Correspondence
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References 1 . Leach IH. MacLennan KA. Gastric lymphoma associated with mucosal and nodal granulomas: a new differential diagnosis in granulomatous gastritis. Histopathology 1990: 17; 87-89.
Micronodular hyperplasia of type I1 pneumocytes
Figure 2. Mucus material within the stomach wall surrounded by a foreign body-type giant cell granulomatous reaction. H & E. x 200.
Sir: We published a case of micronodular pneumocyte hyperplasia associated with tuberous sclerosis'. We recently had the chance to see a second case, this time without association with tuberous sclerosis. An open lung biopsy was performed on a 52-year-old male patient because of recurrent pneumothorax. Tuberculosis many years ago was the only noteworthy lung disease. No signs of tuberous sclerosis were found in a careful clinical examination. The lung biopsy showed small grayish-white nodules, randomly distributed. The largest one measured 2 mm. Histologically the lesions consisted predominantly of a nodular proliferation of cuboidal transformed pneumocytes. Immunohistochemica1 investigations showed an identical reactivity as was found in micronodular pneumocyte hyperplasia. Micronodular pneumocyte hyperplasia thus represents another tumour lesion which may or may not have an association with tuberous sclerosis. It probably belongs to the spectrum of benign adenomatous lesions of the lung. Together with lymphangioleiomyomatosis, it should be placed in a group of benign lung tumours with possible association to tuberous sclerosis.
H.H.Popper further malignant tumour could be identified in the specimen. As Leach & MacLennan point out, granulomatous inflammation is an uncommon finding in the stomach and is invariably benign. Their observation and this one, giving an association between an early gastric signet ring cell adenocarcinoma and granulomatous gastritis, we believe, deserve recognition. Clearly the link between granulomatous disease and tumour of stomach must be more vigorously pursued beyond routine tissue sampling, if malignancy is not immediately apparent. The effect of an early or occult neoplasm could be allpervasive, with tragic results. A-M.H.Rashid R.Menai Williams Department of Histopathology, Royal Berkshire Hospital, Reading R G l S A N , U K
Institute of Pathology, University of Graz, Medical School, Auenbruggerplatz 25, A-8036 Graz. Austria
References 1 . Popper HH. Juettner-Smolle FM. Pongratz MG. Micronodular hyperplasia of type-I1 pneumocytes-A new lung lesion associated with tuberous sclerosis. Histopnthology 1991: 18: 347-354.
Smooth muscle tumours of the external genitalia Sir: I read with great interest the clinicopathological analysis of smooth muscle tumours of the external
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References 1 . Leach IH. MacLennan KA. Gastric lymphoma associated with mucosal and nodal granulomas: a new differential diagnosis in granulomatous gastritis. Histopathology 1990: 17; 87-89.
Micronodular hyperplasia of type I1 pneumocytes
Figure 2. Mucus material within the stomach wall surrounded by a foreign body-type giant cell granulomatous reaction. H & E. x 200.
Sir: We published a case of micronodular pneumocyte hyperplasia associated with tuberous sclerosis'. We recently had the chance to see a second case, this time without association with tuberous sclerosis. An open lung biopsy was performed on a 52-year-old male patient because of recurrent pneumothorax. Tuberculosis many years ago was the only noteworthy lung disease. No signs of tuberous sclerosis were found in a careful clinical examination. The lung biopsy showed small grayish-white nodules, randomly distributed. The largest one measured 2 mm. Histologically the lesions consisted predominantly of a nodular proliferation of cuboidal transformed pneumocytes. Immunohistochemica1 investigations showed an identical reactivity as was found in micronodular pneumocyte hyperplasia. Micronodular pneumocyte hyperplasia thus represents another tumour lesion which may or may not have an association with tuberous sclerosis. It probably belongs to the spectrum of benign adenomatous lesions of the lung. Together with lymphangioleiomyomatosis, it should be placed in a group of benign lung tumours with possible association to tuberous sclerosis.
H.H.Popper further malignant tumour could be identified in the specimen. As Leach & MacLennan point out, granulomatous inflammation is an uncommon finding in the stomach and is invariably benign. Their observation and this one, giving an association between an early gastric signet ring cell adenocarcinoma and granulomatous gastritis, we believe, deserve recognition. Clearly the link between granulomatous disease and tumour of stomach must be more vigorously pursued beyond routine tissue sampling, if malignancy is not immediately apparent. The effect of an early or occult neoplasm could be allpervasive, with tragic results. A-M.H.Rashid R.Menai Williams Department of Histopathology, Royal Berkshire Hospital, Reading R G l S A N , U K
Institute of Pathology, University of Graz, Medical School, Auenbruggerplatz 25, A-8036 Graz. Austria
References 1 . Popper HH. Juettner-Smolle FM. Pongratz MG. Micronodular hyperplasia of type-I1 pneumocytes-A new lung lesion associated with tuberous sclerosis. Histopnthology 1991: 18: 347-354.
Smooth muscle tumours of the external genitalia Sir: I read with great interest the clinicopathological analysis of smooth muscle tumours of the external
