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The relative importance of human immunodeficiency virus (HIV)-associated lymphadenopathy amongst patients presenting for lymph node biopsy in Central Africa is unknown. HIV-1 serology and histology of patients undergoing superficial lymph node biopsy during 1989-1990 in Lusaka, Zambia, were examined in a prospective cohort study of HIV serology and by retrospective review of laboratory records. Of 727 lymph nodes biopsied in Lusaka in 1989-1990, 380 (52 per cent) showed tuberculous lymphadenitis, 160 (22 per cent) histology suggestive of primary HIV lymphadenopathy and 66 (9 per cent) nodal Kaposi's disease. HIV serology was tested in 280 adults and was positive in 91 per cent (255 patients), including 89 per cent (153 of 171) of those with tuberculous lymphadenitis, 98 per cent (63 of 64) of those with histology suspicious of primary HIV lymphadenopathy and all (24 of 24) with nodal Kaposi's disease. Other HIV-associated lymphadenopathy included nodal lymphomas and lymphoepithelial cysts. HIV serology was tested in 22 children and was positive in eight, including four of 14 with tuberculous lymphadenitis. It is concluded that HIV-associated lymphadenopathy, especially tuberculous lymphadenitis, is very common amongst patients presenting for lymph node biopsy in Central Africa.

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The pattern of urological malignancy among the indigenous population of Zambia (determined on the basis of histopathological reports from a major national hospital during an 8-year period) is presented. A total of 6514 malignancies were observed, of which 784 (12%) were of urological origin. Bladder carcinoma, predominantly squamous type, was the commonest urological tumour (51%), followed by carcinoma of the prostate (26%), carcinoma of the penis (18%), renal tumours (4.3%) and testicular malignancy (0.7%). In nearly 32% of the bladder tumours, bilharzial ova were demonstrated histopathologically. Nephroblastoma accounted for 70% of the renal tumours and from a total of 7 cases of testicular tumours 5 were embryonal carcinoma and 2 seminoma. A brief reference is made to the pattern and aetiology of urological malignancies in some neighbouring countries.

A giant fibrous pseudotumor of the right testicular tunics in a 27-year-old Zambian is presented. It has been suggested that associated Schistosoma haematobium infection could have contributed to the giant size and rapid growth of the lesion.

Two Zambian infants presented with massive rectal bleeding caused by cytomegalovirus ileitis. The A 3 month old boy presented with a one day history of bloody diarrhoea. He had previously been in good health. On examination he was pale with a tachycardia of 152 beats/minute. The abdomen was soft and non-tender with hyperactive bowel sounds. There was a large quantity of blood clots on the nappy. Rectal examination confirmed the presence of blood. A provisional diagnosis of typhoid fever was made and in view of the life threatening haemorrhage laparotomy was done as soon as he had been resuscitated. The colon and terminal ileum were loaded with blood and the entire small bowel was covered in transmural plaque-like lesions, the heaviest concentration being in the terminal ileum. The terminal 20 cm of ileum were resected and intestinal continuity restored by ileocaecal anastomosis. When the resected bowel was opened the plaque-like lesions were seen to be ulcerations of varying depth. Postoperatively the infant developed a coagulopathy and wound infection, and (on the tenth day) peritonitis. At the second laparotomy multiple perforations in the remaining part of the small intestine were found and he died a few hours later. The child was seropositive for HIV (Wellcozyme recombinant).

Observations are presented on 11 cases of haemospermia in the University Teaching Hospital, Zambia, a country where bilharziasis is endemic. Seven patients were severely hypertensive but only two had urinary bilharziasis. The incidence of Schistosoma haematobium infection of the prostate and seminal vesicles is discussed and it is concluded that there is no significant association between the parasitic infection and haemospermia.