Bellini duct carcinomas have recently been identified as a new entity in the spectrum of renal cell carcinomas and 10 cases have now been reported. The present paper adds detailed clinical and morphological data on six new cases. In addition, immunohistological and electronmicroscopical results support the origin of these tumours from the renal collecting ducts, especially the papillary ducts (Bellini ducts). A set of immunohistological reactions, including reactions to cytokeratins 13 and 19, vimentin and UEA-1 was found to facilitate the differential diagnosis of Bellini duct carcinomas from other renal cell carcinomas and infiltrating urothelial carcinomas of renal pelvis.

Between March 1986 and June 1989, 3,278 patients with upper urinary tract calculi were treated at our medical center with the Lithostar lithotriptor. The stones were located in the calices in 41.9% of the cases, renal pelvis in 25.7% and ureter in 32.4%. Perirenal hematoma was noted in 0.5% of the patients but this resolved spontaneously within a few days. Auxiliary procedures were performed in 37.3% of the cases, including Double-J stent and ureteral catheter in 26.8%, ureterorenoscopy in 2.1%, percutaneous nephrostomy in 1.6%, Zeiss loop in 4.3% and percutaneous nephrolithotripsy in 3.5%. Of the treatments 83.1% were performed without general or regional anesthesia. Followup after 3 months showed a 63.8% rate free of stone. The Lithostar upgraded with the overhead lithotripsy module is called Lithostar Plus. A total of 25 patients with upper urinary stones underwent treatment with the overhead module. Initial experience revealed fragmentation of stones after the first session in 20 patients, while a second session was necessary in 5. Analgesic sedation was used in 4 patients in whom a Double-J stent was inserted.

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In sera of 72 patients with lung cancer, 20 patients with various benign lung diseases and 34 age matched controls circulating immune complexes were determined by column chromatography on Sepharose 6 B and subsequent testing of the eluate for macromolecular IgG as well as by inhibition of radiolabelled C1q binding to sensitized sheep erythrocytes. Whereas in both control and benign lung disease-sera complexes could be detected in less than 5%, sera of lung cancer patients showed macromolecular IgG in 83% and C1q reactive material in 53% at the time of diagnosis. Patients with metastases exhibited a significantly higher percentage of positive reactions than those without metastases (macromolecular IgG 93%/68%, C1q 71%/28%). The size of the complexes increased with the extent of disease. So far, no signficiant changes in circulating immune complexes could be demonstrated id pretherapeutic values were compared with those after X-ray-, chemo- or immunotherapy with one exception, which is an increase of C1q reactive material after radiotherapy.

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