Nephrogenic adenoma of the urinary bladder and urethra.

The histologic and ultrastructural features of nephrogenic adenomas of the urinary bladder and urethra were studied in multiple specimens obtained from eight patients. Three of these were studied by indirect immunofluorescence for Tamm-Horsfall uromucoprotein. The lesions are uncommon benign metaplastic proliferations of urothelium, occurring most frequently in males as small cystic, papillary, or nodular masses and most often presenting with hematuria. Typically the metaplastic tubules resemble nephronic tubules. A florid atypical and pseudoinfiltrative proliferation of these tubules may led to an erroneous diagnosis of adenocarcinoma. Ultrastructural features of proximal convoluted tubules were identified in some of the tubules, but resemblance to specific segments of distal tubules was less certain. The ultrastructural features combined with the absence of Tamm-Horsfall protein in tubular lumina or cells suggest a mesonephric rather than metanephric homology. The lesions are appropriately treated by transurethral resection or fulguration, but persistent lesions were present in three patients up to 18 yeas after initial treatment.

Mixed mesodermal tumors of the ovary: a clinicopathologic study of 14 cases.

Fourteen cases of mixed mesodermal tumor of the ovary are presented. The actuarial survival of patients with these tumors was 2.5 months. Eighty-six percent of patients were stage III or IV at the time of diagnosis. The stromal or carcinomatous component of the tumor could not be correlated with survival. Both our two longest survivors, 14 and 27 months, were treated with surgery and radiotherapy, one patient with and one without chemotherapy.

Mixed müllerian tumors of the uterus: a clinicopathologic study.

Forty-seven cases of mixed müllerian tumors of the uterus were analyzed clinically and pathologically. All patients but one were postmenopausal. Vaginal bleeding was the most frequent presenting symptom, followed by abdominal mass and pelvic pain. Long-term survival was found only in those cases in which the tumor was localized to the uterus (surgical stage I), particularly if it arose from a benign endometrial polyp. No correlation could be established between survival and tumor size, depth of myometrial invasion, or histologic type of sarcoma. Tumors arising after previous irradiation had a poor prognosis. Treatment included surgery, radiation, and chemotherapy. The cumulative probability of 5-year survival was 35%.

Focal cytomegaly of the adult adrenal cortex. A rare variant of black adenoma.

A pigmented adrenocortical nodule was found incidentally in an adrenal gland resected for endocrine manipulation of breast carcinoma. The sharply circumscribed, nonencapsulated nodule was composed of cells with diameters as large as 95 micron. The cells had ample eosinophilic cytoplasm and contained much lipofuscin pigment. Electron microscopy disclosed tubulovesicular mitochondria, lipofuscin pigment, cytoplasmic vacuolization, and lipid without degenerative changes or intranuclear inclusions. This unusual lesion of adult adrenal glands is best considered as a rare variant of adrenocortical black adenoma.

Epididymal sarcoidosis: case report and review.

Sarcoidosis is considered rarely in the differential diagnosis of scrotal masses. We report a case of epididymal sarcoid in an otherwise asymptomatic young man. The findings on the chest x-ray initially suggested a metastatic testicular neoplasm. Familiarity with this lesion may avert unnecessary orchiectomy. A rational treatment approach is presented and the literature is reviewed briefly.