Uterine myoma in pregnancy.

A review was made of the medical records of 76 patients with uterine myomas during pregnancy with the aim of studying the time and method of diagnosis, symptomatology, treatment, and outcome of pregnancy. In 11 patients (15%) myomectomy was performed during pregnancy. The frequency of abortion was 18% in patients treated both conservatively and with myomectomy. Myomectomy during pregnancy is discouraged in the literature. In cases where conservative treatment cannot be practised it seems that the risk of spontaneous abortion during pregnancy is not significantly increased when myomectomy is performed.

Primary angiosarcoma of the lung presenting as intractable hemoptysis.

Angiosarcomas are rare tumors, and primary pulmonary location has only been reported in very few cases. In the present report a patient with severe, intractable hemoptysis, demanding pneumonectomy, was found to have a single, small angiosarcoma eroding a large bronchus. No sign of tumor-spread to other organs was detected. A review is made of previous reports of angiosarcomas of the lung, and the differential diagnoses are discussed.

Transitional cell tumors of the renal pelvis and ureter associated with capillarosclerosis indicating analgesic abuse.

An association between transitional cell tumors (TCT) and abuse of compound analgesics has been established during the past two decades. Recently thickening of basement membranes around subepithelial capillaries, known as capillarosclerosis, has been reported as a change in the urinary tract pathognomonic for a long-standing abuse of compound analgesics. Therefore the authors reviewed pathologic and clinical data in 59 patients treated for TCT of the renal pelvis or ureter. Capillarosclerosis was found in nine cases (15%) of the TCT group but not in any of the cases selected as controls. Capillarosclerosis is suggested as a valuable marker, which always should be looked for in bladder biopsy specimens. Whenever present it should arouse suspicion of analgesic abuse, and the associated increased risk for developing TCT of the renal pelvis or ureter should be borne in mind.

Systemic lupus erythematosus with rectal stenosis simulating tumour or diverticulosis. Case report.

A case of systemic lupus erythematosus (SLE) with focal involvement of the rectum is reported. The lesion roentgenologically resembled a malignant tumour and was resected. Histologic examination disclosed only typical SLE changes in a very restricted area, with the remaining gastrointestinal tract unaffected. This appears to be the first report of focal colitis as a complication of SLE. The case points the importance of suspecting symptoms from any organ system in patients with connective tissue disorders to be manifestations of that underlying pathology.

Intestinal ischemia due to vascular elastosis caused by metastasizing carcinoid tumor of Meckel's diverticulum.

A case of a carcinoid tumor arising in a Meckel's diverticulum is reported. By the time of detection, the tumor had spread to the mesentery causing ischemia of the small intestine due to the associated vascular elastosis.

Stem cell carcinoma of the colon and rectum. Report of two cases and review of the literature.

Two cases of highly malignant tumors, one originating in the sigmoid colon and the other in the rectum, are presented. Both tumors showed light microscopic, electron microscopic, and immunohistochemical evidence of multidirectional differentiation. The tumors were composed mainly of undifferentiated cells, but focally merging into areas with adenocarcinomatous and squamous differentiation. Ultrastructurally and histochemically, a predominant endocrine differentiation was present in the undifferentiated areas of the tumors. These two cases lend further support to the recent concept of a pluripotential stem cell in the mucosa of the gastrointestinal tract capable of differentiation in several directions.

Non-epithelial basement membrane thickening in the urinary tract associated with phenacetin abuse.

In four cases of capillarosclerosis in the urinary tract associated with analgesic (phenacetin) abuse, the basement membrane (BM) thickening was not confined to the subepithelial capillaries, but was also found around the smooth muscle cells in the luminal part of the tunica muscularis. Electron microscopy confirmed that the changes in the BM around the smooth muscle cells were similar to those seen around capillaries. This non-vascular affection of BM in the urinary tract in patients with phenacetin abuse has not been reported previously. Thus, capillarosclerosis appears to be only part of a BM disorder, that clearly diminishes in intensity with increasing distance from the lumen. It is therefore suggested that the changes are caused by some agent (possibly a metabolite) in the urine diffusing from the lumen into the wall of the urinary tract.

Inverted papillomas of the urinary tract. A case of multiple, recurring inverted papillomas of the renal pelvis, ureter and bladder associated with malignant change.

A case of multiple, recurring urothelial inverted papillomas is reported with localization in the bladder, ureter and renal pelvis. Association of several of these with areas of transitional cell tumours and final occurrence of pure transitional cell tumour of papillary and non-papillary type grade II, causes us to question the original concept of inverted papillomas as benign tumours and lean to the more recent concept of inverted papillomas representing precancerous lesions.