The incidence of primary intracranial glioblastoma multiforme originating in the pineal region is exceedingly rare. Diffuse leptomeningeal involvement, including spinal subarachnoid metastases, by a primary glioblastoma multiforme of the pineal region has not been reported. A report of a case of primary glioblastoma multiforme of the pineal region accompanied by diffuse leptomeningeal and nodular spinal subarachnoid metastases is presented. Extensive evaluation of the complete neuraxis, including histologic examination, in all cases of primary pineal neoplasm appears to be of both diagnostic and therapeutic value.

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An 80-year-old black woman with a clinical diagnosis of unclassified malignant lymphoproliferative disease experienced acute pneumonia four days after chemotherapy was begun. Open lung biopsy revealed acute suppurative pneumonia with dense neutrophilic alveolar infiltrates but without granulomas or caseous necrosis. Numerous intra- and extracellular gram-negative bacilli were present, some of which were acid-fast. Routine bacterial, fungal, and mycobacterial cultures were negative. The organism was successfully cultivated by embryonated egg inoculation with subsequent transfer to buffered charcoal yeast extract agar. Serologic studies using the indirect fluorescent antibody technic confirmed the presence of an organism recently described as the "Pittsburgh pneumonia agent," further suggesting that this particular organism is a significant cause of suppurative pneumonia in the immunocompromised host.