Squamous metaplasia of the pleura with malignant transformation was observed five months after the development of an empyema and bronchopleural fistula in a 58 year old woman with lingular bronchiectasis.Squamous metaplasia of serosal surfaces, and in particular of the pleura, is uncommon.' Metaplasia progressing to carcinoma is even less common-in fact only one report (of six cases) has been published in recent years. Case reportA 58 year old woman was admitted in January 1986 with a tender subcutaneous swelling 7 cm in diameter overlying the fifth and sixth ribs in the left anterior axillary line. Some 35 years previously a bronchiectatic left lower lobe had been resected, and since then there had been occasional episodes of cough with white or green sputum. These episodes had become increasingly frequent in the previous four years, but had responded well to antibiotics. Haemoptysis had occurred twice in the six months before admission. She had had a vagotomy and pyloroplasty for duodenal ulcer in 1977, and a hysterectomy and salpingo-oophorectomy for uterine and ovarian fibroids in 1983. Laboratory investigations showed no abnormality apart from a raised erythrocyte sedimentation rate (78 mm in one hour).At operation the mass proved to be an abscess, which was treated by drainage and resection of the underlying rib. Proteus and Streptococcus species were cultured, and a postoperative sinogram and bronchogram showed a bronchopleural fistula communicating with the abscess site, plus bronchiectasis in the lingula. There was no improvement with antibiotics and physiotherapy, and after five months an empyema was decorticated and the lingula resected. Two weeks later the patient died of secondary haemorrhage from the pleural surface. Permission for a necropsy was refused.The excised lingula was bronchiectatic on gross examination, with pleural adhesions and obvious inflammation of the parenchyma. Microscopically there was severe bronchiectasis and chronic pneumonitis, with irregular fibrosis of the lung parenchyma. The pleura was thickened and densely fibrotic with foci of chronic inflammation; it was lined by moderately hyperplastic and keratotic squamous epithelium showing a prominent granular cell layer (fig 1). In large areas Address for reprint requests: Mr I M Mitchell,

Cervical thymic cysts are rare lesions often misdiagnosed clinically as branchial cyst. Here we report a rare case of multiloculated thymic cyst in a young 8 year old male child on the left side of the neck. Histopathology of the excised cyst revealed mural nodules of thymic tissue with prominent Hassal's corpuscles associated with multiloculated cyst. This case is presented here for its rarity. It should be included in the differential diagnosis of neck masses in children.

In this study, we report a rare case of cervical thymic cyst in an 8-year-old child.

Cysticercosis is caused by the larval stage of Taenia Solium. A middle aged woman presented with a painless solitary nodular swelling on left lateral border of the tongue. Fine needle aspiration cytology revealed only blood elements. Excision biopsy was done and sent for histopathological examination which revealed larvae of the pork tapeworm (Cysticercosis). Cysticercosis in human tissues is unusual. Oral cysticercosis, especially the involvement of tongue is very rare in humans.

No abstract