There are many reports of sclerosing hemangioma from the perspective of its histopathologic features, but its cytopathologic characteristics are less well known. In this report we present the case of a patient in which the cytologic features firmly established a definitive diagnosis; surgical intervention was warranted only after the lesion had grown over the course of 7 yr of close observation. The cytologic diagnosis requires the identification of a dual cell population. Both populations of tumor cell nuclei are immunoreactive for thyroid transcription factor-1, but caution is warranted because this marker may be present in other tumors. Recognition of its distinctive cytologic features can lead to proper diagnosis and conservative management.

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Autopsy reports on 155 successive end-stage renal disease (ESRD) patients and 147 control patients without ESRD, matched for age, race and gender, were collected. Cystic transformation of the kidneys was noted in 58% of the ESRD patients and 13.6% of the control patients. There were 25 ESRD patients with renal adenoma and 3 with renal cell carcinoma. The single best predictor of cystic transformation or tumorous degeneration was patient’s age. A statistically significant association between cystic transformation and gender, as well as the cause of ESRD, was also found. In contrast to previous reports we were unable to document a strong association between the incidence of either cystic transformation or tumorous degeneration with the duration of dialysis, nor did these two parameters correlate with mode of dialysis. We suggest that cystic transformation of the kidneys in ESRD is related to age and renal failure per se, is not strongly associated with duration of dialysis and is independent of mode of dialysis. Concomitant tumorous degeneration was frequent, but this was usually an incidental autopsy finding. Renal malignancy was uncommon and metastases were absent.

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Twenty‐five cases of “Mediterranean abdominal lymphoma,” better known as immunoproliferative small intestinal disease (IPSID), are reported from the American University of Beirut Hospital. All patients were Moslem Arabs from low socio‐economical background. The mean age was 25 years. IPSID is shown in this study to be a distinct disease entity characterized by a triad of clinical, pathological and immunoglobulin abnormalities. The clinical manifestations of the disease included chronic diarrhea, weight loss, diffuse abdominal pain, clubbing of fingers and toes and occasionally palpable peripheral lymph nodes. Radiological studies revealed a malabsorption pattern with evidence of mucosal fold thickening, segmentation and flocculation of barium. Laboratory investigations showed evidence of malabsorption, hypoalbuminemia and hypocalcemia. Two patients lacked evidence of malabsorption. Nine patients had alpha heavy chain protein in the serum. However, intestinal fluid immunoelectropheresis and immunofluorescence studies on involved intestinal mucosa were not performed and therefore, alpha heavy chain disease (αHCD) could not be excluded in the remaining 16 patients. A new staging classification is proposed, and the role of laparotomy in staging is emphasized. In five patients, mesenteric lymph nodes harboured immunoblastic sarcoma whereas the intestinal mucosa in the same patients was involved with a benign‐appearing lymphoplasmacytic cellular infiltrate without evidence of malignancy. Three patients had histologically proven lymphoma in peripheral lymph nodes and all had αHCD. Lymphomatous involvement of distant organs was not observed. One patient with αHCD was considered in the premalignant phase of IPSID. Prognosis was poor as the majority of patients succumbed within two years after diagnosis. The significance of early detection is emphasized. Cancer 40:2941‐2947, 1977.