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bed indicated that the tumor was actively secreting these two hormones, cytochemi- cal heterogeneity was seen in the tumor, in which two distinct populations of cells, one secreting ACTH and beta- endorphin and the other secreting CRH, were identified. This patient, thus, had an unusual syndrome of ectopic ACTH and ectopic CRH secretion.

Ectopic Adrenocorticotropin Syndrome Caused by Lung Cancer that Responded to Corticotropin-Releasing Hormone. Suda, T., Kondo, M., Totani, R. et al. Department of Medicine, Institute of Clinical Endocrinology, Tokyo Women's Medical College, Tokyo 162, Japan. J. Clin. Endocrinol. Metab. 63: 1047-1051, 1986.

ACTH responses to corticotropin- releasing hormone (CRH) were studied in three patients with the ectopic ACTH syndrome caused by lung cancer. Plasma ACTH responded to synthetic CRH in two of three patients. Tumor tissues obtained from these two patients contained CRH and ACTH. In one patient, tumor ACTH secre- tion was stimulated by CRH in vitro. Tumor CRH was immunologically, chromatographically, and biologically similar to hypothalamic CRH. In addition, multiple forms of immunoreactive beta- endorphin were present in plasma and the tumor extracts. From these results, we conclude that some patients with the ec- topic ACTH syndrome have tumors that produce both ACTH and CRH and that CRH can stimulate ACTH secretion by such tumors. Other patients with the ectopic ACTH syndrome do not have ACTH responses to CRH. Therefore, procedures other than CRH testing are needed to differentiate with Cushing's syndrome due to ectopic ACTH/CRH production from those with Cushing's disease, since the latter also usually have ACTH responses to CRH.

Long-Term Survival After Brain Metastasis From Lung Cancer. Sarma, D.P., Weilbaecher, T.G. Department of Pathology, Veterans Administration Medical Center and Louisiana State University Medical School, New Orleans, LA, U.S.A. Cancer 58: 1366-1370, 1986.

A case is reported of prolonged sur- vival after lobectomy for large cell un- differentiated carcinoma of the lung and resection of metastatic carcinoma of the brain. The patient had survived ii years 5 months after lung resection and i0 years 4 months after excision of brain metastasis. A review of the reports of another 12 patients who survived 5 years or longer after craniotomy, shows that the surgical excision of a single metas- tatic lesion of the brain with or without postoperative irradiation offers the best hope for prolonged survival.

Lung Cancer Following Treatment for Lymphoma. Abernathy, D., Beltran, G., Stuckey, W.J. Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, U.S.A. Am. J. Med. 81: 215-218, 1986.

Six patients with lung carcinoma from a group of 206 treated for non-Hodgkin's lymphoma and 82 with Hodgkin's disease are described. Review of the literature shows that an increased risk of solid tumors following treatment for lymphoma has not been conclusively demonstrated. However, some series have reported a relative risk two to three times normal. A few investigators have suggested that there is an increased risk of carcinoma of the lung following treatment for lymphoma. The development of this tumor in six of 288 patients with lymphoma sug- gests that there may indeed be an association. Patients who have been treated for lymphoma should be observed for development of both hematologic and solid neoplasms. In particular, a patient who is a smoker should be investigated thoroughly for lung carcinoma if suspi- cious symptoms or new chest radiographic findings develop.

Sclerosing Adenosis in the Breast of a Man with Pulmonary Oat Cell Carcinoma: Report of a Case. Bigotti, G., Kasznica, J. Department of Pathology, Columbia Presbyterian Medical Center, New York, NY 10032, U.S.A. Hum. Pathol. 17: 861-863, 1986.

A case of sclerosing adenosis of the male breast is reported. This very unusual lesion was found at autopsy in a man with pulmonary oat cell carcinoma. In females, sclerosing adenosis is a well- characterized entity. In males, however, it does not normally occur because of the physiologic lack of lobular development. The possible pathomechanism of this le- sion is briefly discussed, with an em- phasis on presumed lobular stimulation by tumor-elaborated ectopic hormone.

Renal Metastases from Carcinoma of the Lung. Becker, W.E., Schellhammer, P.F. Depart- ment of Urology, Eastern Virginia Medical School, Norfolk, VA 23510, U.S.A. Br. J. Urol. 58: 494-498, 1986.

Five cases of clinically manifest solitary and bilateral renal lesions metastatic from the lung are presented. These cases are unusual in that renal metastases are usually silent lesions discovered at autopsy. Review of the autopsy data from this hospital iden- tified renal metastases in 19% of patients who died from carcinoma of the lung. This incidence parallels that of other series. A solid renal lesion which is identified in a patient with a history