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Free ball thrombi of the left atrium are usually observed with mitral valve disease. The authors report the unusual case of this condition without mitral valve disease. A number of classical echocardiographic criteria suggested the precise nature of this left atrial mass before surgical excision. The diagnosis of a free ball thrombus of the left atrium should lead to urgent surgery because of the high risk of haemodynamic and embolic complications.

A case of mesoblastic nephroma in a 35-year-old woman is reported. The mass was located in the upper pole of the left kidney with a predominant extrarenal development. It was clinically misinterpreted as an adrenal tumor and was cured by tumorectomy alone. The patient is well three years later.

Single lymphangiomyoma, rarely encountered, is a form of lymphangiomyomatosis with characteristic proliferation of smooth muscle cells in lymph nodes and vessels. We observed a case in a 47-year-old woman with no past medical history. An echography performed for menorrhage revealed a single iliac localization in the right pelvis. The precise pre-operative diagnosis was difficult, but the pathology report formally identified the tumor as an isolated form without thoracic involvement. Unlike lymphangiomatosis itself which involves pulmonary lesions and which may require complementary treatment, total exeresis of a single tumour is the only treatment necessary, as was confirmed in this case.

A young woman taking contraceptive hormone treatment for many years developed a hepatocytic adenoma discovered after a massive hemorrhage into the tumor. The patient recovered after a hepatectomy. A total of 160 such cases have been reported in the published literature, and recovery occurred after excision of the lesion in the majority of cases. Stopping the oestrogen-progestogen therapy seems to avoid recurrence but it is still not known whether this is sufficient to produce regression of a benign tumoral lesion.

Four cases of "myospherulosis" are presented with a review of the thirty cases previously reported in the litterature. The disease is characterized by clusters of spherules, surrounded by a thin membranous bag, within a multicystic reaction of muscular and subcutaneous tissue or of paranasal sinuses. The actual nature of these spherules still remains unknown. Several pathogenic hypothesis are suggested.

We report a case of lymphangiomyomatosis (LAM) which occurred in a twenty six year old woman, presenting with protein losing enteropathy and pancreatic fibrosis due to lymphostasis. Despite having no pulmonary lesion, the patient died quickly. The proliferation of smooth muscle involved the mesenteric, peripancreatic lymphatic channels but also the submucosal lymphatic vessels of the duodenum. Only one other case of LAM presenting with protein losing enteropathy has been reported, in which there were no abnormalities in the intestinal tractus or in the pancreas.

Immunocytochemical techniques, applied to material fixed with Bouin's fluid and using immune sera specific to various hormonal polypeptide(s), give a classification of pancreatic and pancreatico-duodenal apudomas based upon cellular functional activity. With a rane containing a minimum of five antibodies (gastrin, insulin, glucagon, somatostatin and pancreatic polypeptide), 15 tumours could be identified amongst the 22 tested. They were either "monohormonal" tumours (10 cases) or "bi- or polyhormonal" tumours (5 cases). In the remaining 7 cases, only rare cells were immunoreactive. A large number of immunoreactivities thus revealed in histological sections are clinically silent or are present in a "forme fruste".

The authors report three anatomoclinical studies concerning apparently moderately aggressive endocrine tumors developped in the sub-mucosa of the duodenal bulb (2 cases) and of the pyloro-bulbar region (1 case), not connected with the pancreas, and occuring in the absence of a parietal ectopic pancreas. Two of these tumors were ulcerous but the associated syndromes (pains and hemorrhage) did not evoke, clinically, a Zollinger-Ellison syndrome. However, examination with immunofluorescence showed the presence of immunoreactive gastrine in a large number of cells. Having found some similar cases in the literature, the authors precise the features of these silent pyloro-duodenal gastrinomas: it is a variety of carcinoids or of "carcinoid-islet cell tumors". The cells contain argyrophile granules (Grimelius stain) which correspond in electron microscopy to neuro-secretory granules that may be quite different from G. granules. In the absence of significant clinical signs and of a radio-immunologic blood test, the presence of immunoreactive gastrin in the cells is the main feature for the diagnostic of these tumors. These tumors seem to arise from the gastrin cells of the mucosa or from their precursors as is suggested by the transitional forms with the fundus of the glands. Whatever the reason of the peculiar functional behavior, these neoplasms can be easily isolated from the anonymous group of duodenal carcinoids.