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Deliberate inhalation of metallic paint results in hemorrhagic alveolitis and the intra-alveolar and lymph node accumulation of particulate-laden macrophages. We present a case of a chronic paint sniffer that illustrates these respiratory tract findings.

We performed ultrastructural analysis on 70 consecutive patients with solitary cancers in lung with the following histologic classifications: adenocarcinoma (42 cases), bronchioloalveolar carcinoma (13), large cell carcinoma (4), and adenosquamous carcinoma (11). Of these 70 cases, nineteen (13 adenocarcinomas, 4 bronchioloalveolar carcinomas, and 2 adenosquamous carcinomas) contained cell surface microvilli with microvillous core rootlets and/or glycocalyceal bodies. Subsequent clinical followup revealed that three of these 19 cases were actually metastatic colon carcinoma. The remaining 16 patients are currently free of extrathoracic primary disease and are therefore, presumably, primary carcinoma of the lung. Since both primary and metastatic tumors showed cell surfaces with microvilli having core rootlets and glycocalyceal bodies, we conclude that the presence of these ultrastructural features does not always permit the distinction between primary and metastatic adenocarcinoma in lung.

Death from tricyclic antidepressant overdose has become an all-too-common occurrence. Several factors, including postmortem concentration changes, can render blood and tissue samples useless for the determination of antidepressant drug concentrations. We present here an efficient method of solid-phase extraction for these drugs from vitreous humor and a reversed-phase, isocratic high-performance liquid chromatographic method for the simultaneous quantitation of amitriptyline, doxepin, and imipramine and their desmethylated metabolites.

Two cases of unsuspected veno-occlusive disease of the liver were discovered at autopsy. Nearly all central veins and sublobular venules were occluded by lipogranulomas consisting of lipid-laden macrophages, epithelioid histiocytes, giant cells, fibroblasts, lymphocytes, and deposits of collagen. The process extended into the sublobular hepatic venules. Large hepatic veins were uninvolved. Known causes of veno-occlusive disease were ruled out, and the cause of the present cases is unknown.