Malignant myeloid blast cells may occasionally form a solid mass in tissues outside the haemopoietic system. These tumours are known as chloromas or granulocytic sarcomas. Chloromas occur most commonly in the context of acute myelogenous leukaemia but, rarely, they occur in the absence of other haematological disease, and may be misdiagnosed as lymphoma. A case of a previously well 35-year-old woman presenting with rapidly progressive triplegia caused by a paraspinal and extradural cervical chloroma with no evidence of bone marrow or other haematological involvement is described. Few cases of spinal cord compression caused by chloroma in otherwise healthy patients have been reported. Morphological features of myeloid differentiation, histochemistry and immunohistochemistry, may all aid in rapid diagnosis and allow early and appropriate therapy.
In New South Wales, from 1945 or 1946, prefrontal lobotomies were conducted in private clinics and in public hospitals but, because of legal and practical hurdles, it is unlikely that psychosurgery was performed in mental hospitals prior to December 1958. This paper gives some details regarding the participation of neurosurgeons and of the major public hospitals in psychosurgery, and touches on the attitudes within the Australian medical profession towards this dramatic new therapy.
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