The ultrastructure of a feminizing granulosa-theca tumor

A 13-year-old girl with evidence of hyperestrinism had a right ovarian tumor removed. This neoplasm was composed predominantly of granulosa cells and exhibited some changes of luteinization. The neoplastic cells displayed an investment of basement membrane material which was closely related to fibrillar collagen within the tumor. Scattered throughout the neoplasms were small numbers of cells with charcteristics of the theca and a few cells had cytoplasmic features suggestive of smooth muscle. The ultrastructural findings of eight similar tumors have been described. In none is the basement membrane material fully appreciated; nevertheless, the production of this extracellular material is a major and distinctive feature of granulosa-theca tumors.

Chronic experimental hyperuricemic nephropathy

Sustained, moderately severe hyperuricemia and severe uricosuria were produced in male Wistar rats by feeding dietary supplements of oxonic acid (0.4 gm. per day) and uric acid (0.6 gm per day). After 1 month, the kidneys showed the previously described histologic features of urate-blockade nephropathy characterized by intratubular deposits, tubular injury, and an exudative response consisting of neutrophilic granulocytes with early tophus formation. After 36 and 52 weeks of hyperuricemia, and with no gross evidence of renal failure, the kidneys showed a predominantly interstitial mononuclear cell infiltrate around regenerated tubules, an increase in interstitial fibrous tissue, infrequent renal tophi, and renal stones. The glomeruli and blood vessels appeared completely normal. There was no evidence of arthritis and no other target organ damage was detected. The chronic renal changes present in this animal model of induced hyperuricemia resemble those seen in human gouty nephropathy. The evolution of the experimental urate nephropathy observed during 1 year suggests that a primary acute inflammatory tubular injury is followed by a diffuse chronic interstitial nephritis and that the glomeruli and blood vessels are not primarily involved in the renal disease. This animal model may provide the opportunity to study factors influencing the renal sequelae of sustained hyperuricemia.

Spironolactone bodies in an adrenal adenoma

Spironolactone bodies were observed in an adrenal cortical adenoma that was removed from a patient with primary hyperaldosteronism (Conn syndrome) treated preoperatively with spironolactone. The electron microscopical evaluation of this adrenal cortical adenoma shows origin of spironolactone bodies from whorls of endoplasmic reticulum in cells with the cytoplasmic features of those from the zona glomerulosa of the adrenal gland. There was no evidence that the bodies were derived from mitochondria, which confirms recent ultrastructural findings in patients treated with spironolactone. These bodies have been described in the adrenal cortex only in patients who have received spironolactone, and the pharmacologic specificity of the bodies strongly suggests a direct mode of action by spironolactone on aldosterone production by cells of the adrenal zona glomerulosa.

Urethral adenocarcinoma (possibly originating in the glands of Littre)

Adenocarcinoma involving the bulbomenbranous urethra is a rare disease. This disease is describe in a 30-year-old man and the surgical management is detailed. The adenocarcinoma described seems to have arisen from the periurethral glands of littre. Despite the radical nature of the tumor excision, it was possible to spare the distal penis in order to achieve a more normal appearance of the external genitalia.

Calcified neurilemoma of the larynx

A calcified neurilemoma was discovered in a 73-year-old man whose main complaint was of progressive hoarseness associated with recent dysphagia. The tumor was located above the level of the right vocal cord, measured 4×3×3 cm and showed extensive cystic degeneration, in addition to calcification. At microscopic examination both Antoni A and B patterns were identified at the periphery of the degenerate tumor. At the ultrastructure level the tumor was composed of collagen fibrils with scattered elongated cells. Cells had a definite basement membrane and cytoplasmic substructures as described in neurilemoma. These benign encapsulated neoplasms are very rare in the larynx and the initial symptom usually is longstanding progressive hoarseness as in this report. Local excision is satisfactory treatment for laryngeal neurilemomas when practical.