Sarcoid Diagnosed by Needle Biopsy of the Spleen

Abstract

ceded by carcinoma in situ. If this be true, then a cervical biopsy obtained one or even more years previous to the time the clinical signs and symptoms of cervical cancer appear may reveal this histological picture of surface carcinoma, and the routine examination of the asympto¬ matic cervix by biopsy as done in many detection clinics becomes not only a useful but an almost imperative pro¬ cedure.Reexamination of the tissue from the eight cases in which a previous uterine curettage had been performed disclosed previously unrecognized carcinoma in situ in only two cases (table 3). It must be remembered, how¬ ever, that unless the cervical canal is purposely curetted, cervical tissue is obtained by uterine curettage only by accident. Actually, in the eight curettage specimens, cer¬ vical tissue was obtained in only four of them, two of which showed carcinoma in situ while the other two had no evidence of abnormality. This should reemphasize the advantage of curetting the cervical canal as well as biopsying the cervix when the uterus is being curetted. SUMMARY AND CONCLUSIONSIn summary, 13 cases of carcinoma in situ not treated as such were studied. The ultimate clinical course was known in all cases. Three of the lesions remained in the noninvasive stage after 2, 4, and 6 years, respectively, while the remaining 10 had progressed to various clinical stages of cervical cancer 1 to 17 years later. How long intraepithelial carcinoma was present before the original biopsy was obtained is, of course, a matter of conjecture.Consideration of these clinical and histological data seems to admit the following conclusions: 1. Carcinoma in situ is potentially invasive, and, if untreated, may progress to clinically evident cervical cancer. 2. As this study is retrospective, it does not indicate that carcinoma in situ always becomes invasive. It does, however, indi¬ cate that clinical cervical cancer is preceded by carci¬ noma in situ in too large a proportion of cases to be coincidental. 3. The clinical course of cervical cancer rep¬ resents only a small segment of its life history and the greater part of its existence is spent in the preinvasive stage. 4. If the patient who is destined to have cervical cancer is fortunate enough to have a cervical biopsy within five years previous to the time she would have de¬ veloped clinical signs and symptoms of cervical cancer, the biopsy specimen is likely to show carcinoma in situ. If the lesion is diagnosed and treated in that stage, the patient's chances of being cured are almost 100%.Sarcoid is a generalized disease with fairly characteristic but nonspecific, noncaseating granulomas found most frequently in the hematopoietic tissues. Clinically it is usually manifested by a chronic course with fever and various combinations of lymphadenopathy, splenomegaly, and hepatomegaly. Leukopenia and reversal of the protein albumin-globulin ratio are frequent.A fairly characteristic diffuse lesion in the lung fields, hilar lymphadenopathy, and, less frequently, osteolytic lesions of the small...