The lymphoid cellular infiltrates in the bladder biopsies from patients with carcinoma in situ before and after BCG intravesical therapy have been determined and characterised. This has been achieved using a panel of monoclonal antibody probes in an indirect immunoperoxidase technique. These studies have revealed the predominance of T-cells of the helper/inducer phenotype (T4+), beta-lymphocytes (B1+) and macrophages (Leu M3+, 3.9+) in bladder biopsies after BCG therapy. HLA.DR antigens were also expressed on the lymphoid cells infiltrate as well as the urothelial cells. These results suggest that the components of an active immune response were present and enhanced in the bladder wall after BCG therapy.

In 10 patients with urodynamically proven outflow tract obstruction, detrusor biopsies were taken prior to and following relief of obstruction. The changes in detrusor innervation were compared following the relief of obstruction within the study group and also with an age-matched control group who were urodynamically normal. There was a significant reduction in detrusor innervation in the study group when compared with controls pre-operatively. Within the study group there was a significant increase in detrusor innervation in 8 patients following relief of outflow tract obstruction. Persistence of symptoms after prostatectomy may be explained by failure of detrusor reinnervation.

Late recurrence of renal cell carcinoma (RCC) has been well documented in the literature. We present two extraordinary cases of solitary, late metastatic recurrence of RCC. The first is a case of a solitary, adrenal metastasis excised 38 years after nephrectomy and the second is a case in which two solitary metastatic deposits were resected 14 and 26 years after excision of the primary tumor. In each of these patients the solitary metastases were initially believed to be primary tumors at other sites; however, on histological examination they were found to be metastatic RCC recurrences. In patients with a previous history of RCC presenting with apparently new solitary lesions, metastatic RCC must first be excluded.

Fifty-five prostate cancer and 55 breast cancer patients with positive bone scintigrams were studied. The pattern of spread in the axial skeleton and pelvis showed differences between the 2 groups. This difference was not related primarily to bone volume at the site of metastasis. The difference in distribution of bony metastases between breast and prostate is explained by our knowledge of Batson's vertebral venous plexus.