Jejunal diverticulosis.

Jejunal diverticulosis is an uncommon condition, but it is often associated with a number of symptoms including postprandial abdominal pain, distension, flatulence, borborygmus, nausea, vomiting, diarrhea and constipation and with complications such as vomiting blood or coffee grounds material, melena and shock. The authors report such a condition in a 71-year-old man. Resection is the treatment of choice for relieving symptoms, and for preventing or treating complications.

Small cell malignant tumors of the thyroid. A light and electron microscopic study.

Three small cell malignant tumors involving the thyroid gland were examined by light and electron microscopy. In each, numerous similarities were presented on light microscopic analysis rendering interpretation difficult. In the first patient the small cells were identified on electron microscopy as moderately well differentiated lymphocytes. This tumor occurred in an elderly woman as a locally invasive thyroid tumor, subsequently involving distant sites, including the liver, spleen, lymph nodes, and soft tissue. The tumor repeatedly regressed following radiotherapy. The patients eventually died with disseminated lymphocytic lymphoma. In the second patient the thyroid tumor, also locally invasive, was composed principally of neoplastic epithelial cells when studied on electron microscopy. This patient responded poorly to radiation and died within a year after diagnosis. The third patient presented with an enlarging thyroid mass, which ultrastructurally was found to be composed principally of well differentiated lymphocytes. Subsequent clinical evaluation established a diagnosis of chronic lymphocytic leukemia. Small cell malignant tumors of the thyroid represent a difficult diagnosis problem for surgical pathologists. Ultrastructural study, we believe, is a useful adjunct in the differentiation of these tumors.

The use of cryosurgery in the control of locally recurrent tumours.

Cryosurgery was used as a mode of treatment in 31 patients with advanced tumours.The patients were selected because of failure of other forms of conventional treatment or because a less radical type of therapy was advisable.The primary aim of the treatment was palliation. Pain was well controlled in almost all patients in whom the main bulk of the tumour could be successfully destroyed. Bleeding was also controlled temporarily and obstruction prevented in other patients.Cryosurgery is a simple procedure, easy to perform, has very few complications and can be repeated at frequent intervals. It is well tolerated by the elderly patients and produces very little postoperative discomfort, permitting earlier discharge from hospital.In selected cases of cancer, cryosurgery has a definite role to play in improving the quality of survival. It is particularly useful in extensive and recurrent cancers of the head and neck region.