Forty-one cases of spindle cell lipoma, an entity first described in 1975, are presented. Of these, 38 were identified in a systematic review of 2478 tumours of adipose tissue diagnosed and treated in one hospital over a 25 year period. This lesion, therefore, accounts for about 1.5% of adipocytic neoplasms and is outnumbered by conventional benign lipomas by approximately 60 to 1. The remaining three were referred cases. Seventy-five per cent of the lesions arose, as expected, on the back of the neck, upper back or shoulder, almost exclusively in males between 40 and 70 years of age. Ten lesions were identified at unusual sites: six in the limbs, three on the face and one on the trunk. One lesion arose within skeletal muscle, a previously unreported phenomenon, and this case showed both cartilaginous and osseous metaplasia. Only one of the 41 tumours has recurred locally. The range of histological features in spindle cell lipoma is described and the differential diagnosis is discussed.

Fifty-four cases of lipoma arising either within or between skeletal muscles are presented. Of these, 52 were identified in a systematic review of 2478 tumours of adipose tissue diagnosed and treated in one hospital over a 25 year period. Intramuscular lipomas account for 1.8% of fatty tumours, arise predominantly in middle to late adult life and, in our series, are commonest on the trunk. They may be divided into infiltrative and well-circumscribed types, respective local recurrence rates being 19 and 0%. Intermuscular lipomas are comparatively rare, 0.3% of fatty tumours, have a similar age distribution and arise most often in the anterior abdominal wall; none of the seven cases recurred. It is important that both pathologists and surgeons appreciate the significant tendency of infiltrative intramuscular lipomas to recur. Hence, preventative surgical measures may be undertaken and worries that the lesion may be sarcomatous can be avoided. Differential diagnosis, most importantly from well-differentiated liposarcoma, is discussed.

The cytological diagnoses of 27 lymph node aspirates were compared with the histological diagnoses or clinical outcome in 23 HIV positive patients. There was agreement between the cytological and histological diagnoses in 14 of the 16 surgically biopsied cases. The clinical outcome in the remaining 11 cases was consistent with the cytodiagnosis. Fine needle aspiration (FNA) is a reliable, miniimally traumatic, cost effective method with high specificity. It is suitable for an initial rapid diagnosis in HIV positive patients with lymphadenopathy. (i Clin Pathol 1993;46:546-566)

Aims-To evaluate the interobserver variation in the diagnosis of cervical intraepithelial lesions, including the new category "borderline abnormalities of uncertain significance" (BAUS) which has not been tested before. The purpose of this study was to evaluate interobserver variation for this proposed classification. MethodsThe study population comprised 122 consecutive patients who had had cervical biopsy specimens taken at colposcopy. The specimens were received fixed in 10% formaldehyde solution and were processed routinely.

Fine needle aspiration of the male breast can present problems of diagnosis because the cytological presentation of gynaecomastia can be confused with that of adenocarcinoma. We reviewed breast aspirates from 24 male patients in order to determine the accuracy of cytology as a method of diagnosing gynaecomastia. Discrepancies were observed between the original cytology reports on one hand and the review cytology and biopsies on the other. Of the 24 aspirates from the male breast, the cytology was reported as negative in 16 cases, suspicious in three cases and malignant in five. In four cases of the negative group, a specific diagnosis of gynaecomastia was made. In two of the negative cases the subsequent biopsies revealed adenocarcinoma. Of the five cases reported on the original cytology as adenocarcinoma, two on review showed the features of florid gynaecomastia and this was confirmed on biopsy and three confirmed the initial diagnosis of adenocarcinoma. The cytological features of gynaecomastia which distinguish it from adenocarcinoma are discussed.