The aim of this study was to investigate the clinical and morphological aspects of drug diffusion and efficacy after perioperative locoregional application of mitoxantrone in patients with early breast cancer. Mitoxantrone was injected at a dose of 0.5 ml (1.0 mg) in two sites around the tumor in 37 patients. Intraoperative inspection of mitoxantrone diffusion in breast and axillary tissues was carried out by blue color of the chemotherapeutic drug. Investigations of reactive morphological changes in axillary nodes were determined intraoperatively by blue stained lymph capillaries identified 2-4 cm laterally from the application sites and in 30 patients a mean of 1.5 stained axillary nodes was found. The light microscopy in the metastatic blue lymph nodes showed circulatory changes, dilatation of marginal sinus and inflammatory alterations. It was concluded that lymphotropic locoregional application of mitoxantrone results in diffusion of the drug in the regional lymph drainage and in cytotoxic effects on axillary nodes.

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An intraduodenal diverticulum in 54 year old woman which caused alcalculous cholecystitis and pancreatitis is described. The diverticulum was missed at the first operation, performed for acute cholecystitis. Before the second it was interpreted as a pancreatic cyst. At the second intervention, the cyst wall was excised through a duodenotomy. Histological examination of the wall of the diverticulum is crucial for correct diagnosis.