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The histopathology of Fuchs' heterochronic iridocyclitis has been infrequently documented. It is surprising for, in the opinion of some observers, the syndrome constitutes about 2% of all cases of uveitis. 1 Its etiology and pathogenesis are largely unknown. It is characterized by unilateral (rarely bilateral) hypopigmentation of the iris, low-grade signs of chronic inflammation in the anterior chamber and vitreous, and, in some cases, cataract and glaucoma. 2 The striking transillumination of the iris has been considered to be a secondary manifestation of atrophy and sclerosis of the stroma and of patchy depigmentation of the epithelium. In large measure, lack of interest in this syndrome has been engendered by the belief that there may be no cause-and-effect relationship between this type of heterochromia and a specific, unique form of uveal inflammation. If true, there would be no reason to consider Fuch's heterochromic iridocyclitis a distinct nosologic entity. 3 In the

The use of sputum cytology has demonstrated that conventional bronchoscopic equipment often fails to permit localization of earlier, more peripheral tumors. The flexible fiberbronchoscope now opens up new bronchial horizons but does not replace rigid instruments. Our experience in 300 fiberoptic studies has suggested certain guidelines for determining in which patients the flexible equipment should be used and in which conventional instruments are preferred. By means of a comprehensive endoscopic study, we successfully localized eight “sputum positive,” radiologically occult bronchogenic carcinomas. The fiberbronchoscope is essential in searching the segments for subtle changes of early cancer. These findings are documented by a color television system. A detailed pathological study demonstrates the importance of preoperative marginal biopsies in excluding carcinoma in situ which may extend some distance from even small tumors. In 94 patients with cancer we located 85 (90%) by direct visualization and/or bronchoscopic specimens. Sixty-eight (72%) involved primarily the segmental or more peripheral areas while main bronchus tumors were large and suggested spread from a more distal site of origin. The fiberbronchoscope has greatly extended our capabilities, allowing a better understanding of early lung cancer and greatly improved localization.

Early bronchogenic carcinoma detected by sputum cytology frequently cannot be localized by conventional bronchoscopic techniques. Six occult tumors were localized in this study with new techniques in differential cytology and flexible fiberoptic equipment. A three-phase study is carried out including: 1. Cytologic localization, 2. Fiberoptic survey, and 3. Histologic mapping of bronchial margins. Findings are recorded by means of a color television documentation system. A review of the surgical pathology in our four cases has revealed a relatively large area of in-situ carcinoma in the region of very small invasive tumors.

Toxic elements of the environment adversely affect tissues, structures, and functions of the respiratory system. Many of these changes are reflected in cells and other elements of pulmonary secretions. Natural defense mechanisms of the respiratory tract are impaired, rendered less effective, and eventually invalidated by toxic inhalants. Tissue changes in response to these toxic inhalants and irritants, especially of the, epithelium can be studied and evaluated cytologically with detection and identification of the various degrees of atypia. These cytologic alterations appear to be valid indications of the carcinogenic potentialities of environmental toxins. In three occupational groups increased frequency of these changes appear to parallel the presence of known or suspected carcinogenic environmental substances. Their cytologic identification may thus help to indicate those individuals or groups for whom preventive or other measures are most needed.

Pleural fluids from 182 patients were studied prospectively. Although red blood cell (RBC) counts of greater than 10,000/cu mm were common with all types of effusions, an RBC count greater than 100,000/cu mm strongly suggested malignant neoplasm, pulmonary infarction, or trauma. Of 31 exudative effusions with a lymphocytic predominance, 30 were due either to tuberculosis or neoplasm. No tuberculous effusions had more than 1% mesothelial cells, while most other effusions contained at least 5% mesothelial cells. Pleural fluid cytological studies showed malignant cells in 33 of 43 patients with effusions due to tumor. More than 50% of the effusions with originally inconclusive pleural fluid cytological findings were proved to be due to neoplasm. When tumor is suspected, at least three separate pleural fluid specimens should be submitted for cytological examination.