of the ovary with the presence of progesterone and androgen receptors in the absence of estrogen receptors.

A case of a malignant Brenner tumor of a postmenopausal woman presenting with vaginal bleedings is described. Clinical and laboratory findings demonstrated estrogenic secretory function and action. The presence of aromatase activity based on in vitro tumor microsomal metabolism of androgen to estrogen is described. Tumor cytosol contained progestin and androgen binding components in the absence of estrogen binding activity. Estrogen binding activity was undetectable both by biochemical as well as histochemical assays.

Malignant Brenner tumor. A histologic, morphometrical, immunohistochemical, and ultrastructural study.

The histologic, morphometric, immunohistochemical, and ultrastructural study of a malignant Brenner tumor in a postmenopausal women presenting with vaginal bleeding is described. A comparison with transitional cell carcinomas is made, and the use of morphometry in grading the urothelial-like epithelium in malignant Brenner tumors is suggested. High preoperative urinary estrogen, low serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels and histologically confirmed atypical endometrial hyperplasia suggested a hyperestrogenism. The reduction in urinary estrogen and the increase in serum LH and FSH after tumor removal and the presence of aromatase activity detected in tumor microsomes confirmed that the tumor was synthesizing estrogen. Estrogen receptors were undetectable both by biochemical and histochemical analysis in the tumor.

Multiple angiomatous proliferations of ileal stoma following Campylobacter enteritis. Effect of laser photocoagulation.

Multiple polypoid sessile tumors arose at the tip of the ileal stoma of a 37-year-old man, who previously underwent proctocolectomy for ulcerative colitis. The lesions developed shortly after a well-established gastrointestinal infection with Campylobacter jejuni with mucosal ulceration. The histological and ultrastructural examination showed angiomatous proliferations, reminiscent of pyogenic granuloma. The destruction of the tumors by laser photocoagulation was followed by superficial ulcerations of the mucosa, which healed without scarring. Small recurrences, however, could not be prevented.

Leiomyoblastoma of the gastric wall.

A patient with leiomyoblastoma of the gastric wall is reported. The manifestations of the tumor are described and guidelines for therapy and prognosis are provided, based on a review of literature.