Systemic karyomegaly associated with interstitial nephritis was first described in 1978 by Mihatsch. Seven cases have been reported to date. We give an account of an autopsy case of systemic karyomegaly in a 30-year-old Italian man. Bizarre enlargement of nuclei was found in renal tubular epithelial cells, Schwann cells and in smooth muscle cells of vessels and bowel and, less obviously, in endothelial and adventitial cells of vessels, in alveolar epithelial cells and in astrocytes of the brain. These findings were associated with chronic interstitial nephritis, nonspecific hepatopathy, adenocarcinoma of the rectum and multiple slerosis. The clinical course was marked by chronic renal failure, chronic haemodialysis and renal transplantation. The patient died 8 years after diagnosis in septic-toxic shock. The aetiology and pathogenesis of the disease are discussed.

Systemic karyomegaly associated with interstitial nephritis was first described in 1978 by Mihatsch. Seven cases have been reported to date. We give an account of an autopsy case of systemic karyomegaly in a 30-year-old Italian man. Bizarre enlargement of nuclei was found in renal tubular epithelial cells, Schwann cells and in smooth muscle cells of vessels and bowel and, less obviously, in endothelial and adventitial cells of vessels, in alveolar epithelial cells and in astrocytes of the brain. These findings were associated with chronic interstitial nephritis, nonspecific hepatopathy, adenocarcinoma of the rectum and multiple sclerosis The clinical course was marked by chronic renal failure, chronic haemodialysis and renal transplantation. The patient died 8 years after diagnosis in septic-toxic shock. The aetiology and pathogenesis of the disease are discussed.

58 consecutive prostatic glands of men without clinical prostatic cancer were investigated. In 40% of all over 50-year-old men (average age: 76 years) a prostatic cancer was found. The macroscopic diagnosis of stage I prostatic cancer was found to be unreliable. Since in routine necropsies the first and decisive evaluation of the prostate is based on macroscopic findings, most prostatic cancers are missed and only 3% are found on an average. To detect prostatic cancer with a minimal diameter of 3 mm reliably, 10-15 large histologic slides have to be investigated. The tumor size, the nuclear polymorphism, the frequency of perineural invasion and the number of inflammatory cells increase with histologic dedifferentiation. The results support the hypothesis, that the clinical prostatic cancer is in fact an enlarged, dedifferentiated stage I cancer. The clinical significance of stage I prostatic cancer is rather small because of the advanced age of the patients. Most of the patients die before the cancer becomes clinical.