The patient was a 64-year-old married woman who had borne two children. Both children had been bottle-fed. She was seen in the breast clinic on 20 August 1976 with a history of a lump in the left breast of nine months' duration. The lump had been painful on occasions and she was aware of an inincrease in size. She had lost 1 5 stones (9 53 kg) in weight. There was no history of previous breast disease or discharge from the nipple. The menopause had been at the age of 50 years.On examination there was a clinical carcinoma, 4 0 cm in diameter, in the lower outer quadrant of the left breast. The skin was tethered but there was no ulceration. Nodes were felt in the left axilla.The right breast and axilla were normal. Mammography showed an opacity, measuring approximately 3-0 cm, in the lower outer quadrant of the left breast. The opacity was noted to have irregular margins and the radiological features of malig-
Two cases of tuberculous cervicitis are presented. The presence in cervical smears of both epithelioid and Langhans' giant cells, which are described, should raise a strong suspicion of tuberculosis.
365and a high incidence of uncertain scan findings, to be used as the only method of search for secondary deposits. The greater accuracy of "9mTc polyphosphate makes it more suitable as the principle means of search though in one patient of the 61 investigated with this isotope we were unable to identify metastases which were clinically and radiologically evident. Care also needs to be used in the interpretation of positive results since an isotopic "hot spot" is a non-specific indicator of abnormal metabolic bone activity and can therefore be produced by any metabolically active lesion, such as are seen, for example, in Paget's disease. We do not envisage that polyphosphate scintigraphy will completely replace x-ray examination in the identification of bone metastases, but we do feel that it should be used as the principle "search weapon" both in the initial assessment of the patient with prostatic cancer and in the continuing management of the disease.
Ischaemic heart disease was unknown in Papua New Guinea until 1964 when the first case was reported. Since then there has been a rapid rise in frequency confined to its major urban area, the capital, Port Moresby. The findings are based on post-mortems in Port Moresby and in Goroka, one of the major towns in the Highlands with its more traditional population, where ischaemic heart disease is now beginning to be seen.
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