Intraosseous "chordoid" sarcoma, chondroblastic or lipoblastic origin?

An unusual sarcoma with myxoid features that apparently originated within the scapula and has been locally aggressive for 10 years is reported. Clinically and by light microscopy it was considered to be a cartilaginous tumor, possibly chordoid sarcoma. By histochemical techniques and electron microscopy it most closely resembles a tumor of brown fat.

Angiolymphoid hyperplasia with eosinophilia: a disease that may be confused with malignancy

Twelve new cases of an unusual, benign vasoproliferative and inflammatory disorder of unknown etiology, angiolymphoid hyperplasia with eosinophilia (ALHE), are described and contrasted clinically and pathologically with those appearing in the literature. Only recently recognized in the United States, the disease is of singular importance because the vascular component may be confused histologically with angiosarcoma, thereby resulting in unwarranted aggressive therapeutic measures. ALHE characteristically affects adults and presents in the head and neck region as either solitary or multiple cutaneous tumors. The lesions are pruritic, frequently bleed after minor trauma, and may be associated with peripheral eosinophilia and regional lymphadenopathy. On rare occasions, the disease may masquerade as a salivary-gland tumor, cause stenosis of the external auditory canal, or present as an osseous lesion of the skull. Extrafacial tumors are uncommon. Excision is the most frequent form of therapy; however, local irradiation, corticosteroids, electrodessication with curettage, and chemotherapy have also had varying degrees of success.

Selling Fitness Through 'Health Promotion'

After five years of testing in Idaho, the Sun Valley Executive Health Institute Is ready to introduce its long-weekend crash course in exercise, diet, health, and wellness.

Office Aerobics: Assessing Fitness Without Fuss

The primary-care physician often leaves exercise prescription to sportsmedicine experts. Now some of those experts are urging GPs and family practitioners to bring aerobics into their offices.

Eosinophilic fasciitis. A pathologic study of twenty cases

This report presents a detailed light-microscopic evaluation of biopsies obtained from 20 patients with eosinophilic fasciitis, a newly recognized disorder characterized by inflammation and thickening of the deep fascia, hypergammaglobulinemia, and peripheral and tissue eosinophilia. Early in the course of the disease, the deep fascia and lower subcutis are edematous and infiltrated with lymphocytes, plasma cells, histiocytes, and eosinophils; these features are associated with impressive peripheral eosinophilia. As the illness progresses, these structures and eventually the dermis become collagenized, thickened, and sclerotic. Tissue eosinophilia may be focal or diffuse and is usually observed in the fascia and/or lower subcutis. Extracutaneous involvement has been limited to a chronic synovitis and tenosynovitis, the latter frequently associated with the carpal tunnel syndrome. Deposits of immunoglobulin and/or complement were found in five of eight biopsies studied by direct immunofluorescence, which suggests that an immunologic stimulus may be responsible for initiating this syndrome. Differential diagnoses are discussed.

Cryotherapy-Putting Injury on Ice

Cheap, simple, safe, and effective, ice therapy after soft-tissue injury can cut weeks off of recovery time-but almost nobody uses it.

Angiosarcoma of the maxillary sinus: literature review and case report

A rare case of angiosarcoma of the maxillary sinus is reported. Review of the literature concerning angiosarcoma of the head and neck revealed 14 previously published cases involving the nose, nasal sinuses, and nasopharynx. Angiosarcoma of the skin and soft tissues of the head and neck differs in behavior from that affecting the nose, nasal sinuses, and nasopharynx. The case reported presents the protracted clinical course of this malignant tumor.

Rhabdomyosarcoma arising within a cystosarcoma phyllodes. Case report and review of the literature

Rhabdomyosarcoma of the breast is a rare tumor that is characterized by its rapid growth, large size, and poor prognosis. It most often presents as a pure neoplasm and infrequently as the stromal component of a cystosarcoma phyllodes. The clinical and pathological features of a cystosarcoma with a rhabdomyosarcomatous stroma occurring in a 45-year-old woman are presented, and the results are discussed in reference to the 24 published cases of mammary rhabdomyosarcoma. The patient was treated by radical mastectomy and died 2.5 years later with pulmonary and cerebral metastases. Though two long-term survivors have been reported, cures are infrequent and no form of therapy has been uniformly successful.

Beloved 'Outlaws'-Trainers Look at Liability

Almost everybody loves the team's trainer, but in most states he's a legal nonentity. And until athletic trainers are afforded legal sanction for their work, they-and their team physicians-are prime targets for liability suits.

The Fitness Boom: Hucksters Ride the Bandwagon

Pushed by big business and advertising agencies, fashionable fitness and aerobic chic have gathered the momentum of a huge, glittering bandwagon-with an impact on health that's both good and bad.

Cystosarcoma phyllodes: a clinicopathologic analysis of 42 cases

A retrospective clinicopathologic evaluation of 42 patients with cystosarcoma phyllodes was undertaken to determine if tumor size, contour, degree of stromal atypia and mitotic activity were reliable indicators of clinical behavior. Excluding size, the latter three determinants showed a positive correlation with prognosis and served as the basis of a classification in which 18 benign, 5 borderline and 19 malignant cystosarcomas were diagnosed. The tumors occurred in women averaging 44.3 years of age who most often presented with a palpable occasionally painful mass with a median diameter of 5 cm. Excision or simple mastectomy were the more frequent forms of therapy. Local recurrences were experienced by 6 patients and occurred in all 3 categories of tumor. Only malignant neoplasms developed systemic metastases which was observed in 4 patients 3 of which have died. On borderline tumor recurred 14 times and eventually proved fatal as a result of contiguous pulmonary involvement. A plea is made to label the stroma of malignant cystosarcomas as to the cell(s) of origin so future investigators may evaluate the effect of various soft tissue patterns on prognosis.

Sarcomas of the breast: a clinicopathologic analysis of ten cases

The clinical and pathologic features of ten mammary sarcomas are discussed. Tumor size, contour, degree of cellular atypia, and mitotic activity were specifically evaluated to determine if they are important indiced of clinical behavior. Results indicate that infiltrating margins, 2-3+ stromal atypia, and eight or more mitoses per 10 HPF are characteristics of neoplasms associated with a poor prognosis. Tumor size was an unreliable criterion. A classification of breast sarcomas is presented with an appeal to avoid use of the term "stromal sarcoma" as a specific pathologic diagnosis. Since a diagnosis based upon cell of origin and correlated with the above morphologic features is fundamental to an intelligent therapeutic approach to this rare group of neoplasms, future reports dealing with this subject should include these details.

Sarcomas of the breast: a clinicopathologic analysis of ten cases

The clinical and pathologic features of ten mammary sarcomas are discussed. Tumor size, contour, degree of cellular atypia, and mitotic activity were specifically evaluated to determine if they are important indiced of clinical behavior. Results indicate that infiltrating margins, 2-3+ stromal atypia, and eight or more mitoses per 10 HPF are characteristics of neoplasms associated with a poor prognosis. Tumor size was an unreliable criterion. A classification of breast sarcomas is presented with an appeal to avoid use of the term "stromal sarcoma" as a specific pathologic diagnosis. Since a diagnosis based upon cell of origin and correlated with the above morphologic features is fundamental to an intelligent therapeutic approach to this rare group of neoplasms, future reports dealing with this subject should include these details.

Pleomorphic adenoma of the epiglottis: report of a case

We describe the clinical and pathologic aspects of an unusual case of pleomorphic adenoma of the epiglottis. A 69-year-old man had impaired speech and a "lumpy sensation" in the throat. Following clinical evaluation and a diagnostic biopsy, the tumor was totally excised with excellent results. Pleomorphic adenoma of the larynx is most uncommon. To our knowledge, no report describing the clinical and pathologic features of this entity in the epiglottis or larynx has been previously reported. This is the only example of an epiglottic pleomorphic adenoma among 391 cases seen at Presbyterian-University Hospital and the Eye and Ear Hospital of Pittsburgh during a 21-year period.

The Structure of the Nitrocamphor Anhydrides

Three isomeric nitrocamphor anhydrides have been isolated. The structure assigned to the anhydrides without indication of the stereochemistry is that shown in (II).