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BACKGROUND Carcinoembryonic antigen (CEA) is used as a serum marker to detect and monitor the status of various kinds of malignant tumors. To determine whether CEA might be detected in secretions collected topically from around the nipple area, and whether its secretion might differ in a cancerous versus a noncancerous breast, we developed a simple method for collecting and measuring CEA, using a small cellulose membrane disk and an enzyme immunoassay. METHODS We measured the amount of CEA excreted from the nipple area of 22 healthy control women and 32 women with unilateral breast carcinoma confirmed histologically. Secretions were collected from the nipple area by affixing a small (20 mm diameter) absorbent disk made of nitrocellulose membrane backed with filter paper to that area for 24 hours. Substances absorbed by the membrane were then subjected to an immunoassay for CEA using anti-CEA antibodies. RESULTS In the 22 healthy subjects, a small amount of CEA (0.6 +/- 0.9 units) was secreted from each nipple, which was equally low regardless of the phase of the menstrual cycle. In contrast, 30 of the 32 women with breast carcinoma secreted significantly greater amounts of CEA from the cancerous (16.1 +/- 8.2) than the noncancerous (2.0 +/- 2.2) breast. Such a difference (14.1 +/- 8.0) in CEA excretion was not observed in the healthy controls (0 +/- 0). CONCLUSIONS These findings suggest that such disks may provide a simple and noninvasive method of collecting trace molecules, including CEA, in skin secretions around the nipple to evaluate functional disorders of the mammary glands, particularly breast carcinoma. Additional studies are indicated in larger groups of women with various stages of breast carcinoma as well as with benign breast diseases.

Because pathologists differ widely in their definition and histologic classification of many types of cancer, progress has been impeded in determining the frequency, nature, and biological behavior of tumors, in elucidating their causes, and in evaluating treatment and prognosis. Histologic definitions and systems of classification that are accepted and utilized internationally are essential to advancement of our scientific information in many aspects of cancer. In order to make meaningful comparisons of data there must be reasonable uniformity in histologic definitions and classifications. Although the disparity in use of different and varying classifications for some tumors is generally recognized, recently more quantitative information has been published for lung cancer. Sobin11 reviewed 57 conveniently available English language papers on lung tumors between 1955 and 1970, and found 13 different classifications used. The 34 papers concerned with treatment and survival used 12 different classifications, and the 23 papers concerned with clinical diagnosis, cytology, epidemiology, genetics, occupation, and pathology used 7. Few papers defined the criteria used for placing cases in different histologic classes. Even greater variation in classification would be expected if papers written in different languages had been included.

BACKGROUND Several studies have proven the usefulness of microvessel quantification as a prognostic factor for patients with various malignant tumors. The aim of this paper was to clarify the relationship between microvessel density (MVD) as a parameter of tumor angiogenesis and liver metastasis in colorectal cancer. METHODS A total of 175 patients with advanced colorectal cancer were evaluated (58 with concurrent liver metastasis). Microvessel quantification was performed immunohistochemically, using monoclonal antibodies against endothelial protein Factor VIII-related antigen (F8RA) and against endothelial surface marker CD34. Finally, the relationship between MVD and liver metastasis was analyzed. RESULTS A significant correlation was observed between MVD for F8RA and MVD for CD34 (n = 175, r = 0.9560, P = 0.0001). MVD in the tumors stained for F8RA ranged from 15.2 to 78.6 microvessels per × 200 field (mean 32.8 ± 11.7), while the tumors stained for CD34 varied between 21.6 and 118.8 microvessels per × 200 field (means 56.1 ± 20.5). A significantly higher MVD was observed in the tumors with liver metastatic disease compared with the tumors without liver metastasis (F8RA: mean 36.1 ± 11.3 vs. 31.2 ± 11.5, P = 0.0090; CD34: mean 64.4 ± 20.4 vs. 52.0 ± 19.4, P = 0.0010). CONCLUSIONS Microvessel quantification within a colorectal tumor using immunohistochemical staining methods has shown a significant correlation between MVD and liver metastasis. Tumors with a greater MVD may thus have a greater hematogenous metastatic propensity. Cancer 1996;77:1722-8.

Background. Retrospective studies have suggested that DNA tumor content (ploidy) has a significant effect on survival. This group has reported, prospectively, that among patients who had colorectal resections for carcinoma, the 2-year tumor recurrence rate was significantly greater for patients with aneuploid tumor than for those with diploid tumors. This paper reports the 5-year survival rates of this cohort of patients. Methods. Three hundred sixty-three patients who had colorectal resections for cancer between November, 1982, and March, 1988, were studied prospectively. The DNA tumor ploidy was measured from fresh and paraffin embedded tissues. These patients were followed regularly in a dedicated colorectal clinic for a minimum of 5 years or until death. Of the 363 patients studied, 2 were lost to follow-up. Results. Forty percent of the tumors were diploid, the remainder aneuploid. The 5-year survival for patients who had curative resections was 76% for those with diploid tumors compared with 64% for aneuploid tumors (P = 0.05 ; Mantel-Cox, 3.7). On further analysis, the survival benefit conferred by a diploid tumor appeared to be confined to those with Stage B tumors. There was no relation between ploidy and sex, age of patient, stage, histologic grade, or site of tumor. Conclusions. Ploidy is a useful objective measurement of the aggressiveness of Stage B tumors. Patients with aneuploid Stage B tumors have a poor prognosis ; this group may benefit from adjuvant therapy

BACKGROUND Retinoids have been studied as chemopreventive treatment for patients with oropharyngeal carcinoma. Vitamin A modulates growth and differentiation of cells, and its deficiency enhances susceptibility to carcinogenesis. The chemopreventive mechanism of action of vitamin A is discussed, and a review of clinical results and side effects of the systemic use of vitamin A is included. The objective of the current report was to review the possible role of topical vitamin A and vitamin A derivatives in the management of patients with oral lesions with a risk of transformation to carcinoma. METHODS: A Medline search was conducted and references identified within the identified papers were also reviewed. RESULTS Only four studies using topical vitamin A for patients with oral leukoplakia have been reported. A complete response was achieved in 10–27% of patients, and a partial response was achieved in 54–90% of patients; however, recurrence of leukoplakia was reported after withdrawing the medication in approximately 50% of patients. The side effects of the topical use were minimal. CONCLUSIONS Although the direct application of higher concentrations of retinoic acid results in suppression of oral leukoplakias only, its use in the treatment of patients with recurrent and persistent lesions may be justified for controlling lesions that otherwise may progress. Further controlled clinical studies are needed. Cancer 2002;95:1258–64. © 2002 American Cancer Society. DOI 10.1002/cncr.10874

Very often not enough patients are entered and/or the follow-up is insufficient to be able to draw valid conclusions in cancer clinical trials. In this article, we discuss the possibility of pooling the data from two or more trials asking the same or similar questions in order to overcome such problems. How comparable the studies should be for combining their data, in terms of design, patient population, follow-up, and end-points, is discussed in the first part of this paper. Whether these general considerations were completely or partially fulfilled in the two prostatic studies of the EORTC and DAPROCA is the subject of the second part of this article. Problems of interpreting apparently contradictory results, like the superiority of zoladex and flutamide over orchidectomy in terms of time to progression with no clear superiority in terms of overall duration of survival, is also discussed.

Analysis of controlled and uncontrolled published papers in clinical cancer therapy has revealed differences in patient data handling, which may reflect both the inherent biases of patient selection for uncontrolled studies and the primary purpose of such studies. A distinction between drug-data oriented research and patient oriented research was advanced to explain these results. If comparable results are to be developed, we urge controlled trials at all phases of treatment development.

Gastric polyps in familial polyposis coli are a unique type of adenomatous (neoplastic) polyp characterized by multiple occurrences. This paper reports 15 cases of familial polyposis coli in 6 different unselected families. Clinical studies such as roentgenogram and endoscopic examinations were carried out in 12 cases, the resected stomach was examined in 2, and autopsy material was used in 2. Elevated lesions were found in the stomachs of 10 (66.7%), which was a much higher incidence than in the results of a nationwide survey of this disease in Japan (10%). We believe that this disease is not necessarily localized to the large intestine, and that the absence of gastric polyps in other case reports is probably due to insufficient examination of the stomach. We also believe that our findings could be influenced by an environmental factor in Japan.

Cytogenetic examination of bone marrow cells from three patients with juvenile chronic granulocytic leukemia (CGL) showed 46,XX,3p-,llpS ,t(llp:3p) in one case, 45XY,-E in another, and 45X(X),-C/47,XX,+G in the third. The case with the translocated chromosome originally presented like an acute lymphocytic leukemia (ALL). An overt clinical picture of juvenile CGL emerged two and a half years later. Serial study of this case revealed no cytogenetic abnormalities until two years after the diagnosis of ALL, when the translocated chromosome was first observed. Unlike the Ph' chromosome in adult type CGL, chromosomal abnormalities in juvenile CGL lack specificity, resembling ALL in this respect. Cancer 39:2017-2024, 1977. N CONTRAST TO THE WELL KNOWN ASSOCIATION I of the Ph' chromosome with adult type CGL, little has been written about cytogenetic abnormalities in juvenile CGL. Recently we made serial observations on bone marrow and blood cells of a 4-year-old child with this condition. The patient had been treated for an original diagnosis of ALL for over two and a half years before the second diagnosis of juvenile CCL was established. We also reviewed the cytogenetic findings of two additional patients seen by us. Abnormalities were found in both. The purpose of this paper is to report the three cases and to discuss correlations between cytogenetic and hematologic findings.

This paper describes an unusual, familial bilateral papillary cystadenoma of the epididymis found in three siblings. The histological characteristics of the tumor were: 1) papillary proliferation of clear cells, consisting of both tall columnar and round ovoid cells, in the efferent duct epithelium; and 2) cystic dilatation of the duct with colloidal material. The present cases were unique in two respects: 1) familial bilateral papillary cystadenomas probably associated with Lindau's disease have not been reported previously: and 2) electron microscopic observations suggested that the tumors originated from the efferent duct.

This paper reviews 8 personally examined cases of primary meningeal mesenchymal chondrosarcoma and 4 similar cases previously reported by others. The clinicopathologic features of these extraosseous intracranial and intraspinal examples are similar to those of other extraskeletal mesenchymal chondrosarcomas. The tumor occurred most often in the second and third decades, showed a moderate tendency to local recurrence (5 of 12 cases) and occasionally metastasized to the lungs (1 case). Both intracranial and intraspinal tumors occurred with equal frequency, but the former, probably due to the later onset of symptoms, had the worse prognosis. Microscopically, they are composed of primitive undifferentiated mesenchymal cells and frequently well-defined islands of hyaline cartilage. There is an apparent correlation between the frequency of mitotic figures and the likelihood of recurrence and metastasis. Electron microscopic study of one example revealed morphologic features similar to those previously described by others and supports the conclusion that the neoplastic cells represent primitive precartilaginous mesenchyme displaying focal cartilaginous differentiation.

Histologic material was studied from 30 patients with metastasizing cutaneous superficial spreading malignant melanoma in an attempt to establish reproducible criteria for the accurate diagnosis of the disease. This paper details the criteria for the histologic diagnosis of primary superficial spreading malignant melanoma of the skin.

Most papillary carcinomas of the thyroid run a surprisingly indolent clinical course, and even widespread lymph node metastases in the neck are not a bad prognostic omen. A small group behaves in a far more aggressive fashion and kills through local invasion of adjacent structures or blood borne metastases. This paper deals with a papillary carcinoma which does not fit into any of these groups. Following hemithyroidectomy for papillary carcinoma in 1970 the patient, a woman aged 70 years, lived comfortably for nine years until she died of what appeared to be an unrelated cause. During these nine years, papillary carcinoma metastases were removed at irregular intervals from unusual locations such as the thoracic wall, both groins, and the thigh. Gross examination, light and electron microscopy, and freeze-etching, all failed to distinguish this tumor from conventional papillary carcinomas. Morphometry showed that the nuclei were significantly larger than those found in other papillary carcinomas, and conventional and flow cytometric DNA analysis proved that the primary tumor and the metastases contained mainly tetraploid cells. One lymph node metastasis had even larger nuclei than the others and also a different, bizarre DNA distribution pattern. This study also showed that the ground glass appearance of the nuclei of papillary thyroid carcinomas does not depend on hypodiploid DNA values. Of about 70 cases of papillary thyroid carcinomas in the world literature studied by conventional or flow cytometric DNA analysis, this case is the only one with tetraploid DNA values. It is therefore tempting to correlate this tetraploidy to its peculiar biologic behavior.

Clinical photographs of 79 prospectively studied cases of non-familial cutaneous malignant melanoma were reviewed; special attention was directed to the distribution pattern of coexistent melanocytic lesions. A group of 15 patients had moles on the covered buttock area. Seven of these patients had large clinically atypical nevi, and biopsies of these nevi showed severe melanocytic dysplasia. Residual elements of melanocytic dysplasia were identified in five of the primary melanomas in this group of patients. It is suggested that these patients represent a distinctive syndrome, the Dysplastic Nevus Syndrome (DNS) and that they are at increased risk for development of primary cutaneous malignant melanoma. The clinically and histologically distinctive dysplastic nevi of these patients are identical to the precursor lesion for melanoma that we have previously described in a familial context, the B-K mole syndrome. This paper represents the first description of this form of dysplasia in non-familial melanoma.

Gamma heavy chain disease is an uncommon disorder characterized by the secretion of abnormal fragments of the gamma heavy chain in serum and urine. Most of the studies of gamma heavy chain disease have focused on the abnormal protein; relatively little information is available on the pathologic findings. This paper reports a patient with gamma heavy chain disease whose bone marrow and lymph nodes showed a morphologic progression from a lymphocytic to plasmacytic proliferation. The English language literature on gamma heavy chain disease is reviewed with respect to pathologic findings in lymph nodes, bone marrow, and peripheral blood.

Only three cases of tracheal paraganglioma have been reported in the literature. This paper describes an additional case, which showed pharmacological and ultrastructural evidence of hormone secretion. It is suggested that this tumor is derived from true paraganglia located in the trachea and not from misplaced or aberrant paraganglionic tissue. Hemoptysis was the only presenting symptom in two of the four reported cases and significant bleeding occurred during biopsy in the other two cases. The long-term prognosis appears good if complete resection is possible.

Detailed histological analysis of 427 cases entered on the first National Wilms' Tumor Study revealed that lesions with foci of marked cytological atypism (anaplasia), and those composed predominantly of sarcomatous stroma, were associated with unfavorable outcome. Twenty-five patients had anaplasia, and 24 had sarcomatous lesions of which a total of 28 (57.1%) died of tumor. Three hundred and seventy-eight patients had tumors which showed neither of these features, and only 26 (6.9%) died of tumor. Seven of ten deaths due to tumor in patients diagnosed before two years of age were associated with sarcomatous lesions. Three sarcomatous patterns were recognized, of which one, designated "clear cell" sarcoma, had a predilection for bony metastases. Using criteria defined and illustrated in this paper it is possible to identify in advance those patients likely to do poorly using current therapeutic approaches.

Our knowledge of the morphology and pathogenesis of malignant neoplasms of the female genital tract has traditionally depended heavily on their light microscopic characteristics. The introduction of transmission, and most recently, scanning electron microscopy, into the field of gynecologic pathology has resulted in a considerable improvement in the diagnosis of genital cancers that are difficult to classify and has provided valuable information for a better understanding of their subcellular dynamics and pathogenetic development. This paper describes and illustrates the ultrastructural alterations that are considered specific for the most common malignant and potentially malignant neoplasms of the genital system in this context. The value of electron microscopy in the morphologic study of genital cancers warrants its increased use in routine diagnostic pathology, as well as further evaluation of it in basic research in this challenging area of investigation.

“Bowen’s disease” is a clinical and histologic diagnosis describing the lesions (single or multiple) of cutaneous in situ squamous cell carcinoma. The case of a 54-year.old man with 60 such intra-epidermal carcinomas, and a history of arsenic ingestion, is presented. The patient was sensitized to dinitrochlorobenzene (DXCB), and his lesions were treated with a topical DNCB preparation. All lesions disappeared completely (demonstrated by biopsy of several sites) except for a large (12 x 7 cm) tumor on the flank which partially resolved. Total re6ession of this lesion was achieved by adding topical 5-fluorouracil (5-FU) therapy. This case demonstrates that the inflammatory reaction induced by DNCE (as evidenced by erythema and by a dense inflammatory cell infiltrate in biopsied areas of treated lesions) can lead to regression of extensive in situ epidermoid carcinoma, and that combined therapy with DNCB and 5-FU can be more effective than DNCB alone. Both agents in appropriate concentrations led to selective destruction of neoplastic tissue with no effect on adjacent normal skin. No systemic toxicity was observed. Cancer 37:1633-1642, 1976. N 1912, PROFESSOR JOHN T. BOWEN OF BOSI ton published a paper entitled “Precancerous Dermatoses: A Study of Two Cases of Chronic Atypical Epithelial Proliferation.”2 Both patients were “males in the fifth decade of their lives,” and both had multiple conNuent, dull red, raised lesions which were scaling and crusted. The lesions had grown slowly and continuously over many years, without any spontaneous disappearance. In 1915 Bowen described a third patient and reviewed three cases from the French literature.3 These early clinical and histologic descriptions are classical for what is now termed in situ cutaneous squamous cell carcinoma, or

Although Nb rat prostatic adenocarinoma rarely occurs spontaneously, the frequency of occurrences is increased by hormone induction. In this study, the Nb rat autonomous prostatic adenocarcinomas, Pr-90 and 13-Pr-12, were heterotransplanted into congenially athymic (nude) mice for the purpose of evaluating the response of these tumors to chemotherapeutic agents. Adriamycin and methotrexate were evaluated in treating both tumors, and cyclophosphamide and BCNU + 5 FU were evaluated in 13-Pr-12. This paper reviews the treatment of autonomous tumors at varying tumor volume, as well as the use of chemotherapeutic modalities at various dosage levels. Significance was observed in animals treated with cyclophosphamide, as well as methotrexate, and at the highest dose of Adriamycin (P < 0.05). Complete tumor regression and marked tumor volume decrease were observed in animals treated with cyclophosphamide and methotrexate. Recent reports have led to some optimism in treating human prostatic adenocarcinomas with Adriamycin and cyclophosphamide.

An indirect immunofluorescence technique (IF) for detecting TdT enzyme was used to study leukocytes present in the cerebrospinal fluid (CSF) of patients with documented acute lymphoblastic leukemia, nonlymphoid leukemias, and unrelated nonmalignant disorders. TdT was found to be expressed in all cases of overt meningeal lymphoblastic leukemia studied but was absent from leukocytes in patients with nonlymphoid leukemia and lymphocytic meningitis. In addition, the IF test proved useful in identifying leukemic blasts in CSF where these were of atypical morphology or present in extremely low numbers. lmmunofluorescence for TdT is a useful tumor marker in the CSF of patients with ALL. Cancer 47:2478-2481, 1981. RMINAL DEOXYNUCLEOTIDYL TRANSFERASE (TDT) is a unique DNA polymerase, which polymerizes deoxyribonucleotides in the absence of DNA template.' The enzyme is found in greatly increased amounts in the blasts of acute lymphoblastic leukemia, both of the common non-T, non-B form (CALL) and also the thymic form (T~Y-ALL).~.~ It is also present in some cases of lymphoblastic lymphoma without overt leukemia, particularly those cases with mediastinal involvement and convoluted nuclear morphology. These tumors frequently express T lymphoid markers and have a predilection to involve the CSF.4 In normal tissues, terminal transferase is found only in the cortex of the thymus and in uncommon small bone marrow cells of lymphoid appearan~e.~,~ Apart from minor transient populations in the liver, spleen, and blood in the immediate postnatal period, other organs contain no detectable TdT+ The identification of TdT+ cells in sites other than bone marrow or thymus in patients with documented TdT-positive lymphoproliferative disease therefore constitutes a tumor-specific marker. In this paper, a highly specific rabbit antibody

This paper evaluates the significance of the clinical stages and histologic features of Hodgkin's disease in 377 U. S. Army cases from World War II with a 15- to 18-year follow-up. From this study 6 histologic types have emerged: (1) lymphocytic and/or histiocytic (L & H), nodular; (2) lymphocytic and/or histiocytic (L & H), diffuse; (3) nodular sclerosis; (4) mixed; (5) diffuse fibrosis and (6) reticular. There is a definite relationship between histologic types, clinical stages and survival. The L & H types are expressions of lymphocytic proliferation and diffuse fibrosis and reticular types represent lymphocytic depletion while the mixed is intermediate between these extremes. Nodular sclerosis appears to be a regional expression of Hodgkin's disease in the mediastinum and is of major prognostic significance in stage I. The histologic types are regarded as expressions of an attempted host response and possibly evidence of the dramatic interplay between the host and the factors responsible for the development of Reed-Sternberg cells. The authors suggest that the Hodgkin's disease process represents the attempted induction of malignant neoplasia and that the evolution of the histologic process is a manifestation of the natural history of the disease.

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.

When the decrease in tumor size is used to evaluate the therapeutic effectiveness of a promising anticancer agent in a short-term clinical trial, it is considered to reflect “objective” response to therapy. This paper discusses the two senses of the word “objective” in the clinical testing situation: (1) objectivity in measuring tumor and (2) objectivity in the evaluation process which utilizes the measurements for classification into response or no response categories. The tumor size data from 1312 patients who received one of five drugs in the Eastern Clinical Drug Program were used for this analysis. The process of evaluating change in tumor size was studied with procedures or criteria for classifying tumor response. The application of various response criteria caused the proportion of responding patients to vary between 0.00 and 0.50; however, regardless of the particular set of response criteria applied to the data, the difference between drugs apparently was maintained.

The paper summarizes the features of adenomas and carcinomas of the thyroid gland in dogs. Only the Boxer breed was significantly over-represented. No sex incidence was apparent. The average age was 10 years in 29 dogs with adenomas and 9.6 years in 28 dogs with carcinomas. Adenomas were small, grew slowly and compressed surrounding parenchyma; most were detected incidentally post mortem. Thyroidectomy for adenoma was carried out in ten dogs; uneventful survival was recorded in five of these for periods ranging from 4 months to 2 years. Adenomas were all of mixed solid and follicular type. Carcinomas grew rapidly, produced extensive local invasion and distant metastases, principally to lungs. Four dogs with carcinoma were thyroidectomized and three of these survived without recurrence of tumor for 1, 1.3 and 3 years; most carcinomas were inoperable. Three of the carcinomas were anaplastic; the remainder were well differentiated and contained solid and follicular elements.

During the period 1931 to 1970, 50 cases of radiation-induced osteogenic sarcoma were seen at the Memorial and James Ewing Hospitals. Twenty-two of these cases had previously been described; the present paper adds an additional 28 cases to the existing series and reviews those factors related to the development of neoplastic changes. In 35 patients, there was evidence of preexisting bone pathology in the form of benign osseous growths. Fifteen patients had soft-part and visceral neoplasms, such as retinoblastoma, seminoma, and breast carcinoma, the involved bone lying in the pathway of the radiation beam. Symptoms ranged from a palpable tender mass in the involved bone to intestinal obstruction secondary to metastatic radiation-induced osteogenic sarcoma. Essentially all bones in the skeletal system appear to have been vulnerable. The radiation dosages ranged from 1,200 rads given in a few weeks to 24,000 rads given in 2 years. Induction time covered a period of 4 through 30 years with a mean of 9 years. Thirty-two of the patients developing this neoplasm have since died of their disease.

This paper describes a case of primary melanoma of the lung. The histologic features required to make a diagnosis of primary melanoma of the lung or bronchus are demonstrated in this case. It is suggested that since melanoma may occur fairly commonly in juxtacutaneous mucous membranes, it is not unreasonable to see a few cases in an adjacent site such as the bronchus of the lung.

This paper describes 6 instances of a peculiar malignant angioendothelioma of the skin in children. Microscopically, the neoplasm is characterized by remarkable, bizarre, intravascular papillary proliferations of atypical endothelium. The tumor is locally invasive and has a potential to metastasize. In spite of this, as far as we know, none of the children have died. All our patients are living and well, free from recurrence and metastases 4 to 16 years after last surgical treatment. The present study was undertaken to demonstrate this curious variant of malignant angioendothelioma in childhood, which has a limited degree of malignancy.

The histologic distinction between mesotheliomas and adenocarcinomas on mesothelial surfaces is sometimes difficult. High concentrations of hyaluronic acid in pleural and peritoneal fluids of mesothelioma patients have been reported. This paper describes results of glycosaminoglycan electrophoresis of papain digests of 7 mesotheliomas and 27 other tumors. Either all or almost all demonstrable glycosaminoglycans in mesotherliomas was hyaluronic acid. Control tissues had variable electrophoretic patterns showing other glycosaminoglycans in addition to hyaluronic acid. In the clinical context of differentiating mesotheliomas and adenocarcinomas in tissue samples, this technique seems simple, economical, and relatively specific.

This paper is a review of 120 cases of primary malignant melanoma of the oral cavity occurring in the Japanese. We have collected 18 cases from our own department and the remainder from the literature. Since malignant melanoma arising from the oral mucosa and ectopic pigmentation are relatively common in Japan, an assumption has grown as to a possible relationship to histogenesis. The analysis of the material and the discussion are focused on these points. Malignant melanoma of the oral cavity is not rare in the Japanese. Some of the cases do not seem to have any relation to oral melanosis, but almost two-thirds of the cases were found associated with it (36.2% of melanoma was associated with pre-existing melanosis, and 29.8% with concurrent or later-developing melanosis). The biological behavior and histologic patterns of these melanoses were similar to those of lentigo maligna of the skin. The pre-existing melanoses seemed to be the most common precancerous lesion of the oral mucosa as far as malignant melanoma was concerned.

The present study deals with 11 malignant tumors arising from the spermatic cord. Ten of the tumors were of mesoblastic origin and one was a teratoma. Local recurrence appeared to be a common problem and was attributed to inadequate removal of the primary tumor at biopsy. Distant metastasis occurred only in the late stages of disease after local recurrence could not be controlled or when retroperitoneal disease had become extensive. Radical orchiectomy followed by retroperitoneal node dissection was considered the treatment of choice for this disease. ETWEEN THE YEARS 1931 AND 1966, 24 PAB tients with tumors of the testicular adnexa were seen at the Memorial and James Ewing Hospitals. Of these, 13 arose in the spermatic cord, 7 in the epididymis, 2 from the tunica albuginea and 1 each from the rete testis and an adrenal rest, respectively. Of particular interest were those cases which were histologically malignant, since many of these had presented with primary intrascrotal swellings often confused with testicular tumor. In addition, these tumors constituted an uncommon group of neoplasms for which the clinical course and prognosis had not been clearly defined.l.11, 21, 34 The present paper deals specifically with the spermatic cord tumors considered to be histologically malignant. Experience with the other adnexal lesions will be described sep

This paper records the frequency and the types of all 46 verified tumors of the minor salivary glands seen during a 8-year period at the University departments of Pathology and Oral Histopathology, Umea, Sweden. The series consisted of 39 benign mixed tumors, 1 oxyphil adenoma, 2 malignant mixed tumors, 3 mucoepidermoid carcinomas and 1 adenoid cystic carcinoma. This series was compared with other series regarding classification and pathologic anatomy. Attention has been called especially to differences in the reported incidences of malignant tumors: in the present series the incidence was unusually low. It is proposed that the nature of the hospitals where most of the published materials were collected could explain the divergencies between different series, which thus seem to represent biased samples. This implies that the widely accepted belief that an unusually high percentage of malignant tumors is found in the minor salivary glands must be seriously questioned.