No abstract

Granulocytic sarcoma (chloroma) was present in 23 of 338 myelogenous leukemia patients autopsied in Hiroshima and Nagasaki during 1949‐1969. There was no evidence that granulocytic sarcoma was more frequent among those who received heavy atomic‐bomb irradiation, although the incidence of myelogenous leukemia was greatly increased in the heavily irradiated group compared with controls. Granulocytic sarcoma was found in 19 of 237 persons with acute myelogenous leukemia, in 3 of 77 with chronic myelogenous leukemia, and 1 of 24 with chronic myelogenous leukemia with blast crisis. It was distinguished from myelogenous leukemia by: significantly higher frequency in children and young adults; clinical manifestations of pain and tumor formation (often with exophthalmos) followed by paralysis and/or urinary incontinence; slightly shorter survival time; and greater intensity of leukemic infiltration in the pituitary. At autopsy, gross tumors occurred most frequently in bone, ovary, lymph nodes, kidney, dura, lung, arm, and breast. The pathogenesis of tumor formation in leukemia is discussed.

Four cases of adenoacanthoma of the pancreas were collected and the literature reviewed. This uncommon histologic variant appears as aggressive and malignant as the more common adenocarcinomas. Two of these four cases had originally been diagnosed as squamous cell carcinomas and were shown to be adenoacanthoma in type after additional sections were examined microscopically. It is the authors' opinion that any squamous cell carcinoma of the pancreas must be thoroughly examined for adenocarcinomatous elements before it can be classified as being pure squamous in type. Also, because metastases may be predominantly of either squamous or adenomatous type, the presence of squamous carcinoma in a metastatic lesion does not eliminate the possibility of a pancreatic primary nor does the finding of two distinct histologic types of metastases necessarily imply two separate primary malignancies. The terminology and origin of this histologic type of pancreatic tumor are discussed.

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