Chronic intestinal lymphocytic microphlebitis.

The authors report two cases of a peculiar microphlebitis of the intestines, similar to that described by Saraga and Costa quite recently [5]. The patients had undergone hemicolectomy because of evolving ileus caused by cecal polyps or lipohyperplasia, respectively. Pseudomembranous-ulcerative inflammation of the cecum and variously intense lymphocytic infiltrates of numerous small submucosal veins and venules of the intestines were found in both cases. Thrombosis occurred very rarely in the affected vessels, although sometimes it was found in deeper and larger veins. Arteries, lymphatics, mesenterial veins and lymph nodes were normal. Parts of the distal ileum and ascending colon displayed the phlebitic changes without mucosal alterations. The authors hypothesize that it was not the abnormal local circulation, but some hitherto not fully clarified immunological disorder that resulted in the disease. In contrast to the claim of Saraga and Costa [5], it is suggested that thrombosis of the small veins does not have a significant role in the development of the lesions, but a complex process that includes the entry of antigens via the altered mucosa followed by an immunogenic inflammatory response of the small veins is responsible for the pathogenesis.

Eosinophilic endomyometritis associated with diagnostic curettage.

Histological study of hysterectomy specimens removed for noninflammatory and nonneoplastic disease revealed 15 severe cases and many more slight cases of eosinophil leukocytic endomyometritis, the degree of which appeared to correlate with injury from preoperative diagnostic curettage. In each case of severe eosinophilic endomyometritis, circumferential mucosal and extensive myometrial damage together with an occluding blood clot at the level of the inner orifice was confirmed. The massive eosinophilia appeared any time between 18 h and 21 days after curettage, and it is proposed that the probable causative agents are eosinophil chemotactic substances liberated from the myometrial mast cells and from the degrading blood clot filling the uterine cavity. There were no clinical signs or symptoms that appeared to correlate with the histological changes observed in this study. This phenomenon may serve as a model for studying the dynamics and functions of eosinophilic leukocytes in humans.

Bizarre leiomyoma of the prostate.

Obstruction of the urethra, caused by a prostatic tumour necessitated prostatectomy in a 49-yr-old man. Histology revealed a moderately cellular and vascular tumour with marked cellular atypia. After a follow-up for three years, the results of both the clinical investigations and prostatic needle biopsy were negative. Thus the original opinion of malignant prostatic mesenchymal tumour was revised, resulting in the diagnosis of bizarre leiomyoma. Subsequently the smooth muscle cell origin and the benign nature of the tumour were demonstrated by electron microscopy and Feulgen-cytophotometry, respectively. This is the first prostatic bizarre leiomyoma in which malignancy was excluded by demonstrating euploid polyploidy. This case also calls the attention to the need of more sophisticated methods in everyday diagnostic pathology.

Simulated cancer of the lower lip attributed to a "caliber persistent" artery.

Observations are reported on three lesions of the lower lip simulating cancer in elderly men and attributed to caliber persistent arteries. Persistent caliber arteries are those with a diameter larger than normal near a mucosal or external surface. Caliber persistency of the lip artery is best characterized by a quotient, using the distance from the border between epithelium and connective tissue as numerator, and its diameter as denominator. A quotient lower than 1.6 to 1.7 may be regarded as indicative of this vascular anomaly.

Non-malignant perineural spread of epithelial tissue in the orofacial region.

A 48 year-old male had two operations because of severe neuralgic pains in the region of the right infraorbital nerve. The first operative specimen consisted of connective tissue, striated muscle fibers and two myelinated nerve bundles, surrounded by a ring of well differentiated squamous epithelium. Initially the lesion was assumed to show perineural spread of cancer in this region. As the pain was not alleviated, a second operation was performed. The framework of the second specimen also consisted of connective tissue and muscle. It contained in addition an atheromalike cyst and some nerve bundles, ensheathed by well differentiated epithelial cells partly in a ring-, partly in a horseshoe-like pattern. The perineural epithelial sheaths could be traced to a rupture of the cyst, and to benign proliferation of its epithelial lining in the connective tissue and along the nerve bundles. Following the second operation the patient was relieved of his complaints. During the last five years he had repeated control examinations but no sign of malignant disease could be found; his state of health was perfect. Our finding of benign perineural spread of squamous epithelium has not been described previously. The nature of the so-called perineural lymph spaces is also discussed.

Chronic idiopathic myelofibrosis. A reversible disease?.

A patient with chronic idiopathic myelofibrosis was subjected to splenectomy 1 year after diagnosis. As a clinically unexpected finding, lymph node biopsy suggested the presence of non-Hodgkin lymphoma. The patient was subjected to intensive combined cytostatic therapy. In the following months, signs and symptoms of myelofibrosis regressed remarkably. The patient died 31 months after splenectomy in massive gastrointestinal bleeding. At post-mortem, myelofibrosis could not be detected in three bone marrow areas and a regular, fat-containing, hypercellular marrow was present. The nature of the previous lymph noede pathology was reconsidered, and angioimmunoblastic lymphadenopathy was diagnosed.

[Experimental methods of creating V X 2 bone tumour in rabbits (author's transl)]. / Experimentelle Methode zur Erzeugung von V X 2-Knochentumoren bei Kaninchen

V X 2-carcinomas were induced in rabbit femurs by various methods. Inoculation near the periosteum after injury of the condylus medialis femoris was considered most successful. Results of 124 inoculations and 10 controls are demonstrated by angiograms, pharmakoangiograms and histologic photographs. Injury of periosteum and bone favors the taking and spreading of malignant growth.

Morphological examination of the juxtaglomerular apparatus following the fluorescence microscopic demonstration of sympathetic nerves.

Several catecholamine demonstrating fluorescence techniques based on the formaldehyde-condensation principle have been examined for the possibility of application of juxtaglomerular granulum demonstrating methods. Freezing and thawing cause a distruption of juxtaglomerular granules. Short formalin fixation does not prevent this damage. Juxtaglomerular granules were successfully stained after freeze-drying. The adaptation of Endes's trichrome method on the basis of the classical catecholamine technique of Falck and Owman resulted in a reliable practical method. Procedures introduced into the trichrome methods to increase the colour and intensity contrast of the staining of juxtaglomerular granules and to stain the elastic membranes are described. Some aspects of the staining mechanism of juxtaglomerular specific granules are also discussed.