Cytology of granulosa cell tumor of the ovary

Granulosa cell tumor of the ovary may create a diagnostic challenge in cytologic preparations. Our experience with needle aspiration material, ascitic fluid, and peritoneal washings indicates that in fluids, despite some similarity between the tumor cells and reactive mesothelial cells, a correct diagnosis can be achieved by careful examination. The paucity of the cytoplasm and an intense indentation of nuclear membrane are the most helpful features in distinguishing the granulosa cells from mesothelial cells. The literature is reviewed, and the controversies regarding needle aspiration of ovarian neoplasms are discussed.

Effects of restraint stress on inoculated tumor growth and immune response in rats

Rats were given injections s.c. of mammary adenocarcinoma cells which developed into undifferentiated carcinomas within a few days. The animals were either left alone or were stressed by restraint for 3 h a day for 11 days and then left for 12 days undisturbed to recover. During this schedule, some animals were sacrificed immediately after the 11-day stress period, whereas others were allowed the 12-day recovery period; unstressed animals were sacrificed as controls on these 2 days. Tumor burden was significantly increased during stress and markedly decreased after the recovery period as compared to unstressed rats. Higher mitotic activity was seen in the tumors of rats which recovered from stress. The immune system responded differently to stress in healthy and tumor-bearing animals. In the tumor-bearing animals, leukocytes were decreased by stress and increased after the recovery period. Lymphocytes were increased, and neutrophiles and large granular lymphocytes were decreased after the recovery period. Total T-cells and suppressor T-cells were decreased during stress and increased during recovery. The percentage of T-cell populations was unaffected by stress, but the percentage of suppressor T-cells increased during recovery. Natural killer cell activity was unaffected by stress but increased after the recovery period. These results indicate that (a) stress and recovery from stress differentially affect tumor development and growth, (b) stress and recovery from stress cause different effects on the immune system in healthy or tumor-bearing animals, (c) stress and recovery from stress stimulate or inhibit different parts of the immune system, and (d) a decreased lymphocyte count and total and suppressor T-cell numbers correlated best with enhanced tumor growth, whereas increased numbers of neutrophils, large granular lymphocytes, total and suppressor T-cells, natural killer cell activity, and a decreased percentage of T-suppressor cells correlated best with depressed tumor growth.

Cytology of mesothelioma of the tunica vaginalis metastatic to the lung

The case of a 63-year-old man with malignant mesothelioma of the tunica vaginalis testis confirmed by electron microscopy is presented. The tumor recurred in the scrotal skin and subsequently metastasized to the inguinal and retroperitoneal lymph nodes. Four and a half years after the original diagnosis, pulmonary metastases were discovered by cytologic examination of bronchial washings and confirmed by transbronchial lung biopsy. The cytologic features of the metastatic malignant mesothelial cells are described and compared to those of mesothelioma cells in body cavity fluids. The role of cytology in the early detection of such tumors is discussed.

Intrapericardial instillation of sodium hydroxide: failure to produce pericardial symphysis

Previously reported clinical studies have suggested sodium hydroxide as an effective agent in causing pleural symphysis. To explore the sclerosing potential of this agent, we instilled 0.5% sodium hydroxide into the pericardium of four dogs. Normal saline was instilled into the pericardium of one control dog. Echocardiograms, 24 hour EKG monitoring and intracardiac pressures were recorded. One dog was sacrificed at the end of 24 hours, another at the end of seven days and three other dogs were sacrificed at the end of 28 days. ST elevations and prolonged episodes of supra-ventricular and ventricular tachycardia were noted during and within 24 hours after the intrapericardial instillation of sodium hydroxide in all the dogs. No arrhythmias were noted in the control dog. None of the dogs showed pericardial symphysis. These results suggest that sodium hydroxide causes serious cardiac arrhythmias when instilled intrapericardially and is of limited value in causing pericardial symphysis.

Virus-associated colitis in homosexual men: two case reports

Two homosexual men with colitis are described. In each case there was evidence of viral infection of the colon. One patient developed toxic megacolon that responded to conservative therapy. The other patient had proctosigmoiditis and opportunistic infections that eventually led to his death. An intensive search for viruses should be made in all homosexual men with proctitis and/or colitis.

Cytopathology of nonlymphoreticular neoplasms metastatic to the central nervous system

During a period of two years (1977 to 1978), 5,185 cerebrospinal fluid (CSF) specimens were examined in the Cytology Laboratory of Memorial Sloan-Kettering Cancer Center. Malignant cells were identified in 853 specimens. Of the positive specimens, 524 were obtained from 118 patients with nonlymphoreticular metastatic neoplasms. The most common tumors were mammary carcinoma (37%), pulmonary carcinoma (27%) and malignant melanoma (18%). The majority of epithelial tumors (77%) were adenocarcinomas. The interval between the primary diagnosis of malignancy and the time of first positive cytology varied significantly according to the type of neoplasm. The interval was approximately five times longer in patients with breast carcinoma and malignant melanoma (52 months) than in cases of lung carcinoma and bladder carcinoma (11 and 9 months, respectively). The prognosis, however, was invariably grave. Seventy-five percent of patients with follow-up died within 100 days of the first positive CSF. The tumor cells were often relatively small, with slight anisocytosis and pleomorphism as compared to their counterparts in other cytologic material. Cytology of the various neoplasms is presented, with attention to the morphologic changes during the follow-up period.

Postpartum dissecting aneurysm of coronary arteries in a patient with sarcoidosis

We have described a case of sudden death in a 27-year-old woman, 16 days postpartum, resulting from a dissecting aneurysm of the right and left coronary arteries. The patient also had multiorgan sarcoidosis. Postpartum coronary artery dissecting aneurysm appears to be caused by weakening of the media, resulting from the loosening of the ground substance during pregnancy and the hemodynamic changes occurring during and after delivery.