Juvenile papillomatosis (Swiss cheese disease) of the breast

Thirty-seven cases of juvenile papillomatosis of the breast were reviewed. The average age was 19 years (range 10-44 years). On examination the patients usually had a localized, multinodular mass that was interpreted as a fibroadenoma. Microscopically, typical lesions featured papillomatosis, sometimes with severe atypia, cysts with or without apocrine metaplasia, duct stasis, and sclerosing adenosis. In one case the breast with papillomatosis adenosis. In one case the breast with papillomatosis has remained free of carcinoma, but at the time of biopsy the patient had secretory carcinoma of the other breast. Papillomatous changes were not observed in the breast with carcinoma. Another woman had lobular carcinoma in situ coexisting with juvenile papillomatosis. After an average follow-up of 8 years, no subsequent carcinoma has been found. Thus, there appears to be little risk for early onset of carcinoma, but without additional follow-up the long-term assessment of this disorder remains uncertain. We recommend that a patient with juvenile papillomatosis have a thorough clinical examination of the breasts at least once a year.

[Prognostic value of the chromosome pattern in tumors of the urinary bladder]

Cytodiagnostic and histopathological studies were made in 42 cases of epithelial urinary bladder tumours. The correlation was investigated between the modal chromosomal number, the frequency of the structural chromosomal aberrations and the degree of histologic malignancy (cellular anaplasy and invasion of the bladder wall). The proliferative rate was also determined of the analized tumours. In all the epithelial tumours that have been studied it was noted that the more malignant the tumour, the higher was the value of the modal chromosomal number, and the more frequent the chromosomal abnormalities. The proliferative rate of polyploid tumours was significantly higher as compared with that of the diploid ones. The presence of a polyploid mitotic population, as well as of structural chromosomal disturbances in a tumour with a low degree of malignancy, as demonstrated histologically, may have a prognostic significance.

The evolution of cancer of the colon and rectum

The malignant potential of adenomas of the colon and rectum varies with size, histological type and grade of epithelial atypia. The adenomatous polyp is usually small and has a low malignant potential, whereas tumors with a villous structure are usually larger and have a much higher cancer rate. Severe atypia is more common in villous adenomas than in adenomatous polyps. Evidence is presented which suggests that most cancers of the colon and rectum have evolved through the polyp-cancer sequence although the majority of adenomas do not becoma cancerous during a normal adult life span. The slow evolution of the polyp-cancer sequence is stressed. The implications of the polyp-cancer sequence for the design of cancer prevention programmes and the study of the aetiology of large bowel cancer are discussed.

Familial florid papillomatosis of the nipple

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