The streptolysin 0 hemolysis method for isolation of cancer cells in the blood was employed for direct observations of the incidence and some characteristics of circulating megakaryocytes. In a series of 168 patients, circulating megakaryocytes were found in 77 per cent of the blood samples. Each sample contained an average of 1.2 megakaryocytes per ml. of blood. The megakaryocytes were most frequent in pulmonary arterial blood and a number of the cells had an apparently intact abundant cytoplasm. Pulmonary venous blood contained megakaryocytes much less frequently. These were almost always without cytoplasm or with only a narrow rim of it and as a rule small naked nuclei or their fragments were found. Manipulation of lung tissue resulted in an increased amount of megakaryocytes in the pulmonary venous blood. The megakaryocytes in pulmonary and systemic circulation were more numerous in advanced malignant disease than in early cases, and more common in inflammatory disease or severe anemia than in other nonmalignant disease.

Fine-needle aspiration biopsy of the spleen was performed On IOI patients with suggested sarcoidosis; it was the final diagnosis In 79. Adequate specimens were obtained in all cases with a O.8x80 mm or O.7x40 mm disposable needle. Fine-needle biopsy specimens of the spleen showed a granulomatous reaction in 19 out of the 79 cases with sarcoidosis (24%). There were three minor biopsy complications that required no treatment.

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ABSTRACT. Simultaneous occurrence of medullary and papillary thyroid carcinoma in the same gland is obviously extremely rare. One such patient is reported here and two pairs of sibs are described, one with medullary and the other with papillary thyroid carcinoma.