We report the fourth case of an osteoclastoma-like giant cell tumour of the renal pelvis. A special feature was that although thorough sampling of the tumour showed an osteoclastoma-like pattern throughout, it was intimately associated with carcinoma in situ change of the adjacent transitional epithelium and this provides further support for the view that these tumours are of epithelial derivation. However, immunohistological and ultrastructural studies failed to reveal epithelial features within the tumour cells and the possible significance of this finding is discussed.
A clinical comparison of the nodular and diffuse variants of lymphocyte-predominant Hodgkin's disease (HD-LP) has shown them to be similar in all respects, including survival and relapse-free survival (RFS). In addition, they appear similar to mixed cellularity (MC) and nodular sclerosing Hodgkin's disease (HD-NS) with regard to clinical course. Thus, the reported phenotypic differences between nodular lymphocyte predominant Hodgkin's disease (HD-LP[N]) and other forms of the disease do not appear to be reflected in clinical behavior.
The authors describe a case of a 73-year-old man who had been treated with corticosteroids and azathioprine for 3 years for the Lambert-Eaton (myasthenic myopathic) syndrome, who had a primary esophageal Ki-1-positive large cell anaplastic lymphoma. Cancer 68:418-421,1991. RECENTLY DESCRIBED SUBTYPE of non-Hodgkin's A lymphoma,' Ki-1 (CD 30)-positive large cell anaplastic lymphoma, most commonly affects the skin. lymph nodes, and gastrointestinal tract.2-6 We describe a case of Ki-I-positive large cell anaplastic lymphoma of the esophagus which occurred in a 73-year-old man who had received 3 years of immunosuppressive therapy for the Lambert-Eaton (myasthenic myopathic) syndrome. Case ReportIn 1983, a 66-year-old man had exercise-induced weakness affecting his lower limbs, which on occasion would spontaneously give way beneath him. Over a period of a few months he described difficulty in standing from sitting, in climbing stairs and had noticed that his eyelids drooped toward evening.An initial diagnosis of myasthenia gravis was made based on the history and temporary reversal of his symptoms by the administration of edrophenium chloride on two occasions. He had consistent electromyographic studies. The chest radiograph. biochemical profile, and full blood count were normal. He was treated with pyridostigmine bromide (60 mg four times daily) and later, in I984 after a course of plasmaphoresis a thymectomy was performed, although no thymic tissue was detected histologically.In 1986 the diagnosis was changed to that of the LambertEaton syndrome, due to the absence of reflexes to clinical testing and repeatedly negative assay for acetylcholine receptor antibodies. lnvestigations revealed no evidence of underlying pulmonary or other malignancy. His weakness was effectively controlled with prednisolone, azathioprine, and 3.4-diaminopyri-
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