[A case of tracheal adenoid cystic carcinoma in a young woman]. / Przypadek raka gruczolowato-torbielowatego tchawicy u mlodej chorej.

A case of an adenoid cystic carcinoma of trachea is presented. A 30-year-old non-smoking woman with strong inspiratory dyspnea at rest was admitted to the Dept. of Pulmonary Diseases. At auscultation a respiratory murmur was more silent at right lung and stridor over trachea was heard. CT scan revealed tumor at the bifurcation of the trachea. Bronchoscopy was made and biopsy established the diagnosis: adenoid cystic carcinoma. The tumor was partially removed with rigid bronchoscope and radiotherapy was started. Clinical improvement occurred; in control CT scan tumor vanished. The trachea cancers are rare. Symptoms often mimic asthma or chronic bronchitis. Thus in every patient with chronic cough and dyspnea bronchoscopy should be made. A treatment of choice is primary resection and postoperative radiotherapy.

[Pulmonary lymphangioleiomyomatosis as a very rare interstitial lung disease]. / Limfangioleiomiomatoza jako jedna z bardzo rzadkich przyczyn chorób sródmiazszowych pluc.

Lymphangioleiomyomatosis (LAM) is a rare lung disease affecting premenopausal women characterized by an abnormal proliferation of smooth muscle cells that leads to the obstruction of airways, lymph and blood vessels. We present a case of a 46-year-old woman who was admitted to our department with dyspnoea and dry cough. The patient had a history of spontaneous pneumothorax 2 years prior to admission. Physical examination revealed dull percussion note on the lower right side of the chest. The chest X-ray film showed diffuse interstitial parenchymal infiltration and flattened costodiaphragmatic angle on the right side. The high resolution computerized tomography (HRCT) scan showed the numerous air filled cysts, about 25 mm in diameter with thin regular walls and liquid in the right pleural cavity. The effusion in a pleural cavity was chylous. Airway obstruction (FEV1/FVC 57% of predicted), markedly elevated residual volume (140%), and decreased DLCO were observed in functional pulmonary tests, and she underwent diagnostic videothoracoscopy. Pulmonary biopsy specimens confirmed diagnosis of LAM. The patient has been under careful observation, no treatment was instituted. The patient remains clinically stabile. During the last six months of observation she has normal sex hormone levels, therefore there exists a possibility of postmenopausal remission of symptoms.

[Thyroid crisis diagnosed on the basis of anatomic-pathologic examination]. / Przelom tarczycowy rozpoznany na podstawie badania anatomopatologicznego.

Graves-Basedow disease is the most common cause of hyperthyroidism. Rhabdomyolysis is occasionally associated with metabolic coma or severe electrolyte disturbances. We describe rhabdomyolysis accompany ing thyroid crisis. A 48-years old man admitted with hypovolemic shock developed rhabdomyolysis, congestive heart failure, hepatic failure and renal failure and then died. It is interesting that correct diagnosis was done on the basis of microscopic examination of specimens of the thyroid gland.

Glomus tumour of the oesophagus.

The authors describe a unique case of glomus tumour (glomangioma) located in the oesophagus in a 79-year-old woman.

Rhodanese activity and total sulfur content in frog and mouse liver.

The activity of rhodanese was histochemically tested in cryostat sections of the frog (Rana temporaria) and mouse liver. The activity levels were evaluated in sections, and the results were expressed as the ratio of the area of all granules, products of the enzymatic test, to the total analyzed area (area fraction). The present study confirmed the biochemically detected activity of rhodanese, and showed a large pool of endogenous sulfane sulfur donors, substrates for rhodanese, in the frog liver. The area of a single granule corresponded to the size of the mitochondrium, what suggests enzyme localization in this organelle. In view of this it should be considered whether the rhodanese activity, biochemically detected in the cytosolic fraction of the frog liver, results from the enzyme action. The total content of sulfur in cryostat sections of the mouse and frog liver was calculated and compared on the basis of the Energy Dispersion Spectrum (EDS) obtained by a scanning microscope. These studies showed higher total sulfur content in the frog liver than in the mouse liver. The high total content of sulfur in the frog liver in autumn might be associated with sulfur storing for protein biosynthesis during the period of hibernation.

Epithelial-myoepithelial carcinoma of the bronchus.

The authors describe an extremely rare case of epithelial-myoepithelial carcinoma of bronchial mucous glands involving lower lobe of the right lung, which was detected on a routine radiological examination in a 34-year-old woman, and then surgically resected.

Sclerosing hemangioma of the lung--benign sclerosing pneumocytoma.

Three cases of sclerosing hemangioma of the lung were studied. All developed in women aged 28, 32 and 59 years. They had been discovered on routine chest roentgenograms and then surgically removed. In two cases the tumours were solitary, in one case there were six tumours varying in size. The histology of this rare tumour and its various types as well as the results of immunohistochemical studies have been described, partly indicating its epithelial origin.

[Neuromas of the extrahepatic bile ducts]. / Nerwiaki pozawatrobowych dróg zólciowych.

Authors collected three cases of neuromas situated in the wall of extrahepatic bile ducts, which occluded lumen and caused jaundice. In two cases without any evidence of previous surgery or cholelithiasis, neuroma was localized in ductus choledochus. After excision of ductus choledochus and cholecystectomy, we performed hepaticojejunostomy Roux--en Y. In the last patient, 7 years after cholecystectomy, neuroma localized in hepatic duct was treated by T-tube. In all patients with mechanical jaundice, before operation we had never correctly diagnosed this very rare cause of obstruction of extrahepatic bile ducts.

Visceral leishmaniasis diagnosed by trephine biopsy. A case report.

A case of visceral leishmaniasis has been reported in a 41-year-old man. The diagnosis was made on the basis of trephine biopsy and fine needle aspiration biopsy of the spleen.

Amyloidoma and marginal zone malignant lymphoma (MALT type) in the gastric antrum. A case report.

A case of a lymphoma of the marginal zone (MALT type) in the antrum of the stomach concomitant with an amyloidoma immunohistochemically corresponding to amyloid AL has been reported in a 69-year-old woman.

Tracheobronchial amyloidosis.

The authors have described eleven cases of tracheobronchial amyloidosis, in 6 men and 5 women with a mean age of 58.7 years. The follow-up period ranged from several month to six years. The clinical picture and histopathological changes in bronchoscopic and postmortem sections in two patients were described. In all cases immunohistochemical examinations for the presence of amyloid AA, AL, transthyretin (prealbumin) and beta 2-microglobulin were performed. In six cases the presence of transthyretin was found. The remaining reactions were negative. Resorptive giant cells reaction to amyloid was observed in 3 transthyretin positive cases and 1 transthyretin negative case. Four cases with negative amyloid in the examination for the presence of transthyretin accompanied bronchial carcinoma, all these cases were men with a mean age of 63.0 years.

Intravesical interleukin-2 in T1 papillary bladder carcinoma: regression of marker lesion in 8 of 10 patients.

PURPOSE: We evaluate the therapeutic effect of intravesical interleukin-2 (IL-2) on T1 papillary bladder carcinoma after incomplete transurethral resection. MATERIALS AND METHODS: After incomplete transurethral resection we treated 10 patients in whom the marker lesion was left in place with 3 x 10(6) Chiron units IL-2 in 50 ml. saline plus 0.1% human serum albumin. The solution remained in the bladder for 2 hours and it was instilled on 5 consecutive days. The effect of IL-2 treatment on the marker lesion was evaluated by cystoscopy and repeat biopsy of the marker site 2 months after treatment. In addition, the effect on the recurrence of bladder tumors was studied. RESULTS: At 2 months 8 of the 10 marker lesions (80%) had completely regressed and there were no tumor cells on repeat biopsy. Four patients remained tumor-free after 30 to 54 months. We noted no toxic effects. In 1 patient with a 7-year history of bladder cancer the marker was only partially regressed after 2 months. After removal of the marker this patient remained tumor-free at a followup of 54 months. CONCLUSIONS: To our knowledge this report represents the first study of the effect of IL-2 on marker lesions left in place after transurethral resection. The results indicate that IL-2 instillations are feasible, and the combination of transurethral resection and IL-2 instillation may have a powerful antitumor effect. The therapeutic effects may not simply be due to intravesical IL-2, because previous transurethral resection probably caused some influx of infiltrating cells and the marker may have had tumor associated antigens. Consequently these effects may be due to the interaction of tumor associated antigens, infiltrating cells and IL-2.

Thymomas and thymic carcinomas. Evaluation of the Müller-Hermelink classification.

In the present study the Müller-Hermelink classification was used to analyze 39 thymomas and 4 thymic carcinomas collected over 20 years at the Chair and Department of Pathomorphology CM UJ. Our series consisted of 10 medullary thymomas (25.6%), 13 mixed (33.3%), 7 organoid (17.9%) and 9 cortical thymomas (23.0%). The mean age of the patients was 50.3 and it was the highest in patients with mixed thymomas-58.4 years and the lowest in patients with organoid thymomas-38.9 years, the difference being statistically significant. In the present series women were predominant (24:15). Myasthenia gravis was observed in 10 patients (25.6%), 5 women and 5 men, in 7 of them it was associated with cortical and organoid thymomas. Medullary, mixed and organoid thymomas were usually of lower stage (I and II), having a better prognosis than cortical thymomas and thymic carcinomas. One organoid thymoma recurring after 7 years evolved into cortical thymoma. Two thymic carcinomas were diagnosed as anaplastic, low differentiated, one as sarcomatous and one as well differentiated squamous carcinoma. The mean age of the patients was 39.7 years. The prognosis in all the patients with thymic carcinoma was poor. Based upon personal experience the authors regard the Müller-Hermelink classification as useful, easy to apply, reproducible and providing important prognostic information.

Mature cystic teratoma of the mediastinum containing a carcinoid. A case report.

We report a case of mature mediastinal teratoma containing mature pancreatic tissue and carcinoid in a 57-year-old woman who underwent a successful surgical operation.

Pulmonary mucinous cystadenoma of borderline malignancy. A report of two cases.

Two cases of pulmonary mucinous cystadenoma of borderline malignancy with favourable prognosis have been reported. The discussion section contains a review of current opinion about differentiating these neoplasms from mucinous carcinomas.

Pulmonary Langerhans cell granulomatosis (histiocytosis X) in an adult woman. A case report.

A case of histiocytosis X in the lungs of a 49-year-old woman diagnosed by immunohistochemistry has been described. Reaction to antigen S-100 confirmed the presence of dendritic cells in pulmonary infiltrates and bronchial lavage. The treatment with Encorton and Methotrexat appeared successful.

Amyloid tumour (amyloidoma) of the mediastinum.

A unique case of a surgically treated primary amyloid tumour of the mediastinum has been reported in a 40-year-old man. Immunohistochemical examinations revealed the presence of transthyretin and amyloid AA within the amyloid masses.