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Interesting findings were obtained in the lung biopsy of a 46 year old female patient with secundum atrial septal defect and pulmonary hypertension. In the intima of small pulmonary arteries, there were a marked increase in elastic fibers and marked proliferation of longitudinal smooth muscle cells. The vascular lumen was markedly stenotic, but reconstruction of small pulmonary arteries indicated that all vascular lumina were patent. The case was accordingly diagnosed as operable and closure of atrial septal defect was undertaken. Three years postoperatively, the patient is well with much improved condition and lowered pulmonary arterial pressure was demonstrated by cardiac catheterization. This case had apparently serious vascular lesions due to severe intimal thickening which we labeled "musculoelastosis", but it was found that such thickening alone did not cause peripheral pulmonary arterial occlusion. It is therefore thought to be a benign pulmonary vascular condition.longitudinal muscle cells ; small pulmonary arteries ; pulmonary hypertension ; musculoelastosis findings, which were the basis for our decision to operate, and the late postoperative outcome after three years will be described in this report.

A case of Ewing's sarcoma which originated from the right zygomatic arch of 23-year-old female was presented and 52 cases of Ewing's sarcoma reported in Japan from 1950 to 1961 including authors' case were reviewed. Ewing's sarcoma has been the subject of considerable controversy. Ewing 1,2,3) regarded the tumor as a myeloma derived from perivascular lymphatic endothelium of the bone marrow and called it an endothelial myeloma. Willis4) considered it a syndrome of a non-osteogenic, round-celled, radio-sensitive tumor in a bone of usually a metastatic origin. On the other hand, Oberling5) classified the tumor as a variant of reticulum cell sarcoma. At present, however, there seems to be general agreement on this chaotic subject that it belongs to a special entity and originates from the reticuloendothe lial system of the bone marrow.

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