Cholesterol granuloma formation is an unusual development in the advanced stage of mammary duct ectasia. Its recognition is important because it can be clinically, mammographically, and grossly confused with carcinoma. Five such cases thought clinically to be carcinoma are presented. The histologic findings in cholesterol granuloma are distinctive and consist of multiple cholesterol crystals arranged either singly or in tightly-packed arrays. Foreign body giant cells surrounding the cholesterol deposits are invariably present.

Cognitive immaturity and distortion are frequently observed in normal adolescents, as well as those with severe psychiatric and behavioral disorders. Misunderstandings of the therapy process and an unstable therapeutic alliance often complicates treatment. Cognitive therapy provides a paradigm for therapeutic intervention and management of therapeutic-alliance problems with adolescents.

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A modified tannic acid-phosphomolybdic acid-dye procedure is used for staining myoepithelial cells in formalin fixed surgical and autopsy material. Paraffin sections are brought to water, mordanted for 1 hr in Bouin's fixative previously heated to 56 C, cooled while still in Bouin's, rinsed in tap water until sections are colorless, rinsed in distilled water, treated with 5% aqueous tannic acid 5-20 min, rinsed in distilled water 30 sec or less, treated with 1% aqueous phosphomolybdic acid 10-15 min, rinsed 30 sec in distilled water, rinsed in methanol, stained 1 hr in a saturated solution of amido black or phloxine B in 9:1 methanol:acetic acid, rinsed in 9:1 methanol:acetic acid, dehydrated, cleared and mounted. Myoepithelial cells of sweat, lacrimal, salivary, bronchial, and mammary glands are blue-green with amido black or pink with phloxine B. Fine processes of myoepithelial cells are well delineated. Background staining is minimal and the procedure is highly reproducible.

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