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The morphologic features of glycogenosis types I to X are described using light and electron microscopic techniques. With knowledge of the clinical presentation, the effect of intravenously administered glucagon on the blood sugar level, and the morphologic alteration of tissues obtained from liver and skeletal muscle, a presumptive diagnosis can be made in all the glycogenoses. The procedure for definitive diagnosis in each of the glycogenoses is indicated.

A 23-year-old man died four months after being admitted to the hospital because of back pain, 9.9 kg weight loss in 2 months, 8 to 10 loose stools per day, and periodic sweating. The carcinoid syndrome was present but no hypoglycemia. At autopsy, malignant carcinoid tumor was found in the pancreas. No other tumor was found in the usual primary sites for carcinoids. Biochemical findings and clinical data in retrospect support the morphologic diagnosis of pancreatic islet cell carcinoid tumor. Our case and a review of the literature emphasize that metastasizing tumors of the pancreas associated with excessive production of indolic compounds are frequently aggressive and the survival time is short (range 3 months to 4 years; mean 15 months).

Morphologic diagnosis of a virus infection encountered in routine postmortem examinations would depend in general, if not always, on the recognition of specific cellular changes such as are now generally accepted as presumptive evidence of an infection of this nature. Especially significant would be the presence of cellular inclusions of certain types, cytoplasmic or nuclear or both. The inclusions of the cytoplasm are sometimes more characteristic of the particular virus concerned than are those which occur within nuclei, and in certain instances they are pathognomonic of the infecting agent. Although intranuclear inclusions are less characteristic of the specific virus, it is probable that they too are unique for each virus that causes them, notwithstanding one's inability to differentiate them accurately at present. In the diagnosis of a virus infection one also takes into account the type or types of cells involved and the effect on them of the agent concerned

Attention is called to a renal neoplasm in the newborn resembling Wilms' tumor of older children, but with a distinctive gross and microscopic appearance. Similar neoplasms are recorded in the literature and have a benign course. Nephrectomy is considered adequate treatment for these lesions that we choose to designate as renal hamartomas in the newborn. Because these hamartomas of the kidney in the newborn are benign in contrast to Wilms' tumor, radiotherapy and chemotherapy should be withheld in the newborn with a renal neoplasm until a specific morphologic diagnosis is established. Arteriography may prove helpful in the detection of these benign renal tumors.

In 1911, Sistrunk 1 published our earlier experience at the Mayo Clinic with regard to the finding of intestinal parasites in individuals residing in the middle Northwest. Since then the examination of the stools in certain cases has led so frequently to the identification of entamebas that we have come to consider this infection as a relatively common one. In the diagnosis of the different types of amebas present, Craig's 2 description of the morphologic characteristics has been followed in our laboratories by Sistrunk and Sanford. Moreover, the recent work of Darling 3 and Craig 4 on the identity of Entamoeba tetragena with Entamoeba histolytica inclines us to prefer to group eases in which a morphologic diagnosis of either one of these parasites was made as Entamoeba histolytica . In this review, however, the former distinctions between tetragena and histolytica are maintained because of any interest that may remain in connection

Summary 1)Six thousand two hundred and eighty-one specimens of sputum or bronchial secretions from 2,066 patients were studied by cytologic techniques. Two hundred and forty-one patients had bronchogenic cancer diagnosed by pathologic studies. 2)A positive cytologic diagnosis was made in 55 per cent of these 241 patients. When five or more sputum specimens were examined, the accuracy rose to 90 per cent. 3)The clinical applications of cytologic diagnostic techniques are discussed: a)Cytology is of value to the thoracic surgeon in establishing a reliable preoperative morphologic diagnosis of lung cancer. b)A positive cytologic diagnosis may be made in many cases where the lesions are located in the periphery of the lung or upper lobe bronchi where bronchoscopic examinations are of limited value. c)Difficult diagnostic problems may be solved when a definite morphologic diagnosis of cancer is made by positive cytologic studies. d)In patients with coexistent pulmonary tuberculosis and bronchogenic carcinoma, cytologic studies may clarify a confusing clinical picture. e)Cytologic studies of sputum may be utilized as routine screening procedures on patients with minimal or no pulmonary symptoms. 4)In our series of pathologically proved bronchogenic cancer, a positive cytologic diagnosis was made oftener and sooner than other morphologic diagnoses. In 47 per cent of these cases cytology was the first diagnostic procedure to establish a morphologic diagnosis. 5)Earlier diagnoses will be made when cytologic techniques are applied immediately after cancer is suspected. 6)Earlier diagnoses will be made when this diagnostic method is utilized on patients with equivocal lung lesions detected by routine roentgen surveys. 7)Earlier diagnoses will be made when patients with cough and sputum—whether cancer is suspected or not—are routinely studied by cytologic techniques.

The fatty meal was of value in diagnosing noncalculous filling defects in the proximal half of the gallbladder. It was of minimal value in diagnosing stones. Without the fatty meal, a morphologic diagnosis would have been missed in about 1 per cent of our material. It was of limited value in the diagnosis of function, as a possible manifestation of cholecystitis. It is to be recommended not routinely, but in those patients with gravitational suboptimal density in the infundibulum, and the unusual case of suboptimal concentration without the demonstration of stones in spite of the additive technique. Under these conditions, about one-third of the examinations will require the fatty meal.

Allergy is an acquired specific alteration in the capacity of the system to react, brought about by an antibody mechanism. Conventionally Antibodies are modified serum globulins that make it possible for certain serologic and/or cellular reactions to develop; the term "antibody" is extended to include a cell with specifically altered properties toward the antigen. In primary allergic dermatoses the cutaneous lesions develop as a direct consequence of the antigen-antibody union; erythema nodosum and other "id" reactions are of this type. In nonprimary allergic dermatoses there is some less direct relationship to the allergic process; most cases of atopic dermatitis are of this type. Nonprimary allergic sensitivity, like the primary types, can be either immediate or delayed. H'story taking and skin testing are extremely valuable and often essential for the etiological diagnosis; but they never establish the morphologic diagnosis, which is the physician's first responsibility. Skin tests are sometimes worse than useless because so many atopic persons give numerous positive reactions that are etiologically irrelevant. There are no cutaneous tests that help to establish the diagnosis of infectious eczematoid dermatitis and nummular eczema, but the morphologic characteristics of these two dermatoses are fairly precise, so that these labels can be applied on the basis of inspection alone. The distinction between primary and nonprimary allergic dermatoses is of practical importance because it determines how the condition will respond to any interference with the antibody-antigen union.

No problem in pathology has caused so much interest, discussion and controversy in the last few decades as the syphilitic affections of the aorta. The pathologic anatomists were foremost among those who endeavored to throw more light on this question. Ignorance concerning the etiologic agent of syphilis, and the difficulty of morphologic diagnosis postmortem have prevented and delayed the ultimate solution of this problem. First I shall attempt to present a brief historical survey in order to show with what zeal and with what perseverance the solution was pursued. The oldest experiences concerned observations and descriptions of the aortic aneurysms. The first fact which the old observers thereby determined was the occurrence of aneurysms of the aorta in comparatively young persons at a time when the changes of aortic intima due to increasing age cannot bring about any serious damages to the aortic tube. Therefore the atheromatous changes of the