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By using the combination of alpha-naphthyl butyrate esterase and chloroacetate esterase for cytochemical detection of monocytes and granulocytes, respectively, we examined and identified five adult patients with acute myeloid leukemia whose leukemic cells often (20 to 30%) had the characteristics of both monocytes and granulocytes. All five patients were men, 23 to 82 years of age. Two patients had manifestations of preleukemia. One of these two patients had received treatment for lymphoma for 12 months before acute myelomonocytic leukemia was diagnosed. One patient had gum hypertrophy, and two had leukemia cutis. At the time of initial examination, four patients had blood leukocyte counts higher than 80,000/mm3 and one had leukopenia. Four patients received chemotherapy; three responded temporarily but died within 1 year after the myelomonocytic leukemia had been diagnosed. The patient with leukopenia has remained in complete remission for 2 years. With more frequent use of double esterase stains for classification of acute myeloid leukemias, this variant of acute myelomonocytic leukemia should be detected more often and its clinical behavior should be better understood.

A patient was seen initially with an orbital tumor causing blindness of the left eye. Although disseminated prostatic carcinoma was found, the origin of the orbital tumor was not established until prostate antigen was demonstrated in biopsy specimens by an immunoperoxidase technique. Orbital metastasis from prostatic carcinoma has been reported in 16 cases. Confirmation of the diagnosis may be difficult and, in the past, has largely been indirect as judged by clinical trial. The immunoperoxidase technique for detecting prostate antigen in tissue sections is both sensitive and specific. Application of this technique resulted in the diagnosis of this technique resulted in the diagnosis of this unusual manifestation of metastatic prostate cancer. The possibility of additional clinical applications of this immunohistochemical technique within the field of ophthalmology is raised.

The value of needle aspiration of intrathoracic lesions is enhanced by a cytologic technic which permits rapid interpretation. The results of cytologic examination of aspirates from 30 patients with peripheral lesions of the lung is presented. The rapid method, the Papanicolaou stained smear method, and the histologic method are compared and found to be complementary to one another.

Iron-containing macrophages, present in various tissues in patients with iron-storage diseases, have been demonstrated to pass from the intestinal villus into the intestinal lumen, acting ...

A method for the cytochemical demonstration of β-glucuronidase activity in blood and bone marrow is described using naphthol AS-BI-β-d-glucosiduronic acid as substrate and hexazotized pararosanilin as coupling reagent. β-Glucuronidase was found to be present in most of the cells of blood and marrow. The reaction was strongly positive in macrophages, monocytes, plasma cells and some of the lymphocytes. It was moderately positive in granulocytes and thrombocytes and weakly positive in cells of the erythroid series. β-Glucuronidase is known to be a lysosomal enzyme, but certain discrepancies exist between the content of this enzyme and the number of lysosomal structures as seen electron microscopically. It appears that not all of the lysosomes contain β-glucuronidase and that sites of β-glucuronidase other than lysosomal exist in certain cell lines, i.e., the lymphocytes and the plasma cells. For this reason, it is suggested that cytochemical investigations of lysosomes should always include the simultaneous demonstration of different lysosomal hydrolases.

Acid phosphatase in human leukocytes was examined in a large number of patients with a variety of hematologic diseases. In chronic lymphocytic leukemia the total leukocyte acid phosphatase activity was markedly decreased. This was due to the drastic increase of enzyme-poor leukemic lymphocytes and the concomitant decrease of enzyme-rich monocytes and neutrophils. Further examination by disc gel electrophoresis revealed that the leukocytes in this disease contained only one of the five acid phosphatase isoenzymes present in a normal leukocyte preparation. Total acid phosphatase activity was not significantly altered in other hematologic disorders, yet different ratios of the isoenzymes shown by disc gel electrophoresis were observed in Hodgkin's disease, chronic granulocytic leukemia, acute granulocytic leukemia, infectious mononucleosis and leukemic reticuloendotheliosis.