Sonographic findings of testicular teratoma with pathologic correlation.

Testicular teratoma is a rare tumor in children. We recently encountered two boys, aged 18 months and 2 years respectively, with this tumor. Sonography revealed an intratesticular mass in both. The first revealed a predominantly cystic lesion with echogenic components along its wall. The second showed a complex mass occupying most of the right testicle, and containing several areas of calcifications and cysts. Excellent pathologic correlation was obtained in both. Preoperative diagnosis of testicular teratoma is possible if the characteristic features are recognized. The prognosis is good following orchiectomy in the pediatric patients.

Q-fever. The liver and bone marrow pathology.

Eighteen liver and seven bone marrow biopsies from 44 patients with clinically and serologically proven Q-fever seen during a recent outbreak were studied. Highly distinctive fibrin-ring granulomas were found in seven liver and four bone marrow specimens. Lipid or nonspecific granulomas often containing neutrophils and variable numbers of giant cells were noted in 13 livers and seven bone marrows. A wide variety of nongranulomatous histological changes, frequently including steatosis and nonspecific "reactive" hepatitis, were seen in the liver biopsies. Identifiable rickettsiae were not present in tissue sections studied by microbiologic stains or electron microscopy. The histological response pattern to Coxiella infection is varied, and Q-fever should always enter the differential diagnosis of a granulomatous disease encountered in liver and bone marrow specimens.

Possible defect in the bile secretory apparatus in arteriohepatic dysplasia (Alagille's syndrome): a review with observations on the ultrastructure of liver.

Ultrastructural observations on 12 liver biopsies from 10 patients with arteriohepatic dysplasia syndrome (Alagille's syndrome) are reported. The electron microscopic changes in the liver in this condition are different from those seen in other forms of chronic intra- and extrahepatic cholestasis. In particular, the bile canalicular and pericanalicular changes classically observed in cholestasis are infrequently seen. When compared with other forms of intrahepatic cholestasis including syndromes associated with paucity of intrahepatic bile ducts, the ultrastructural changes in Alagille's syndrome appear to be distinctive. Bile pigment retention is found in the cytoplasm especially in lysosomes and in vesicles of the outer convex face of the Golgi apparatus (cis-Golgi), but rarely in bile canaliculi or the immediate pericanalicular region. These results suggest a block in the Golgi apparatus or in the pericanalicular cytoplasm.