Fine needle aspiration biopsy (FNAB) was performed in 31 patients with hydatid disease by IS operators in 41 biopsy eventsduring the period 1983-93. The FNABs were unintentionally done without prior clinicalsuspicionof hydatid cysts (HCs) in 18 patients and intentionally(with prior clinicalsuspicionofHC) in 13 patients for pathologic confirmation required for specific therapy. The FNABs were performed with the guidance of fluoroscopy (n=7), CT (n= 14) or ultrasonography (n= 10).The material included both closed, open and ruptured HCs from different locations such as abdomen, thorax, spine and bone. Pathologic confirmation of HC was achieved by recovering and demonstrating parasitic material in the specimen. In only 7 of 31 patients were the specimens diagnostic at the initial interpretation. This emphasizes the importance of alerting the pathologist about the possibility of hydatid disease.In 25 of 31 patients (81%) no biopsy reactions occurred. In 5 patients minor allergic reactions occurred and 3 had filling of air into intrathoracic cysts not requiring therapy. One patient, with a FNAB 'of a liver HC, had a sudden severe drop in blood pressure, which required anti-shock therapy with subsequent recovery without sequelae. All complications occurred with non-intentional biopsy of He. Suggestions for diagnostic and therapeutic management of patients with HC and advice to avoid or limit potential complicationsor spread of diseaseare givenwherea planned biopsy is necessary for appropriate and effective therapy.

Fourteen patients with intractable bleeding of obstetric or gynecological origin underwent transcatheter angiographic arterial embolization. Three patients had postpartum hemorrhage associated with dilutional coagulopathy, anticoagulant therapy and placental leukemic metastases, or placenta percreta. One patient had locally advanced gestational trophoblastic tumor, one had uterine sarcoma and 8 had advanced cervical malignancy. Bleeding was completely controlled in all patients regardless of the initiating event. The embolizing material was gelatin sponge particles in 12 patients, and spring coil in 2. In experienced hands, angiographic arterial embolization is a safe, effective and less invasive alternative to surgical ligation in some clinical states of pelvic female genital tract hemorrhage.

No abstract

Primary pancreatic lymphomas are rare. We reviewed our experience at King Faisal Specialist Hospital and Research Center; the hospital tumor registry identified five patients with primary pancreatic lymphoma among the 1,212 adult non-Hodgkin's (NHL) cases referred to this institute during 1987-1994. The histology was diffuse large cell in all cases. According to the Ann Arbor classification, four patients had stage IE and one patient stage IIE disease. The diagnosis was established by laparotomy in three and ultrasound or CT-guided biopsy in two patients. All patients received chemotherapy. Radiotherapy was used in two cases; in one patient the pancreatic bed was irradiated, whereas in the other radiation was given for obstructive jaundice. Four patients are alive with no evidence of disease at 84, 26, 24, and 21 months follow-up. One patient relapsed at 12 months following chemotherapy and is alive with disease at 23 months follow-up. The clinical and radiological findings in primary pancreatic NHL are not pathognomonic, and the diagnosis is only established on histopathological examination. The management should be nonsurgical as the response to chemotherapy and radiation appears to be no different from NHL at other sites.

Lipomas lying close to bone are called parosteal lipomas. They usually cause some bone reaction. We are reporting a dramatic example of this rare condition and have discussed the differential diagnosis and management.