Recurrent angiolymphoid hyperplasia with eosinophilia mimicking temporal arteritis associated with nephrotic syndrome.

We report on a middle-aged Caucasian male who presented with nephrotic syndrome that on 2 consecutive recurrences was accompanied by a pulsating tumor suggesting temporal arteritis. Renal biopsies showed features of a low-grade mesangial-proliferative glomerulonephritis. The resected tumor in the temporal region revealed a lesion consistent with angiolymphoid hyperplasia with eosinophilia (ALHE), with moderate inflammatory involvement of the temporal artery. The patient was successfully treated with oral prednisolone in addition to removal of the tumor, but has remained steroid-dependent. To our knowledge, only 2 cases of ALHE and nephrotic syndrome have been reported so far in non-Japanese individuals [Altman et al. 1995, Sonkodi et al. 1987], and we are not aware of any previous case combining these features while simultaneuosly mimicking temporal arteritis.

[Epipharyngeal cancer]. / Epifarynxcancer.

The article surveys the incidence and pathogenetic factors of nasopharyngeal carcinoma. The authors present a retrospective study of 36 patients with malignant tumors in the nasopharynx who were treated at Haukeland University Hospital between 1972 and 87. 26 out of 27 patients with nasopharyngeal carcinoma had advanced disease. Symptoms and signs are described. Radiation therapy was the main treatment modality. The total five year survival was 18%.

An explosive decompression accident.

Four divers in a compression chamber system were suddenly decompressed from 9 atm to 1 atm. One of the divers was about to close the door between the chamber system and the trunk when the accident happened. He was shot out through the door and severely mutilated. The three others died on the spot. The autopsy results are described. The most conspicuous finding was large amounts of fat in the large arteries and veins and in the cardiac chambers, as well as intravascular fat in the organs, especially the liver. This fat can hardly have been embolic, but must have "dropped out" of the blood in situ. It is suggested that the boiling of the blood denatured the lipoprotein complexes, rendering the lipids insoluble.

Differences in the occurrence and age distribution of lesions in other organs in women with/without cervical neoplasia.

Over a 5 1/2 yr study period lesions leading to biopsy were reported in 902 of 3.937 women (23%) with a record of cervical neoplasia, compared to 1,142 of 13,030 controls (9%). This applied irrespective of the severity of the cervical lesion. In women with a record of cervical neoplasia, again irrespective of the severity of the lesion, relatively more lesions were seen in other organs in the younger age groups (45 yrs and less). In contrast the number of such lesions increased with age in the controls. While the present study gives no indication of the possible nature of the implied link between cervical neoplasia and the other lesions involved, it is suggested that the possibility of a common virus aetiology should be explored.

Cervical lesions in patients with malignant melanoma.

Koilocytes were found in the cervical epithelium in association with cervical intra-epithelial neoplasia in 8 out of 9 cases of malignant melanoma. This suggests that the cervical lesion in them was of viral origin. In 62 women with malignant melanoma but without cervical atypia there was also an excess of koilocytosis compared with controls with neither lesion. These findings point to the possibility that human papilloma virus infection may also be involved in the development of malignant melanoma, as it has been shown to be in cervical intra-epithelial neoplasia.

Ovarian pregnancy associated with the intra-uterine contraceptive device. A survey of two decades.

Records of 25 cases of ovarian pregnancy in the period 1965 to 1984 were reviewed. Seventeen cases (68%), had an IUCD in situ, and 15 of these had occurred during the last decade. The ratio of ovarian pregnancy to all ectopic pregnancies was 1:13 in the IUCD group versus 1:78 in the non-IUCD group (p less than 0.025). In contrast to patients with tubal pregnancies, those with ovarian pregnancy very seldom have a history of pelvic inflammatory disease (PID), infertility, or earlier pelvic operations. Subsequent fertility is good compared with patients with tubal pregnancies, for patients both with and without IUCD.

Stromal metachromasia: a marker for areas of incipient invasion in ductal carcinoma of the breast?

This morphological study of small ducts with in situ breast carcinoma demonstrates the changes that occur in the adjacent stroma when it stains metachromatically with toluidine blue. They are indistinguishable from those reported in areas with infiltrative tumour growth, and are accompanied by progressive damage to the duct wall. The latter may be destroyed as a result of this reaction that starts in the stroma, the tumour cells being thus provided with a possible means of escape from their in situ localization. This interpretation is in contrast to accepted teaching that the factors that facilitate infiltration are provided by the tumor cells. The observation is also of potential diagnostic interest.

Stromal metachromasia: a marker for areas of infiltrating tumour growth?

The presence of stromal metachromasia is reported in 23 of 38 cases of invasive carcinoma of the uterine cervix, its absence from 34 of 35 'in-situ' lesions. The metachromasia was seen at the zone of host/tumour interaction. Its presence was associated with changes in the morphology of the stromal cells and adjacent mast cells. The implications of these observations to the interpretation of tumour histology are discussed.