Exaggerated venous mural hypertrophy in association with metastatic adenocarcinoma of the prostate.

A 61-year-old black man presented with metastases to the right groin 5 years after 125iodine treatment for a well differentiated primary prostatic adenocarcinoma. Medium sized veins within and immediately adjacent to the neoplasm showed marked mural thickening due to hypertrophy and hyperplasia of the inner circular and outer longitudinal muscles. There was no histological evidence of radiation effect in the stroma or in the tumor cells. We could find no report in the literature of such changes associated with metastatic carcinoma.

Segmental infarct of the testis due to hypersensitivity angiitis.

We present a case of hypersensitivity angiitis causing a segmental infarction of the testis. The lesion presented as a discrete, palpable mass that led to orchiectomy. Hypersensitivity angiitis has not been reported previously to affect the testes or to produce a segmental infarct in any solid organ. A discussion is given of the vasculitides, especially periarteritis nodosa, that may involve the testes.

Subungual keratoacanthoma.

The subungual keratoacanthoma is a benign neoplasm which simulates and must be differentiated from squamous cell carcinoma. Subungual keratoacanthomas are rapidly growing tumors, causing bone destruction which usually heal spontaneously. The lesion most often presents as a painful, enlarging mass in middle-aged Caucasian patients. Radiographic examination demonstrates a lytic cup-shaped erosion of the underlying distal phalanx. It is essential to recognize keratoacanthoma and separate it from squamous cell carcinoma, both for prognostic and therapeutic reasons. We present two cases of proven subungual keratoacanthoma and discuss their radiographic and histologic characteristics, as well as the current treatment alternatives for this entity.

Metaplasia. An overview.

Metaplastic changes are common lesions found at widespread locations, occurring in both reactive and neoplastic tissues. Metaplasia has the following characteristics: (1) it can arise not only as a proliferation and transformation of immature (stem) cells, but also as a direct or indirect transformation of mature cells; (2) through metaplasia, a given cell may exhibit epithelial, mesothelial, or mesenchymal characteristics, regardless of the tissue of origin; and (3) its importance lies in that metaplastic changes can often be symptomatic and may simulate tumors clinically, grossly, or histologically.

Endodermal sinus tumor in pregnancy: report of a case and review of the literature.

The endodermal sinus tumor is a rare germ cell tumor characterized by extremely rapid growth and grave prognosis. The case of a 17-year-old black primigravida with a 19-week intrauterine gestation and concurrent endodermal sinus tumor of the ovary is presented. This case is the eighth reported case of this tumor during pregnancy. alpha-Fetoprotein and other oncofetal antigens are postulated as agents of rapid growth of this tumor. It is suggested that immunotherapy with antibodies against alpha-fetoprotein and other oncofetal antigens might change the unfavorable outcome of this tumor.

Osteogenic sarcoma of the tongue.

A 45-year-old woman had a mass in the left side of the tongue. Histologic examination of the tumor revealed it to be an extraskeletal osteogenic sarcoma. Pulmonary metastases were seen on admission. The patient had a rapid downhill course and died. Extraskeletal osteogenic sarcomas are well-recognized albeit rare neoplasms. In a search of the literature we were unable to find a single case arising in the tongue. The electron microscopic findings are also presented.

Retroperitoneal neurofibromatosis and venous anomalies.

A 45-year-old woman had abdominal pain, azotemia, and hypertension. Intravenous pyelography revealed bilateral ureteral compression by extrinsic tumor masses that proved to be neurofibromata by histologic examination. After surgical removal of the tumors, she became normotensive and asymptomatic. In addition, severe medial hypertrophy of veins was seen in the tissue examined. We believe that the latter is most probably related to the neurofibromatosis and is analogous to the hypertrophic arterial changes known to occur in patients with von Recklinghausen's disease.

Association of pulmonary alveolar lipoproteinosis with mycobacterial infection.

A case of pulmonary alveolar proteinosis associated with tuberculosis of the lung is reported. The patient had fever, cough, and pulmonary cavities. Sputum cultures for Mycobacterium tuberculosis were positive on three occasions. Thirty-three months later, diffuse bilateral lower lobe infiltrates developed. An open lung biopsy revealed filling of the alveoli by a periodic-acid-Schiff-positive amorphous granular material. There is a significant association between this disease and various infectious and fungal agents, but its association with tuberculosis is rare. It has been reported only three times before in the English literature. This appears to be the fourth documented case with this association. A review of the literature with special emphasis on tuberculosis associated with alveolar lipoproteinosis is presented. The electron-microscopic findings are also described.

A light and electron microscopic study of a hemangiopericytoma of the prostate with local extension.

A case of primary hemangiopericytoma of the prostate is reported. The patient presented with obstructive uropathy and was diagnosed as "benign prostatic hypertrophy." A transurethral resection was done and was diagnosed as "cellular leiomyoma." Obstructive symptoms recurred and skin and pubic bone involvement appeared 2 months later. Light and electron microscopy of the repeat transurethral resection and biopsy of the perineal mass confirmed the diagnosis of hemangiopericytoma of the prostate.