Bottleneck optical limiters: the optimal use of excited-state absorbers.

Passive nonlinear absorptive limiters offer an effective means to protect human eyes and other focal-plane sensors from damage by pulsed laser radiation. New device designs are proposed in which dye molecules are driven into strong ground-state depletion by the incoming threat pulse while the internal fluence values are kept below the material failure level. Pulse-energy suppression ratios greater than 10(4) for 10-ns pulses together with linear transmission greater than 70% should be possible with existing dyes.

Cervical intraepithelial neoplasia III in an adolescent with Bowenoid papulosis.

Bowenoid papulosis (BP) is a cutaneous condition of the external genitalia seen primarily in young adults. Evidence supports an etiologic role of human papillomavirus (HPV), particularly type 16. HPV-16 is also associated with an increased risk for cervical intraepithelial neoplasia (CIN) and invasive carcinoma. A 17-year-old female, referred to the adolescent dysplasia clinic with a diagnosis of condyloma acuminatum, was presented. She had multiple smooth, shiny, brown 3- to 4-mm papules on the external genitalia. Biopsy confirmed BP. Colposcopic examination of the cervix and biopsy showed CIN III. The patient's sexual partner was examined colposcopically, and no suspicious lesions were seen. The patient underwent laser vaporization of her external genital and cervical lesions. At the time of treatment, some of the initial BP lesions had spontaneously regressed. This case highlights the need to evaluate females with BP for possible CIN, to examine sexual partners, and to use ablative therapy, as there is the potential of malignant progression in BP.

Condylomas of the uterine cervix initially interpreted as squamous carcinoma: a report of four cases including a lesion resembling the Buschke-Loewenstein giant condyloma.

The recognition of human papilloma virus (HPV)-induced cervicovaginal condylomatous lesions is in a period of dynamic development. It is estimated that condylomatous involvement of the uterine cervix is epidemic and that is particularly true in the younger, more sexually active woman. While cervical condylomas are often associated with cervical dysplasia, carcinoma in situ, or even invasive carcinoma, they are sometimes misdiagnosed as these entities. Four cases of cervical condylomas are presented that were clinically suspicious for malignancy and initially interpreted as squamous carcinomas on the basis of the histopathological findings.

Cytologic findings in primary malignant carcinoid tumor of the cervix. Including immunohistochemistry and electron microscopy performed on cervical smears.

The cytologic findings in a primary malignant carcinoid tumor of the cervix are presented. In addition to the presence in the smears of cells suggestive of squamous carcinoma and adenocarcinoma, which led to an initial diagnosis of adenosquamous carcinoma, there were multinucleated giant cells with prominent, reddish nucleoli, finely granular chromatin and grayish-blue to eosinophilic cytoplasm, as well as smaller pleomorphic cells, against a tumor-diathesis type of background. Immunocytochemistry performed on the cervical smears showed the presence of serotonin, and ultrastructural analysis revealed abundant intracytoplasmic, membrane-bound granules in malignant cells, thus confirming the diagnosis of a carcinoid tumor.

Giant fibrosarcoma of the ovary.

An unusual case of a huge primary ovarian fibrosarcoma, the largest tumor of its type reported to date, is presented. The gross, light microscopic, and ultrastructural features are described. The tumor was unique in three aspects: (a) its massive bulk; (b) the prompt relief of symptoms after debulking; and (c) most significantly, the lack of extensive abdominal metastasis in spite of its high grade, large size, and 6-month delay in resection.

Dysgerminoma with syncytiotrophoblastic giant cells presenting as a hydatidiform mole.

There have been a total of 11 cases of pure dysgerminoma with syncytiotrophoblastic giant cells (SGC) previously reported in the literature as of June 1981. All were Stage IA, all were treated with unilateral salpingo-oophorectomy, and the preoperative serum human chorionic beta-gonadotropin (beta-hCG) titers ranged from 2000 to 3160 mlU/ml. A recent case at William Beaumont Army Medical Center involved a 20-year-old Hispanic female who presented with a 20 weeks' size pelvic-abdominal mass which was sonographically consistent with a hydatidiform mole. An initial preoperative serum beta subunit hCG was 193,000 mlU/ml. At the time of surgery a Stage IC dysgerminoma of the right ovary was discovered and right salpingo-oophorectomy performed. In reviewing all 11 previously reported cases, not only is this case the first Stage IC reported, but it also is the first to present as a hydatidiform mole, has the highest ever reported preoperative beta-hCG, and provides the first ultrastructural study of this tumor type. The unusual clinical presentation and management of this case are discussed and a brief review of the clinical and pathological features of this unusual tumor is given.

Corpus luteum formation in the fetus.

A well-developed corpus luteum was found at autopsy in a premature infant who died 26 hours post partum. Intrauterine pituitary-gonadal development and regulation are briefly reviewed and a possible mechanism of intrauterine fetal ovulation is presented.

Pigmentosis tubae, a new entity: light and electron microscopic study.

The authors noted an unusual finding in the fallopian tubes of a 31-year-old woman who had received external and internal whole pelvis radiotherapy for squamous cell carcinoma of the cervix. Aggregates of macrophages containing pigment, identified in a subepithelial location, were reminiscent of melanosis coli, which is caused by abuse of anthracene-containing laxatives. Electron microscopic examination of the pigment revealed cytoplasmic material with the appearance of lipofuscin, identical to the pigment described in cases of colonic melanosis. After a careful study of possible etiologic agents, it was concluded that the pigment most likely resulted from cellular damage caused by radiotherapy. The authors are not aware of any other reported case of this entity, which will be called pigmentosis tubae.

The origin of the pseudoglandular spaces in metastatic smooth muscle neoplasm of uterine origin. Report of a case with ultrastructure and review of previous cases studied by electron microscopy.

The entity known as "leiomyomatous hamartoma," a term that has been used in reference to metastatic smooth muscle neoplasms of uterine origin (MSMNUO), is uncommon. Several articles have dealt with clinical and light microscopic aspects of this lesion. Four reports on the ultrastructure of this type of neoplasm have been published, but they have been primarily concerned with its smooth muscle component. Much controversy exists as to whether the glandular elements are part of the neoplastic process or preexisting pulmonary elements. This ultrastructural study confirms that the gland-like spaces represent entrapped alveoli and terminal respiratory bronchioles.

Müllerian adenofibroma of the endometrium. A report of a case with ultrastructural study.

A case of müllerian endometrial adenofibroma is presented and the light and ultrastructural features are described. The tumor arose in the lower uterine segment and was composed of a prominent fibroblastic growth of club-shaped papillae projecting into cystic spaces and into the endometrial canal. The lining epithelium was both mucinous endocervical and endometrial in type. A feature not previously described was smooth muscle within the stromal component. The endometrial adenofibroma is a distinct clinicopathologic entity and is part of the family of uterine mixed mesodermal tumors.

Primary carcinoid tumor of the uterine cervix presenting as an adenosquamous carcinoma. The importance of electron microscopy and immunohistochemistry in evaluating poorly differentiated cervical neoplasms.

Primary carcinoid tumors of the uterine cervix are uncommon gynecologic neoplasms. An unusual case of this neoplasm is presented that was originally diagnosed as a poorly differentiated adenosquamous cervical carcinoma. A subsequent metastatic pulmonary nodule was discovered 13 months later with the unexpected histologic and ultrastructural features of a carcinoid tumor. The primary cervical malignancy was reassessed ultrastructurally and the original diagnosis was changed to that of a poorly differentiated carcinoid tumor. By using immunoperoxidase techniques, it was observed that serotonin granules were present in the neoplastic cells of the lung and cervix, confirming the carcinoid nature of the tumor. This case differs from the majority of those reported as poorly differentiated cervical carcinoids in that it did not resemble an undifferentiated small cell (oat cell) carcinoma, but was more typical of an adenosquamous carcinoma. This case supports the role of electron microscopy and immunohistochemistry in the complete evaluation and diagnosis of less-differentiated cervical neoplasms in order to specifically identify the primary cell (cells) of origin. Only in this way can one definitively support the diagnosis of a primary carcinoid tumor and perhaps, with this knowledge, the clinicobiologic behavior of this cancer can be altered and possibly improved by initiating different or adjunctive treatment modalities.

Congenital lipodystrophy and polycystic ovarian disease.

A case is presented of congenital lipodystrophy and diabetes coexistent with severe polycystic ovarian disease characterized by primary amenorrhea and pronounced virilization. The relationship of these two disease entities is unknown. This case strengthens the suggestion that isochronia may not be coincidental.

Complete remission of widely metastatic endometrial stromal sarcoma following combination chemotherapy.

A 21-year-old female underwent a hysterectomy with the finding of an endometrial stromal sarcoma (7-9 mitoses/10 HPF) confined to the uterus. However, within 30 months of hysterectomy, metastases occurred in the spinal cord, femur and lungs. Treatment consisted of surgery and irradiation for the spinal cord metastases and ten courses of combination chemotherapy, Adriamycin, vincristine, cyclophosphamide (6 courses) and megestrol acetate (continuous since course 7). This therapy resulted in a complete clinical remission which has been maintained for eight months since completion of chemotherapy. It is suggested that this regimen be employed in patients with this rare and lethal tumor.