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Primary and metastatic lesions from a fibroxanthosarcoma (FXS) originating in the neck of a 29‐year‐old Caucasian woman are reported. Light and electron microscopic observations are correlated to define the various types of cells constituting this neoplasm. Ultrastructural examination verified that several types of cells can act as facultative fibroblasts. Since a malignant potentiality cannot be predicted solely from the histopathology of fibroxanthomas, an attempt was made to categorize certain ultrastructural nuclear and cytoplasmic organelles associated with FXS cells. This was done in order to further define the malignant neoplastic cells of the FXS, so that distinguishing the malignant from benign forms of this neoplasm may become more feasible.

Patients with malignant obstructive airway lesions often present with total or segmental atelectasis of lung. In spite of prompt initiation of palliative external radiation alone, some patients were unable to complete the planned course of radiation therapy. Since May 1983, 17 patients with malignant obstructive endobronchial lesions have been treated by endoscopic Nd:YAG laser vaporization of the tumor. One to seven days later, fractionated external radiation therapy was initiated. Endoscopic use of the laser was repeated as needed during the course of treatment. Fifteen out of 17 patients successfully completed the planned course of therapy. The improved performance status was sustained in 13 of 15 patients for 2-13 months. A control group was selected from among patients with similarly located lesions who underwent external radiation treatment only prior to the availability of the Nd:YAG laser therapy. One patient developed radiation pneumonitis six weeks after completion of a second course of external radiation, another patient developed bronchopleural fistula after laser treatment which healed following closed chest tube drainage. The others had longer palliation of symptoms and improved quality of life. The results indicate that relief of airway obstruction by use of the Nd:YAG laser improved the patients' ability to tolerate subsequent external radiation treatment.

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Urinary excretion of nonesterified cholesterol (NEC) in men with testicular and prostatic neoplasms has been investigated. Control patients with non‐steroid‐related benign and malignant tumors and patients with nonneoplastic diseases were also studied. Normal range of NEC excretion was determined in healthy individuals and was found to be 0.10‐1.20 mg/24 hours (3 S.D., 99.5% population), with a mean of 0.65 ± 0.18 mg/24 hours. Twenty‐nine of 32 patients with adenocarcinoma of the prostate (91%) had NEC hyperexcretion. In addition, all patients with choriocarcinoma, teratocarcinoma, and embryonal cell carcinoma of the tesds (8 cases) had NEC hyperexcretion. Hyperexcretion of NEC was also present in patients with metastatic carcinoma of testes and prostate in which the primary tumor had been removed. Testicular seminomas (19 cases) on the other, hand, revealed a normal urinary excretion of NEC. The effects of therapy on NEC excretion were investigated in some of these patients, and their NEC values appeared to correlate with the clinical course of the disease. Approximately 25% of the control patients over 45 years of age without histologically demonstrable testicular and/or prostatic carcinomas revealed NEC hyperexcretion. This hyperexcretion of NEC in the control groups can possibly be explained in part by the presence of “latent” adenocarcinoma of the prostate that was not detected. It is recognized that at least 30% of necropsies performed in men at this age group will harbor an unsuspected adenocarcinoma of the prostate. Our previous work in this field has shown NEC hyperexcretion in women with carcinomas of the steroid‐producing glands and their target organs. This suggests a certain cell specificity. The specificity of the results in both men and women, in respect to type of cells involved, effects of therapy, and lack of correlation of the NEC excretion with the serum levels of cholesterol, supports the concept that most of the urinary cholesterol is of endogenous origin, and appears to represent an expression of cell biochemical function.