Forty-four cases of skin and soft tissue angiosarcoma seen at M. D. Anderson Hospital before 1976 were reviewed. The cases fell into six different clinical groups: scalp-face, 17 cases; postmastectomy, 14 cases; postradiation, 5 cases; leg with vascular stasis, 2 cases; breast, 2 cases; and miscellaneous, 4 cases. In all cases in the first four groups, the tumors involved primarily the dermis and subcutis and showed similar blends of vasoformative and solid histologic patterns. Two tumors in the miscellaneous group closely resembled those in the larger groups, but the other two in that group (both located in deeper soft tissue sites) and the two breast angiosarcomas had a somewhat different microscopic appearance. Survival was generally poor in all groups, owing to frequent local recurrence and early metastasis; median survival for the entire series was 20 months. Findings of significantly favorable prognostic importance were tumor size less than 5 cm (in the scalp-face group) and a moderate or marked lymphoid infiltrate in and around the tumor. Less significant favorable factors were a distal location ( in the postmastectomy group) and a low degree of pleomorphism. Only nine patients had long-term, disease-free survival.

It has been known for some time that the compliance with antidepressants in general practice is sub-optimal, but no new studies have been carried out since the 1970s, since which time training in general practice has improved and new classes of antidepressants have been introduced. In this study 46 patients commenced on an antidepressant for clinical reasons by their GP were interviewed 10-12 weeks later by a research worker. Thirty two percent of patients stopped medication within 6 weeks and 63% of these did not inform their GP of their decision. Side-effect burden was significantly associated with non-compliance. Selective serotonin re-uptake inhibitors showed a slight but non-significant compliance advantage in this small study but all patients treated with SSRIs were initially prescribed a dose for which there is evidence of superiority of effect over placebo, while only 30% of those on tricyclics were prescribed such a dose. Further work to establish accurate methods of determining compliance and effective ways of enhancing compliance with antidepressants in general practice is required.

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BackgroundAsbestos is the primary known cause of malignant mesothelioma. Some cosmetic talc products have been shown to contain asbestos. Recently, repeated exposures to cosmetic talc have been implicated as a cause of mesothelioma.MethodsSeventy‐five individuals (64 females; 11 males) with malignant mesothelioma, whose only known exposure to asbestos was repeated exposures to cosmetic talcum powders, were reviewed in medical‐legal consultation. Out of the 75 cases, 11 were examined for asbestiform fibers.ResultsAll subjects had pathologically confirmed malignant mesothelioma. The mean age at diagnosis was 61 ± 17 years. The mean latency from exposure to diagnosis was 50 ± 13 years. The mean exposure duration was 33 ± 16 years. Four mesotheliomas (5%) occurred in individuals working as barbers/cosmetologists, or in a family member who swept the barber shop. Twelve (16%) occurred in individuals less than 45 years old (10 females; 2 males). Forty‐eight mesotheliomas were pleural (40 females; 8 males), 23 were peritoneal (21 females; 2 males). Two presented with concomitant pleural and peritoneal disease. There was one pericardial, and one testicular mesothelioma. The majority (51) were of the epithelioid histological subtype, followed by 13 biphasic, 8 sarcomatoid, 2 lymphohistiocytoid, and 1 poorly differentiated. Of the 11 individuals whose nontumorous tissues were analyzed for the presence of asbestiform fibers, all showed the presence of anthophyllite and/or tremolite asbestos.ConclusionsMesotheliomas can develop following exposures to cosmetic talcum powders. These appear to be attributable to the presence of anthophyllite and tremolite contaminants in cosmetic talcum powder.

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The case of a 53-year-old man with acute megakaryoblastic leukemia (M7) was studied. At time of diagnosis, the platelet count was 980 X 10(9)/L and abnormal platelet vacuoles were present. The vacuoles were periodic acid-Schiff (PAS) positive. Electron microscopic examination showed large aggregates of glycogen. Findings of qualitative platelet function studies were abnormal. The authors' study and review of the literature indicates that thrombocytosis with large platelet vacuoles accompanying a blast cell population suggests a diagnosis of M7 and indicates the need for appropriate confirmatory studies.

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