Coexisting adenocarcinoma and cystadenofibroma (malignant cystadenofibroma) of the ovary.

We have described an adenocarcinoma observed as a grossly discrete area within a cystadenofibroma of the ovary. Fewer than 35 cases of malignant cystadenofibroma have been reported. We find our observations lend support to the prevailing thought that these neoplasms most often originate from preexisting cystadenofibromas.

The normal parathyroid and the borderline with early hyperplasia: a light microscopic study.

The light microscopical appearance of the normal parathyroid gland based on an autopsy study of 138 glands from 38 adults without evidence of hyperparathyroidism, is described. It differs from earlier descriptions in that we found less adipose tissue in the glands of many normal adults than had been reported. This observation is in keeping with several other recent reports. Other features of the normal gland are also described. This study suggests that at times, a distinction between normal and early hyperplasia cannot be made, especially if the distinction is based solely on the amount of stromal adipose tissue present. Histological features which appear to indicate abnormality are cytological atypia, chief cell nodularity and diminished intracytoplasmic lipid. A gland which is equivocally enlarged but which has minimal stromal adipose tissue and one or more of the above features is most likely to be abnormal.

Fetal rhabdomyomatous nephroblastoma with a renal pelvic mass simulating sarcoma botryoides.

Fetal rhabdomyomatous nephroblastomas are very rare histologic variants of Wilms' tumor. These neoplasms are composed predominantly of fetal striated muscle and isolated regions of typical trimorphic nephroblastoma. This case is presented because in addition to its rarity, part of the tumor formed a renal pelvic mass which simulated sarcoma botryoides. However, ultrastructural analysis of this area revealed nephronogenic epithelial differentiation rather than embryonal rhabdomyoblasts, a distinction of important clinical significance. The literature is reviewed, and the clinicopathologic importance of distinguishing this variant from classic Wilms' tumor, the rhabdomyosarcomatous type of Wilms' tumor and congenital mesoblastic nephroma is stressed.

Carcinosarcoma of the bladder.

We present 2 cases of carcinosarcoma of the bladder. These tumors are considered as true admixtures of epithelial and mesenchymal neoplastic cells rather than 2 separate neoplasms that touch or marginally invade each other. Although the etiology of this tumor is unclear it tends to be aggressive and probably requires an early radical operation with adjuvant radiotherapy and chemotherapy.

Follicular adenoacanthoma of the thyroid gland.

A 67-year-old euthyroid black woman presented with a painful palpable thyroid nodule. Microscopic examination revealed an extensively infarcted follicular carcinoma with minimal capsular and vascular invasion and advanced squamous metaplasia. From the regions of squamous metaplasia, ultrastructural analysis demonstrated both squamous and adenomatous features within the same individual cells. We stress the prognostic importance of histologic distinction between adenoacanthomas and adenosquamous or squamous cell carcinomas. The literature is reviewed and the aetiology, pathology, classification and prognosis of primary thyroid cancers with squamous epithelium are discussed.

Metaplastic papillary tumor of the fallopian tube--a distinctive lesion of pregnancy.

The clinical and pathologic features of four examples of a distinctive intraluminal papillary epithelial tumor of the fallopian tube are described. All four cases occurred in fallopian tubes removed in the immediate postpartum period. The nature of this lesion and its relationship to previously described epithelial lesions of the fallopian tube are discussed.

Xanthogranulomatous pyelonephritis associated with renal carcinoma.

The first case of xanthogranulomatous pyelonephritis associated with renal carcinoma is reported. Differentiation of the 2 entities clinically may be difficult and, since treatment regimens recommended in the past have included partial nephrectomy in cases of limited xanthogranulomatous pyelonephritis, one must hereafter be aware of such a combination when considering such a therapeutic modality.

Multiple bilateral dens in dente as a factor in the etiology of multiple periapical lesions.

A case of multiple bilateral dens in dente of the maxillary anterior region with associated multiple periapical lesions of the maxilla is reported. Examination demonstrated the condition known as dens in dente to be present in all six maxillary anterior teeth. Also noted was a large palatal swelling which was confirmed to be an infected maxillary radicular cyst. The multiplicity, severity, and consequences of the dens in dente as reported in this case may indicate prophylactic restorative therapy.

Mucosal hyperplasia in clonic diverticula.

Benign, nonpolypoid mucosal hyperplasia has been consistently observed adjacent to colonic carcinomas. In order to determine the specificity of this association we looked for this type of mucosa in diverticulosis with or without diverticulitis, a disease thought not to be causally related to carcinoma. Nonpolypoid mucosal hyperplasis was frequently found within diverticula suggesting that this mucosal abnormality is, in some instances, unrelated specifically to malignancy.

Benign (nonpolypoid) mucosal changes adjacent to carcinomas of the colon. A light microscopic study of 20 cases.

Numerous reports deal with the presence or absence of remnants of benign polyps adjacent to colonic carcinomas. Little attention has been paid to light microscopic mucosal alterations of a nonpolypoid nature found adjacent to these neoplasms. The general assumption has been that this mucosa is normal or not significantly altered. In this presentation we describe nonpolypoid mucosal changes found adjacent to 20 randomly selected carcinomas of the colon. We found these changes to be variably but consistently present. Their possible significance is briefly discussed.

Condyloma acuminatum and squamous carcinoma of the vulva.

Reported is the association of condyloma acuminatum and squamous carcinoma of the vulva in three cases and condyloma followed by squamous dysplasia in a fourth case. This association has previously been reported in both male and female genitalia and in the perianal area. In our four cases, cancer or squamous dysplasia followed long-standing or extensive condyloma, but there was no evidence of transformation from condyloma to carcinoma. In one of the cases, areas of squamous dysplasia occurred in multiple foci within a large condyloma. It is not known whether condyloma acuminatum is a precancerous skin lesions, but long-standing or extensive condylomas should alert one to the possibility of carcinoma.

Unilateral salpingitis due to Enterobius vermicularis.

A case of perforated unilateral salpingitis in which Enterobius vermicularis ova were identified in the inflammatory process is reported. Arguments for considering the parasite to be of etiologic significance in the production of the pathologic changes and clinical symptoms are presented. The infrequent occurrence of symptoms associated with ectopic localization of Enterobius vermicularis is emphasized by a review of the literature.