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A fully investigated case of metastasizing "desmoplastic" medulloblastoma is reported in a 25 year old man who succumbed 2½ years following craniotomy and radiotherapy, and who exhibited the unusual picture of a leukoerythroblastic anemia and diffuse osteosclerosis.

Unusually large, oval and pleomorphic secretory granules were noted by electron microscopy in an acidophilic adenoma of the pituitary. The tumor, which was removed by surgery from a 42-year-old woman with elevated blood growth hormone levels and the clinical features of acromegaly, was found to contain growth hormone by the immunoperoxidase technique. This ultrastructural abnormality of secretory granules was not reported so far and was not seen among the 58 cases of growth hormone-producing adenomas investigated in our laboratory. The present case clearly shows that the cytogenesis and cellular composition of pituitary adenomas cannot be determined by solely examining the size and shape of secretory granules.

A 45-year-old female with selective deficiency of C4 and systemic lupus erythematosus developed puzzling gastrointestinal and systemic symptoms in the last 6 months of her life. Extensive investigation of the gastrointestinal tract did not yield any diagnosis, and the patient died shortly afterwards. Autopsy revealed evidence of a typical Whipple's disease of the jejunum and lymph nodes. This association has not been previously described. The disease is reviewed with emphasis on its being an opportunistic infection in an immunosuppressed host with a complement deficiency and SLE.

In the morphologic study of surgically-removed pituitary adenomas, histology, electron microscopy as well as immunocytochemistry at the light microscopic and ultrastructural level were used. In material of 370 adenomas, 226 tumors (61.7%) were found to derive from the “acidophil” cell line. Thirty-one of these were densely granulated growth hormone cell adenomas; 38 were sparsely granulated growth hormone cell adenomas; 1 was composed of densely granulated prolactin cells and 114 of sparsely granulated prolactin cells. The latter represent the most common tumor type in the human pituitary. Twentyone adenomas were mixed, consisting of growth hormone cells and prolactin cells; 17 tumors were classified as acidophil stem cell adenomas. The latter are immature, aggressive neoplasms assumed to originate in the common precursor of growth hormone cells and prolactin cells.