Deba P. Sarma

Goblet cell carcinoid of the appendix

A goblet cell carcinoid (adenocarcinoid) of the appendix was studied ultrastructurally and found to have features at variance with those of previously reported cases. The findings support a hypothesis that adenocarcinoids represent a composite, biphasic neoplasm of two morphologically differentiated cells, each derived from a common endodermal embryologic origin.

Incidental prostatic carcinoma: Tumor extent versus histologic grade☆

One hundred forty-three incidental carcinomas from 500 step-sectioned prostates were classified independently by two pathologists according to the Gleason system. The area involved by each tumor was measured by photographic techniques. Observer agreement was 94 per cent when tumors were divided into groups with pattern scores 4 or less (less than or equal to 4) and greater than 4 (greater than 4). About 25 per cent of tumors in both races had pattern scores 4 or less (less than or equal to 4). Tumors with pattern scores greater than 4 (greater than 4) were, on the average, significantly larger than those with pattern scores 4 or less (less than or equal to 4) (p less than 0.001). We therefore believe that the Gleason histologic classification system is reproducible and that it discriminates tumors with different biological behavior.

Human penile ossification

Abstract True human penile ossification is rare. We report such a case with roentgenologic evidence and histologic confirmation, and we offer some comments concerning etiology.

Leiomyosarcoma of the buttock

A 56-year-old man had a deeply invasive leiomyosarcoma of the right buttock. Leiomyosarcomas of the skin and subcutaneous tissues are rare, and most occur on the extremities. Wide local excision is the therapy of choice.

Human os penis.

We report a case of human penile ossification with roentgenologic and histologic confirmation. The English literature is reviewed, and the pathogenesis of such a rare lesion is presented. Penile ossification appears to be an acquired metaplastic process occurring in an area of fibrosis.

Leiomyosarcoma of the scrotum.

mucous membranes, t,2 In this case, the diagnosis was based on the characteristic clinical features and biopsy of the buccal mucosa. Although antimalarials have been used in the treatment of several dermatoses, they do not seem to have been used in the treatment of lichen planus? lsaacson et aP reviewed the possible mechanisms of action of antimalarials in inflammatory disorders. These include: inhibition of complement activation in vitro, interference with complement-dependent antigen-antibody reaction, reduction of formation of immune complexes, and binding to and sterilizing lysosomal membranes retarding the release of hydrolytic enzymes. They also inhibit chemotaxis of polymorphonuclear leukocytes, macrophages, and eosinophils and suppress cell-mediated immune reactions. It is through one or more of these mechanisms that antimalarial drugs may help in the management of lichen planus, in which various immunologic abnormalities have been found? In this patient, chloroquine phosphate induced remission and the nails were restored to normal. However, 10 weeks after discontinuation of treatment, her nail lesions recurred.

Adenocarcinoma of gallbladder presenting as ureteral obstruction.

A fifty-five-year-old man presenting with unilateral renal colic and ureteral obstruction was found to have ureteral metastasis from a primary gallbladder carcinoma. This appears to be the second report of such a case in the English literature.

Do We Need to Cross Match Blood for Elective Laminectomy

Elective laminectomy cases do not need a routine order for typing and cross matching of blood. Data from the literature and from personal experience in the blood bank of a 580-bed general hospital are presented to support this conclusion. An ABO-Rh type and an antibody screen can safely substitute for routine cross matches for such cases. The use of type and screen rather than cross match allows the blood bank to distribute limited blood resources more efficiently without jeopardizing the patients.