Endometrioid carcinoma of the fallopian tube.

A case of endometrioid carcinoma arising in endometriosis of the fallopian tube is described. One case of tubal endometrioid carcinoma has been reported previously, but the entity has not hitherto been recognized among primary fallopian tube tumors. The clinical presentations, histopathology, and pathogenesis of this rare tumor are discussed.

The incidence of carcinoma in solitary "cold" thyroid nodules.

Two hundred and three patients with single thyroid nodules were referred for radioactive scan of the thyroid. Solitary "cold" nodules were identified in 130 patients and 68 of these patients came to surgery. Of this group, 12 patients were found to have carcinoma. There was no obvious selection process which distinguished the 68 patients who underwent surgery from the 62 who did not. There is a significant risk of thyroid neoplasms occurring in patients with solitary "cold" nodules, and this is particularly true in patients under forty.

Chondrosarcoma simulating malignant atrial myxoma.

A 69-year-old patient underwent removal of a left atrial tumor which was diagnosed clinically and pathologically as atrial myxoma. Fourteen, 18 and 22 months later, distant metastases were discovered. Two of the metastases were removed entirely and one partially. The metastatic tumors were also thought to be of myxomatous origin by light and electron microscopy. Only at autopsy was it demonstrated that the patient had a primary chondrosarcoma of the pelvis giving rise to widespread myxoid metastases to the heart and other sites.

Suspected multiple primary tumors of the lacrimal and parotid glands.

A 63-year-old man had apparent primary tumors of the lacrimal and parotid glands. Initially an adenocarcinoma of ectopic lacrimal gland origin was suspected following biopsy of a mass in the left orbit. The patient received radiation therapy to this area and showed no recurrence of the original lesion or development of other tumors for a period of 27 months. At that time, the patient returned with a mass in the left preauricular area. This was surgically resected and found to be an adenocarcinoma of the left parotid gland. Both tumors were histologically similar, mucin-secreting adenocarcinomas. There has been no further evidence of tumor growth in an additional three-year period.

Oncocytic neoplasms of salivary glands: a report of fifteen cases including two malignant oncocytomas.

Fifteen oncocytic (oxyphilic granular cell) neoplasms of the salivary glands collected from three large university medical centers are presented. The histologic and ultrastructural criteria that characterize oncocytes are presented and electron micrographs of two of our cases are discussed. Included in the series are 10 benign oncocytomas, two malignant oncocytomas and three benign, oncocytic pleomorphic adenomas. The clinical and pathologic features of benign oncocytomas are reviewed, with special attention to the variety of gross and microscopic changes present. The literature on malignant oncocytomas is critically reviewed, diagnostic criteria are evaluated, and a unique case is discussed in detail. Reference is made to a group of neoplasms that we designate as benign locally aggressive oncocytomas. The problem of differential diagnosis between oncocytoma and bening, oncocytic pleomorphic adenoma is considered.

Hyperinsulinemic hypoglycemia associated with a neurofibrosarcoma.

A patient with a posterior mediastinal malignant neurofibrosarcoma and recurrent episodes of severe hypoglycemia was demonstrated to have basal hyperinsulinemia on repeated study. Despite hypoglycemia, there was no glucagon response to aminogenic stimulation. No immunoreactive insulin was detected on extraction of the tumor and no secretory granules of beta type were seen on electron microscopic examination of tumor tissue. Following tumor removal, plasma glucose and insulin levels returned to normal. Alpha cell function improved. These findings suggest stimulation of pancreatic beta cell secretion and possible inhibition of alpha cell response by an extrapancreatic tumor.

Long-term remission in diffuse histiocytic lymphoma treated with combination sequential chemotherapy.

Seventeen patients with Stage III or IV reticulum cell sarcoma were treated with three cycles of a 5-drug regimen between February, 1969 and December, 1970. Of the 17 patients, 9 attained a complete remission and 6 had a parital remission; 2 were considered unevaluable. Recently, the original biopsies from these patients were reclassified according to the criteria of rappaport et al. The results were: diffuse histiocytic--8; nodular histiocytic--2; diffuse mixed--2; nodular mixed--3; diffuse lymphocytic poorly differentiated--1; nodular lymphocytic poorly differentiated--1. Of the 8 patients with diffuse histiocytic lymphoma 6 attained complete remission, 1 had a partial remission, and 1 was unevaluable. One of the 6 with complete remission relapsed at 7 months and died 2 months later. However, the other 5 are alive and in continued unmaintained remission for 55 to 65 months.

Lymphangiomyomatosis: report of a case with ureteral involvement and chyluria.

A 54-year-old woman, presenting with chyluria and progressive dyspnea, is reported. Necropsy revealed co-existent lymphangiomyomatosis and pneumoconiosis in the lungs. Retroperitoneal lymphangiomyomas surrounded the distal ureters, and cystoscopy revealed pyelolymphatic backflow into renal lymphatic sinuses. The finding of chyluria with atypical smooth muscle hyperplasia within the ureters is extremely rare. Previously reported cases of lymphangiomyomatosis are discussed and compared with our own. Electron micrographs of involved lymph nodes are presented and the findings briefly evaluated.