We describe 13 cases of inflammatory lesion of breast lobules in young and middle-aged women, presenting as breast lumps, with, in five cases, associated breast pain. The patient with the most florid bilateral disease subsequently developed Hashimoto's thyroiditis. This prompted us to consider an autoimmune pathogenesis for all the breast lesions. We confirm a previously documented association of such breast lesions with diabetes mellitus and review the evidence for a possible HLA association. Increased HLA-DR expression by breast epithelial cells was observed in cases available for study. Of the seven patients screened for circulating autoantibodies, three had none, one had smooth muscle antibodies, one parietal cell, one parietal cell and thyroid microsomal, and the seventh had the thyroid autoantibodies expected in Hashimoto's disease. Five of seven patients whose HLA-status was determined were HLA-DR3, 4 or 5 positive, either singly or in combination. Immunophenotypic analysis of the mammary lymphoid infiltrate showed that the majority of infiltrating lymphocytes were B-cells.

Split-bolus MDCT urography provided at least 50% opacification of the majority of upper urinary tract segments and had high sensitivity, specificity, and accuracy for the detection of upper urinary tract tumors.

No abstract

SUMMARY.-A retrospective detailed study of 272 cases of breast carcinoma treated by radical mastectomy was published by Hamlin (1968). An (McWhirter, 1957), delay (Registrar General, 1967), clinical stage (Paterson, Tod and Russell, 1939), axillary node involvement (Myers, Axtell and Zelen, 1966), size of axillary nodes (Fisher, Slack and Bross, 1969), internal mammary node involvement (Handley and Thackray, 1954), malignancy grading of tumour (Bloom, 1950), host response (Hamlin, 1968), hormone balance (Hayward, Bulbrook and Greenwood, 1961), serum cholesterol levels (Juret, Aubert and de Kaou6l, 1967), treatment (Bloom, Richardson and Harries, 1962).It is clear from this list that many of these factors are interdependent. Age and menopausal status are related and both are probably related to hormone balance and perhaps to serum cholesterol levels. The size of the tumour, the delay in seeking advice, the clinical stage, and the node involvement are almost * Present address: