Cholesterol granuloma of the maxillary antrum.

Five cases of cholesterol granuloma in the maxillary antrum are described. The lesion takes place in the mucosa. It seems likely that filtration and haemorrhage are the 2 main ways in which cholesterol is concentrated in certain tissues.

Ambulant management of patients with recent myocardial infarction.

Thirty-two patients who had remained ambulant and active after suffering an acute myocardial infarction were observed for 6 months. Complications were present initially in 11 but proved transient. One patient died of a new coronary thrombosis 15 weeks after the initial episode.

Otolaryngological disturbances in Waldenstrom's macroglobulinaemia.

Four cases of Waldenstrom's macroglobulinaemia (WM) are described in which otoloaryngeal symptoms were present. Symptoms in WM are related to (a) bleeding diathesis and (b) hyperviscosity of the blood. The bleeding diathesis was manifested as epistaxis in 2 cases.

Undifferentiated carcinoma of the nasopharynx: a light and electron microscopical study.

Light microscopical study of 29 cases of undifferentiated carcinoma of the nasopharynx showed evidence or origin of the tumour cells from overlying epithelium in 10 cases. In all cases the tumour cells had a distinctive cellular appearance of 'empty' chromatin deficient nuclei, prominent nucleoli and indefinite cytoplasmic margins. Electron microscopy indicated desmosomes and poorly defined tonofilaments in addition to the above cytoplasmic features.

Pathology of 'non-healing (midline) granuloma'.

In a histological study of biopsy and postmortem material from 30 cases of nasal disease in which a clinical diagnosis of 'midline granuloma' or Wegener's granuloma had been given, we selected 10 cases on the basis of the presence of widespread coagulative necrosis and atypical cells. Evidence is provided that such changes represent a malignant neoplasm of histiocytic lymphoma type. Local invasion and spread to cervical and more distant lymph nodes, spleen, liver, and kidney were seen in some of the cases.

Benign adenomatous neoplasm (adenoma) of the middle ear.

This presentation is a study of the pathogenesis, clinical behaviour and therapeutic response of 20 cases of a primary adenomatous neoplasm confined to the middle ear cleft. The investigation supported origin of the tumour from the middle ear mucosal epithelium. Clinical behaviour was that of a benign, localized, non-metastasizing neoplasm.

Objectivity in the classification of tumours of the nasal epithelium.

A survey of tumours derived from each of the four cell types of nasal epithelium is presented. Criticism is levelled at the adoption of additional terms for tissue types such as lympho-epithelium and transitional cell epithelium and tumours said to be derived from them. Electron microscopy is of assistance in classification particularly in the detection of evidence of keratin synthesis.

Laboratory diagnosis of laryngeal disease.

The most important method used in the laboratory diagnosis of laryngeal disease is histological examination of material removed at biopsy. Surgical and technical aspects of this procedure are discussed. A review of diagnoses made of laryngeal biopsies in a single year by the writer's laboratory is given together with a brief description of the pathology of the commonest non-malignant conditions.

Differentiation of squamous carcinoma of the larynx as a determinant of prognosis.

The changes seen by light and electron microscopy in the differentiation of squamous carcinoma are described. The grading of the differentiation of squamous carcinomas by overall impression and by quantitative methods are discussed. Reasons are given for retaining the former in the assessment of prognosis.

Silent cerebral embolism in patients with rheumatic mitral valve disease.

Electroencephalograms were recorded in 71 stroke-free patients suffering from mitral valve disease, complicated by atrial fibrillation in 33. The incidence of EEG abnormalities was not related either to the presence or absence of atrial fibrillation or to the type of valve lesion present, and did not differ significantly from the incidence observed in the general population. The findings suggest that occurrence of symptomatically silent emboli is not a feature of rheumatic mitral valve disease.