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We experienced a case of papillary adenofibroma of the uterus presenting with perforated peritonitis. An 81-year-old woman was seen at the hospital because of an abrupt abdominal pain. CT visualized a low density mass mimicking myoma of the uterus. Barium enema revealed a stenosed portion in the sigmoid colon. A probable diagnosis of perforated diverticulitis of the sigmoid colon was made and laparotomy was carried out. A hard tumor protruding into and perforating at the serosa side of the right wall at the fundus of the uterus was found out. Hysterectomy and adnexectomy were performed. Histopathologically the excised tumor was diagnosed with perforated papillary adenofibroma of the body of the uterus. Papillary adenofibromas of the uterus are rare, especially such a tumor presenting with spontaneous rupture as a complication that has not been reported so far.

We experienced a case of early gastric cancer of the anastomosed site occurred about 40 years after a gastrojejunostomy for gastroptosis. A 69-year-old woman was admitted to the hospital because of rectal bleeding of bright red in color. There was a previous history of undergoing gastrojejunostomy for gastroptosis at the age of 29. After admission upper gastrointestinal endoscopy visualized a relatively sharrow depression with slightly rough mucosa surface and two polypoid elevated lesions arround the anastomosed site. The patient was diagnosed as having a type IIc gastric cancer and gallstone. Subtotal gastrectomy (B-I) mainly involving the anastomosed site, partial excision of the jejunum with end-to-end anastomosis, and cholecystectomy were carried out. Histopathologically the cancer lesion was intramucosal cancer (tub2) growing around the oral side of the anastomosis, without infiltration into the jejunum nor lymph node metastasis. There have been 34 cases of gastric cancer following gastrojejunostomy including this case so far. Their average age was 62.3 years. The disease was common in men and often appeared following the operation for peptic ulcer. Their gastric cancers were detected after an average disease-free interval of 27.4 years. Gastric cancers frequently appeared at the anastomosed site and the half of them were in an early stage.

From November 1981 to the end of August 1984, 456 patients with breast lesions underwent aspiration biopsy cytology (A.B.C.). This study includes 109 for whom the diagnosis was histologically confirmed at surgical biopsy. Seventy-five lesions were histologically proven to be malignant and 34 were benign. The accuracy of diagnoses with A.B.C. was; true positive 86.7 per cent (65/75) of the time, true negative 82.6 per cent (28/34) of the time, false negative 5.3 per cent (4/75) of the time and false positive 5.7 per cent (2/34) of the time. Unsatisfactory or inadequate aspirated tissue made A.B.C. diagnosis difficult in 5.5 per cent (6/109) of the cases. Three out of 7 with malignant tumors, who were wrongly diagnosed as benign by A.B.C., had tumors with a diameter of 1.0 cm or less. Two benign cases which were falsely diagnosed as malignant also had small tumors about 1.0 cm in dia- meter. Although A.B.C. is more reliable than other conventional supple- mentary diagnostic techniques (mammography, ultrasonography, etc.), it is important to carefully follow clinically questionable cases which appear nega- tive, using A.B.C..

Sclerosing solution was injected into a parathyroid cyst through a needle used for aspiration biopsy cytology. One year has passed without a recurrence and a cure is expected.