This report describes 16 cases of the recently recognized anaplastic large cell Ki-1 lymphoma. The disease showed a male:female ratio of 2.2:1 and a bimodal age distribution with peaks in the third and eighth decades. The clinical presentation was highly variable, with lymph node, skin, bone and gastrointestinal tract being the most commonly affected sites. The lymph nodes usually showed subtotal or sinusoidal involvement, and parenchymal fibrosis was common. The large neoplastic cells were almost invariably admixed with many reactive small lymphocytes, histiocytes and/or neutrophils. Two cytological types could be delineated: type I (pale cell, four cases) consisted of large polygonal cells with distinct pink-staining cell membrane and pale cytoplasm and pleomorphic nuclei showing marked chromatin clearing; and type II (basophilic cell, 12 cases) consisted of round or oval cells with basophilic cytoplasm and/or paranuclear pale hof, pleomorphic nuclei often reniform or lobulated and with frequent multinucleated wreath-like and Reed-Sternberg-like cells. Immunohistochemical studies showed that nine cases (56.3%) exhibited a T-cell phenotype, three cases (18.8%) each exhibited a B-cell or null-cell phenotype, while one case exhibited both T- and B-cell markers. Cutaneous involvement at presentation was associated with a favourable outcome, and spontaneous regression was common. For patients with non-cutaneous presentation, the prognosis was relatively good for young patients treated with aggressive chemotherapy, but was grave for old patients.

The cytologic and histologic findings of seven cases presenting clinically as salivary gland swellings are described. These included two cases of pilomatrixoma of skin in the parotid region, two cases of neurilemmoma in the submandibular area, a case of Kimura's disease in the peri-mandibular gland lymphoid tissue, a case of Castleman's disease in intraparotid lymph node, and a case of branchial cleft cyst in the parotid region. It is important to recognize lesions that masquerade as salivary gland tumors so that misdiagnosis and overdiagnosis on smears can be avoided and the patients can be treated appropriately.

Partial hepatectomy 24 h before a single i.p. dose of dimethylnitrosamine, diethylnitrosamine or ethylmethylnitrosamine increased the carcinogenic response in the liver of rats as determined by the number of tumours and the number of "focal proliferations" produced. Secondly, in rats given a single i.p. dose of diethylnitrosamine, 3 partial hepatectomies 5, 10 and 15 weeks after dosing the animals increased the carcinogenic response in the liver. The stimulus of repeated partial hepatectomy therefore appears to act as a "promoting agent" for liver carcinogenesis, that is if the single dose of diethylnitrosamine is regarded as an "initiating agent" in the terms of the two-stage hypothesis. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4

Ischemic heart disease and stroke are the leading causes of mortality worldwide according to the World Health Organization. Hypertension is a major factor in the development of these diseases. Olmesartan is an angiotensin II receptor blocker (ARB) indicated in the treatment of hypertension. There are several case reports describing sprue-like enteropathy caused by olmesartan. We report on a 72-year-old patient referred to our hospital for work-up of chronic diarrhoea, vomiting and weight-loss, and villous atrophy on intestinal biopsy. The patient's symptoms abated upon cessation of olmesartan. This case illustrates the need for a thorough medication history and regular review during work-up. We hope it will add to the current understanding of this rare phenomenon.

A 60 year old lady was referred to the Princess Alexandra Hospital (Brisbane, Queensland, Australia) tertiary Otolaryngology, Head and Neck Unit from a peripheral hospital for investigation and management of a tumour at the base of the tongue. Biopsy of the tumour revealed it to be an epithelial-myoepithelial carcinoma of the base of the tongue. This is an extremely rare tumour in this location with only 2 other case reports in the world literature: the patients were treated with chemo-radiotherapy and surgery respectively. Our patient was made aware of the world literature and was able to make a fully informed decision on her choice of treatment modality and was treated with radiotherapy. Increasingly journals are limiting publication of case reports to "world firsts" only. We present a case where such a policy would have denied patient choice and possibly led to detrimental treatment.We review the world literature of tongue base epithelial-myoepithelial carcinoma of the tongue.

Thymectomy was carried out for treatment of myasthenia gravis in 27 unselected Chinese patients and thymoma was found in 13 of them. This 48% incidence of thymomas is two to three times greater than in Japanese and European patients, respectively. The reason for the higher incidence of thymomas observed in Chinese patients may be related to the presence of the Epstein-Barr virus genome in thymoma. Furthermore, all of the thymomas in our patients were lymphoepithelial and histologically resemble nasopharyngeal carcinoma and undifferentiated carcinoma of the salivary gland. Both these tumours are closely linked to the Epstein-Barr virus and in Hong Kong, nasopharyngeal carcinoma is the third commonest cause of death from malignancy. We recommend early thymectomy for patients with myasthenia gravis particularly in geographical areas where there is a high incidence of nasopharyngeal carcinoma and undifferentiated carcinoma of the salivary gland.

Summary.-In mice given a single dose of diethylnitrosamine, a hepatonecrotic dose of carbon tetrachloride, 5 weeks after dosing with DEN and repeated 6 times at 4-weekly intervals, augmented the tumour yield in the livers. A single hepatonecrotic dose of CC14 24 h before a single dose of DEN also increased the number of tumours produced. The effect of the repeated administration of CC14 after the dose of DEN occurred in addition to, and was therefore independent of, the enhancing effect of a single dose of CC14 before DEN.These results may be interpreted as implying (1) that the liver in the regenerative phase after a hepatonecrotic dose of CC14 is more susceptible to an initiating action of DEN, i.e. produces more potential foci of tumour growth than in the normal liver and (2) that the repeated doses of CC14 leading to repeated phases of regeneration, after the dose of DEN, provide a promoting stimulus.

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