Nathan B. Friedman

Neurogenic nature of so-called inflammatory fibroid polyps of the stomach.

This paper reinterprets the condition previously designated “inflammatory fibroid polyp” of the stomach as the gastric analogue of appendiceal neural hyperplasia (appendiceal neuromas). The histopathologic features of the appendiceal and gastric lesions are analyzed in detail and evidence is presented which indicates their analagous nature. Further evidence in favor of the neural nature of these gastric lesions is proffered by the demonstration within them of abundant neurites. The differences between the gross appearance of the appendiceal and gastric neural proliferations may be explained by their differing sites of origin. The etiology and pathogenesis of gastric neural polyps remains open to question and requires further study of suitable clinical and experimental material.

Blue nevus of the uterine cervix

This paper describes 3 instances of melanotic nevi occurring in the stroma of the uterine cervix, a subject heretofore discussed primarily in the foreign literature. The lesion is interpreted as a visceral analogue of the cutaneous blue nevus. The presence of stromal blue nevi in the cervix and the prostate support a neural origin for the cell of the blue nevus. The possible relationship between visceral blue nevi and some malignant melanomas is discussed and a plea is made for careful examination of visceral organs for disclosure of additional instances of this lesion so that its incidence and distribution may be evaluated more fully.

Carcinoma of the breast arising in fibroadenomas, with emphasis on lobular carcinoma: A clinicopathologic study

This paper deals with the clinicopathologic features exhibited in 7 cases of carcinoma of the breast arising in fibroadenomas. The average age of the patients was 44, a figure similar to that reported in the only other comparable study, approximately 20 years older than the peak incidence of fibroadenomas in the general female population. Lesions were uniformly asymptomatic and varied in known duration from 10 days to 10 years. Clinical and gross pathologic examinations were characteristic of fibroadenoma. The predominant pathologic expression of the carcinoma developing within a fibroadenoma appears to be lobular rather than ductal and is primarily one of lobular carcinoma in situ, an occurrence which supports the concept that a portion of the mammary epithelium within some fibroadenomas is of terminal duct and lobular derivation. The clinical and pathologic features of lobular carcinoma are reviewed, and recommendations for appropriate management of both lobular and ductal neoplasms are offered.

Lymphomas of the testicle

Although lymphomas of the testicle anecdotally may be confined to that organ, in general they represent a part of the disease which is distributed widely in other parts of the body. A review of the literature and of our nine cases indicates that of those presenting initially in the testicle, the first recurrence is often in a visceral organ or in a noncontiguous lymph node region. Frequent involvement of Waldeyers ring, the paranasal sinuses, and contralateral testicle makes this disease worthy of further study.

Primary metastasizing aortic endothelioma

An instance of malignant endothelioma, primary in the aorta, metastasizing to intestine and bone, is reported. The aortic tumor was successfully resected. The unexpected finding of a large hepatic growth at autopsy raised the possibility that the aortic neoplasm was a metastasis. Histochemical, immunologic, and ultrastructural studies supported the diagnosis of an endothelial neoplasm. Although a number of malignant aortic and large vessel tumors have been reported, only four previous instances appear to be endotheliomatous.

Metastatic Hemangiopericytoma Associated with Microangiopathic Hemolytic Anemia: Review and Report of a Case

The hemangiopericytoma is an invasive tumor of vascular origin. No matter how benign the course and how circumscribed the mass, it must be considered a lesion with high malignant potential. In the case reported here, a hemangiopericytoma of the pancreas with metastasis to the liver was associated with microangiopathic hemolytic anemia in a 78‐year old woman. The anemia may have been present before the onset of metastasis. If so, it could have been a major factor in the breakdown of host response and could have initiated the malignant dissemination. Under these circumstances it could be an indicator of metastasis in patients with previously diagnosed tumors. However, there are many cases of metastatic malignancy associated with this anemia in which the opposite situation holds. The anemia is usually of extracorpuscular origin. Apparently intravascular coagulation caused by injury from tumor‐cell aggregates in small vessels induces erythrocyte fragmentation on fibrin strands. A vicious cycle of cell fragmentation, vascular injury and fibrin strand formation completes the course. Analysis of the findings should be based upon more than a strictly pathologic approach; it should also be related to the new discoveries in cancer research.