Charles E. Alpers

Fetus in fetu associated with an undescended testis

Fetus in fetu is an extremely uncommon cause of an abdominal mass in the neonate; fewer than 30 generally accepted cases are recorded in the literature. We report a case of intraabdominal fetus in fetu, with a unique location within an undescended left testicle. Chromosomal studies of cells from the fetus in fetu and the surviving infant revealed identical 46,XY karyotypes.

Pleomorphic Carcinoma of the Gallbladder: Case Report and Ultrastructural Study

Carcinomas of the gallbladder with pleomorphic spindle cell histology are unusual. We report such an occurrence in a 47-year-old male with a neoplasm showing both a mixed squamous and a pleomorphic spindle cell pattern. Ultrastructural studies supported the likelihood that this lesion represented a pleomorphic carcinoma and revealed unique paracrystalline structures intimately associated with tonofilaments. For this reason we believe that this and some other previously diagnosed sarcomas and carcinosarcomas of the gallbladder are in reality poorly differentiated carcinomas of either adeno, squamous, or mixed type. This illustrates the need for critical ultrastructural assay to determine the nature of poorly defined and differentiated neoplastic growths.

Sonographic evaluation of the rejecting ureter

In 10 mongrel dogs, the sonographic features of the pelvocaliceal system and ureteral peristalsis during acute rejection were correlated with the electromyographic (EMG) findings and histologic appearance. There were significant alterations of the ureteral dynamics during rejection as demonstrated by changes in the pressure tracings, the progressive decrease of electrical activity of the ureteral muscle, and decreased peristalsis with pelvicaliectasis as demonstrated on real-time ultrasound. The sonographic changes of peripelvic and periureteral thickening corresponded to histologic changes of edema and inflammatory infiltrate with disruption of the muscular layer. In the presence of clinical and sonographic findings of kidney rejection, the demonstration of hydronephrosis and thickened pelvic wall should be considered as another measure of the rejection process.

Hemangiomatous Anomaly of Bone in Crouzon's Syndrome: Case Report

A striking and diffuse hemangiomatous architecture was identified by microscopic examination of bone specimens obtained at cranial synostectomy and from the craniofacial area of a young boy with Kleeblättschadel deformity and Crouzons syndrome. A retrospective review of the histopathological appearance of bone specimens from other patients with Crouzons syndrome treated on our service and a review of the literature on craniosynostosis suggest that the hemangiomatous pattern seen in this patient is rare if not unique. The unusual pathological findings provide evidence that the underlying pathophysiology of this disorder may be heterogeneous.

Malignant fibrous histiocytoma, myelomonocytic leukemia, and Hodgkin's disease arising in an elderly man

A 74‐year‐old man developed a locally invasive malignant fibrous histiocytoma of the scalp with multiple facial recurrences and concomitant hematopoietic dysplasia occurring over a 2‐year period. One month prior to his death, his hematologic profile evolved into myelomonocytic leukemia. Mixed cellularity Hodgkins disease involving mediastinal and periportal lymph nodes, which was not suspected antemortem, was discovered at autopsy. In the experience of the authors, this association of neoplasms is unique and raises the possibility in this case of an unidentified stimulus to neoplastic transformation of cells of histiocyte/monocyte origin.