An environmental control strategy incorporating widely available technology may have played an important role in controlling this outbreak of construction-associated invasive aspergillosis.

Primary splenic lymphoma is a relatively infrequent cause of splenomegaly, its reported incidence being less than 1%. Nonetheless, various series have reported on its occurrence and its unfavorable prognosis, but these series have reported data on heterogenous populations, including many patients with nodal or hepatic disease. We report on a series of nine patients with primary splenic lymphoma. None of these patients had biopsy-proven evidence of extrasplenic disease and were categorized as involving spleen only (stage 1) or spleen and splenic hilum (stage 2). In this series, classified by the recent N.C.I. working formulation, four patients had intermediate or high-grade histology and five patients had low-grade histology. There was no correlation between histological subtype and prognosis, nor could other factors be delineated to explain their favorable prognosis. The median survival in this group of patients was 7.48 years, and no evidence of relapse has been documented. The data suggest that primary splenic lymphoma, treated by splenectomy alone or combination therapy, may be potentially curative. Further studies should address the question of aggressive accurate staging in hopes of obtaining homogenous patient populations so that appropriate treatment in primary splenic lymphoma can be better defined.

Erythrocytosis after renal transplantation represents an anomaly of both IGF-I and its major binding proteins. Further studies are under way to better define this dysregulation and determine whether IGF-I can play a more generalized role in secondary forms of erythropoiesis.

Although the spleen is frequently involved in disseminated non-Hodgkin's lymphoma (NHL), splenic presentation as the initial or only site of disease is uncommon. The true incidence of splenic lymphoma is difficult to estimate because of the variable definition of this disease, however, the diagnosis of primary lymphoma of the spleen should be limited to involvement of only the spleen and splenic hilum. Using this restricted definition, our experience suggests that the prognosis of NHL of the spleen, when pathologically staged, may have a favorable prognosis which approximates that seen with limited stage NHL at other sites. The influence of pathologic subtype on natural history and the impact of adjuvant therapy are discussed.