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NONTRAUMATIC spontaneous rupture of an apparently normal spleen, considered by some as an impossibility, is indeed a rarity. Ask-Upmark 1 studied a total of 120 cases of rupture of the spleen, and it included only 2 cases in which the history was absolutely negative regarding trauma. One of the cases concerned a 43 year old man in whom the ruptured spleen was macroscopically normal. No microscopic examination was made. The other case was that of a 30 year old man. The ruptured spleen weighed 250 Gm., and it contained no coagula. The microscopic examination showed hyalinization of the arterioles and increase of stroma. Ask-Upmark concluded that a spontaneous rupture of a normal spleen is possible, explaining it on a basis of a functional lienal apoplexy. Zuckerman and Jacobi 2 reported a case of genuine spontaneous rupture of a normal spleen in a 29 year old woman, with a report of

In the differential diagnosis of tumors, experience has shown how little one can depend on purely clinical methods for accuracy. Transillumination, x-ray examination, or x-ray in combination with the injection of radiopaque substances or air have been discussed in the past, particularly in connection with the diagnosis of breast tumors. In the final analysis, however, we must turn to the pathologist, for his corroborative evidence is by far the most important. How to obtain this evidence with the least danger to the patient is the problem. Of the methods in use, we have the frozen-section biopsy, various types of punch biopsy, and aspiration biopsy. Without going into a discussion of the merits of each one at the present time, it will be conceded that, until now, the aspiration biopsy has been the simplest and least traumatizing. Its general acceptance, however, has been hampered considerably by the fact that, save in the hands of a very few, it has failed to yield material for a positive diagnosis with s...

In the years that have elapsed since the invention of the Vim-Silverman biopsy needle, there has been ample time and opportunity to use it under various conditions, and from time to time, in the literature1and in personal communications to me, it has become apparent that certain improvements were desirable. To understand the importance of the improvement about to be described it will be necessary to review briefly the technique of needle biopsy as it is now performed with the original needle. The skin is prepared with a suitable antiseptic and anesthetized with procaine hydrochloride. A sharp-pointed scalpel is used to pierce the skin, and the outer needle with a stylet in place is introduced through the skin and advanced into the tissue up to the surface of the suspected tumor. The stylet is then withdrawn and the inner split needle is introduced in its place and advanced its