SYNOPSIS Argentaffin carcinoma (carcinoid tumour) of the ileum has been found to be associated with ischaemic ileal necrosis due to elastic sclerosis of the mesenteric blood vessels. This vascular change was present in 17 out of 25 ileal tumours, all of them invasive, but was absent in 75 appendicular, rectal, and other carcinoids. The pathology is described and essential points of difference are noted from the cardiovascular changes in the carcinoid syndrome. This elastic vascular sclerosis may be due to a product of the tumour and constitute an additional component of the complex range of changes that makes up 'the carcinoid spectrum'.Necropsy experience with 10 cases of ileal argentaffin carcinoma (carcinoid tumour) revealed four in which ischaemic necrosis of the tumour-bearing segment of intestine had resulted. The mesenteric blood vessels were found to be narrowed by massive proliferation of elastic tissue, mainly in the adventitia. In three cases death was directly attributable to peritonitis caused by this complication. Similar vascular changes were present in a further three cases, two of which showed evidence of impaired blood supply. This observation has prompted a retrospective study of the regional blood vessels in argentaffin carcinoma which confirmed the relatively frequent, though hitherto overlooked, occurrence of this vascular lesion. It was found to be present in ileal tumours only and the implications of this distribution on pathogenesis are discussed. MiterialHistological material from 100 cases of argentaffin carcinoma was reviewed. Ten of these were necropsy cases and 90 were surgical specimens. All occurred in the 12-year period from 1956 to 'Present address:

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Book reviews Evaluation and Management of Hospital Infections. New Perspectives in Clinical Microbiology no 5. Ed Ralph van Furth.

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