We report two cases of myofibroblastoma with unusual pathological features, in a 66-year-old woman and a 49-year-old man. Both tumours were unilateral, grossly nodular and well circumscribed, but not encapsulated. The lesions were made up of bipolar spindle cells arranged in fascicular clusters separated by bands of hialinized collagen; one included several islands of mature cartilage next to fat cells. The other contained atypical mononucleated and multinucleated giant cells. No mitotic figures were observed. Immunohistochemically, both tumours showed strong and diffuse cytoplasmic staining for vimentin and CD 34 and focal positivity for alpha-smooth muscle actin, and both were negative for cytokeratins, CD 68, Ham 5, 6, Mac 387, and S-100 protein. Desmin was positive in one case. Ultrastructural study revealed populations composed of fibroblastic cells without signs of myofibroblastic differentiation in one case; the second featured abundant undifferentiated mesenchymal cells with myofibroblastic differentiation. Both patients remain disease-free 38 and 36 months after lumpectomy.

The level of quinone oxidoreductases (microsomal and cytosolic DT-diaphorase, NADPH-cytochrome P450 reductase and NADH-cytochrome b5 reductase), superoxide dismutase and glutathione-related enzymatic activities in diethylstilbestrol (DES)-induced carcinogenesis in kidney from Syrian golden hamsters are presented. Animals that exhibited two different stages of DES-induced carcinogenesis in kidney--pre- and neoplastic lesions and tumorous lesions (after 6 and 8 months of continuous exposure to DES respectively)--were studied in comparison to kidneys from control animals. A dramatic decrease in microsomal and cytosolic DT-diaphorase activities (13.6 and 37.8% of controls), as well as in glutathione disulphide reductase (39.5%), and less marked in superoxide dismutase (45.6%), NADH cytochrome b5 reductase (61.9%) glutathione transferase (GST) towards 1-chloro-2,4-dinitrobenzene (CDNB) (66.2%) and glutathione peroxidase (GSH-Px) (80%) activities, were observed in kidneys with pre- and neoplastic lesions. NADPH-cytochrome P450 reductase and GST activity towards 4-hydroxy-2,3-trans-nonenal (4-HNE) showed no statistically significant variation at this stage of carcinogenesis. In kidney from animals with tumorous lesions, all the enzymatic activities mentioned above decreased, except for superoxide dismutase, which was increased to 186% of the control activity. GST activity towards 4-HNE again showed no statistically significant variation. These results suggest that if one-electron reduction of diethylstilbestrol-4',4''-quinone (DESQ) occurs, it may play a very important role in the development of DES carcinogenesis (pre- and neoplastic lesions), since at this stage of carcinogenesis the primary defense mechanisms against the oxygen free radicals generated in this way, i.e. SOD activity, is reduced to less than a half of control values. Both cytosolic and microsomal DT-diaphorase activities are unable at this stage of carcinogenesis to promote effectively the two-electron reduction of DESQ, which would avoid the initial formation of superoxide anion. The consequences of these decreases may be an increased steady-state concentration of superoxide anion and hydrogen peroxide, which in the presence of iron might lead to lipid peroxidation. GST activity towards 4-HNE could be responsible for the possible higher steady-state concentration of this lipid peroxidation product during DES treatment. The induction of DT-diaphorase and its protective role in the prevention of the development of pre- and neoplastic lesions in kidney from Syrian golden hamster during DES treatment is also discussed.

(a) The type of signal (arterial or venous) and its distribution detected by color and pulsed Doppler is more helpful than the assessment of the spectral quantitative parameters obtained by pulsed Doppler. (b) The presence of intratumoral venous flow remarkably suggests benignancy. (c) The presence of both intra- and peritumoral arterial flow in the same lesion strongly suggests malignancy.

Tuberculous endophthalmitis is a rare condition not described to date in association with intravenous drug abuse. Characteristics such as the lack of proven tuberculous disease in other organs and intense progression towards panophthalmitis make this case all the more interesting. The histopathological diagnosis is based on the identification of acid-alcohol resistant bacilli, and typical granuloma lesions with focal caseosis in stained sections.

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