On univariate survival analysis using the Kaplan– Meier product-limit method and log rank test, lower CB immunoreactivity (£50% of positive tumour cells) appeared prognostically advantageous over more extensive reactivity when predicting disease-specific survival (89% versus 48% at 5 years, P = 0.038) (Figure 2), but not so locoregional control or failure- free survival. None of the other three studied param- eters showed any prognostic value. In head and neck carcinomas, more convincing results have been reported from biochemical studies, revealing a signifi- cant prognostic influence of cysteine protease inhibitor levels in tissue cytosols. 12 acknowledgement Supported by the Slovenian Research Agency Grant P3-0307. S Primoz ˇ I Oblak N Gale 1 LS ˇ mid 2 J Kos 3 Department of Radiation Oncology, Institute of Oncology, 1 Institute of Pathology, Medical Faculty University of Ljubljana, 2 University Department of Otorhinolaryngology and Cervicofacial Surgery, Clinical Centre and 3 Department of Pharmaceutical Biology, Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia 1. Strojan P. Cathepsins and their endogenous inhibitors in clinical oncology. Radiol. Oncol. 1996; 30; 120–133. 2. Strojan P. Cisplatin based chemotherapy: the only alternative in chemoradiation of head and neck cancer? Experience of the Institute of Oncology Ljubljana, Slovenia. Rep. Pract. Oncol. Radiother 2007; 12; 329–337. 3. Strojnik T, Z ˇ idanik B, Kos J, Lah TT. Cathepsin B and L are markers for clinically invasive types of meningeomas. Neuro- surgery 2001; 48; 598–605. 4. Lah TT, Kalman E, Najjar D et al. Cells producing cathepsins D, B and L in human breast carcinoma and their association with prognosis. Hum. 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A report of two patients with bilateral disease DOI: 10.1111/j.1365-2559.2008.03146.x Sir: Sclerosing haemangiomas (SH) are rare pulmonary tumours, first described by Liebow and Hubbell in 1956. 1 Despite initially being classified as endothelial in origin, more recent ultrastructural and immuno- histochemical data have shown that they are epithelial with evidence of differentiation towards pneumo- cytes. 2,3 In addition, rare coexistent foci of neuroendo- crine (NE) differentiation may be found. 3 Most cases are solitary, occurring in non-smoking young women, and behave in a benign fashion. Herein, we present two cases of combined SH and tumourlets, with bilateral widespread nodularity that mimicked disseminated malignancy. Follow-up data at 6 and 24 months show that behaviour is indolent without therapy in both cases. Both patients (female aged 43 years, and male aged 47 years) presented with non-productive cough and wheeze, without dyspnoea. One patient had undergone resection of a lentigo maligna from the anterior chest wall 4 years previously. Lung function tests in one case were within normal limits. Imaging showed bilateral multiple nodular opacities, with the suspected diagno- sis being disseminated malignancy. Surgical lung biopsies of both cases showed multi- ple SH of variable sizes up to 4 mm and multiple tumourlets (Figure 1), with some nodules comprising both cell types. In areas comprising SH, surface epithelial cells were immunopositive for epithelial membrane antigen (EMA; Dako, Ely, UK; 1:20 dilu- tion), thyroid transcription factor (TTF)-1 (Dako; 1:80 dilution) and MNF116 (Dako; 1:50 dilution), with the stromal cells positive only for TTF-1 and EMA 614 Correspondence Ó 2008 The Authors. Journal compilation Ó 2008 Blackwell Publishing Ltd, Histopathology, 53, 599–617.