A 54-year-old man with a complaint of dysphagia was found to have a prominent stricture in the proximal esophagus. A biopsy of the stenotic area indicated sarcoma, leading to subtotal esophagectomy. The surgically removed esophagus demonstrated a well-defined intramural mass, consisting of a mixture of fibroblastic cells with bland cytological appearances and inflammatory cells. Reflux esophagitis which was present distal to the stricture seemed to play a role in the development of this inflammatory pseudotumor.

We present a case of unilateral adrenal medullary hyperplasia in a 63-year-old woman with clinical signs and symptoms of pheochromocytoma unassociated with multiple endocrine neoplasia. The surgically removed adrenal gland revealed diffuse medullary hyperplasia with multiple micronodules measuring up to 2 mm. The micronodules were composed of enlarged chromaffin cells with atypia, histologically similar t o those of pheochromocytoma, forming small solid alveolar patterns separated by a fibrovascular stroma. Removal of the hyperplastic adrenal gland resulted in disappearance of paroxysmal nocturnal hypertension and palpitation. These results suggest that diffuse and nodular medullary hyperplasia is the precursor of pheochromocytoma. Acta Pathol Jpn 40 : 683-686,1990.A-63-year-old woman presented with a 3-year history of paroxysmal nocturnal hypertension and palpitation. Because she was a nurse, she had examined her own blood pressure during the nocturnal attack, and found it had risen to 200 mmHg. She had no positive family history of MEN. Ultrasonography and computed tomography (CT) revealed no morphological abnormalities of the thyroids and parathyroids, except for a small adenomatous goiter. The normal blood values of calcium (4.6 mEq/l), calcitonin (80 pg/ml) and carcinoembryogenic antigen (CEA) (3.3 ng/ml) also ruled out the possibility of MEN.Laboratory data under asymptomatic conditions were as follows: slight elevation of plasma norepinephrine

An 85-year-old man was found to have a calcified mass protruding from the joint space of the right temporomandibular joint (TMJ). Microscopically, the removed mass consisted of chondromyxoid tissue with atypical chondrocytes, resembling a cartilaginous tumor. However, the chondromyxoid tissue contained abundant deposits of rod-shaped to rhomboid crystals which proved to be calcium pyrophosphate dihydrate (CPPD) crystals. The review of the literature revealed that tophaceous pseudogout was the most common variant of CPPD deposition disease involving the TMJ.

We describe a case of well differentiated adenocarcinoma of the gall-bladder that arose from a localized type of adenomyomatosis. Grossly, the cancer was located in the fundus and exhibited a polypoid and well demarcated nodule with multiple small cysts. Histologically, the nodule consisted of glandular structures and stroma containing bundles of smooth muscle cells. The glandular epithelia were varied in appearance, ranging from malignant to benign glands. The adenocarcinoma was limited to the nodule, with normal surface mucosal epithelia and without obvious stromal invasion.

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