The surface morphoIogy of normal term amnion was studied by scanning electron microscopy. Four patterns were observed. Two of the patterns showed distinctive minority populations of cells. In one, there were cells surrounded by intracellular channels; in the other, there were large flat cells. The microvilli in all four patterns showed variable morphology in different samples. Possible functional implications of the findings are discussed.
The features of four cases of malignant haemangioendothelioma involving the liver and other organs are described. Two cases were associated with a microangiopathic haemolytic anaemia. The nature of the tumours and possible pathogenesis for the anaemias are discussed.
Summary
The histological and cytological assessment of material obtained with an intrauterine jet washing device from 138 patients with postmenopausal bleeding, abnormal premenopausal bleeding or infertility is presented. In the first part of the study 55 washings were examined by histological techniques and the findings compared with those in material subsequently obtained by curettage or endometrial biopsy. Only 32 (58 per cent) of the washings were satisfactory for evaluation of the endometrium compared with 46 (84 per cent) of the curettings. When, in the second part of the study the washings in 83 cases were examined by both histological and cytological methods, 76 (92 per cent) were satisfactory compared with 59 (71 per cent) of the curettings. Cytological examination of the washings in the postmenopausal women provided a significantly higher proportion of satisfactory specimens than histological examination alone or evaluation of the curettings. In the whole study, three cases of endometrial carcinoma were diagnosed by endometrial washings and by curettage, while in six cases of endometrial hyperplasia one false negative was obtained by histological examination of the washings and one by examination of the curettings. This study shows that endometrial samples obtained with the intrauterine jet washer provide information about the endometrium which is comparable with that obtained by conventional curettage, and also that in postmenopausal women endometrial lavage may be more reliable than curettage.
The appearances of the amnion from two patients with polyhydramnios and two patients with oligohydramnios are described. In polyhydramnios the amnion showed a normal incidence of all the four patterns found in normal amnion at term and no abnormal features were noted. In oligohydramnios, two of four normal patterns predominated and intercellular canals were sparse.
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