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In the past years, the number of hospital clinical autopsies have significantly decreased, with the risk of loosing some of the functions of this procedure, among which the evaluation of the diagnostic accuracy, which has been considered as a health care quality index, stands out. In this paper, the consistency between clinical diagnosis and autopsies in a general hospital is studied, as well as its association to some potentially relevant factors. We review 91 autopsies performed in patients dying in the Service of Internal Medicine during a period of six years. Each case was classified though consensus among a clinician and a pathologist into: mayor clinicopathological discrepancy, minor discrepancy or complete consistency. The relationship between consistency and age, sex, average length of stay in the hospital and study period was analyzed. The 91 autopsies were performed on 64 men and 27 women. The mean age was 63 years and the average length of study in the hospital was 9.7 days. The global consistency was 71.4%. In 15 (16.5%) cases, a major discrepancy was observed and in 11 (12.1%), a minor discrepancy. No differences were observed in the degree of consistency with respect to age, sex, average length of stay and study period. Cardiovascular diseases showed the greatest proportion of major discrepancies at the expense of three cases of pulmonary thromboembolism. We conclude that the degree of concordance in this study is consistent with other studies and we discuss the relevance of clinical autopsies regarding several aspects of health care.

A pseudomesotheliomatous adenocarcinoma, which is a rare form of peripheral pulmonary tumor with diffuse thickening of the pleural cavity mimicking a mesothelioma, and a malignant mesothelioma with a carcinoma like disseminating pattern are presented. The biopsy obtained by thoracotomy in one case, and the necropsy studies enabled the diagnosis by the microscopic pattern, the presence of mucosubstances (PAS diastase) and the immune histochemical profiles with antibodies against several antigenic groups (CEA, EMA, CAM 5.2, and Vimentin. The value of these techniques to differentiate adenocarcinomas and mesotheliomas is discussed. The presence of CEA orients to an epithelial origin of a neoplasia.

Deep cystic colitis is a rare disease of which about one hundred cases have been reported in the medical literature. Two forms are known, segmental and localized, the latter being the most frequent. We offer a case of a patient who developed a picture of deep localized cystic colitis on a previous surgical anastomosis, a very infrequent association. The value of intraoperative biopsy in these cases is discussed. It is necessary to be aware of this entity and its clinicopathologic correlations to differentiate it, especially from the therapeutic and prognostic points of view, from well differentiated colorectal carcinoma and colloid (mucoid extracellular) carcinoma.

A description is offered of a toxic and febrile young patient with diarrheic syndrome of twenty days evolution secondary to extranodal lymphoma of cecal location. A concomitant immunity deficit--selective IgA deficit--appeared in the form of chronic mucocutaneous candidiasis and discoid lupus, and in the absence of familial antecedents. As a result of this case study, an association of gastrointestinal lymphoma of unusual location with an underlying immune disorder, the literature was reviewed.