We examined frozen sections of frontal cortex, medulla, and dorsal root ganglia from a patient with small-cell lung cancer and paraneoplastic encephalomyelitis, involving the medulla and dorsal root ganglia, with a panel of antibodies reactive for IgG, IgM, C3, B cells, T cells, T cell subsets, macrophages, and class I and II (HLA-DR) major histocompatibility complex (MHC) antigens. We detected an antineuronal antibody (anti-Hu) in the serum and CSF of the patient and found deposits of IgG in the periphery of some neurons in dorsal root ganglia. The infiltrates were almost exclusively T cells with a predominance of CD8-positive cells. Neurons did not express class I or II MHC antigens. Satellite cells in the dorsal root ganglia from the patient and controls were HLA-DR-positive. These data indicate that CD8-positive T cells predominate in the inflammatory infiltrates of paraneoplastic encephalomyelitis. IgG deposits may be relevant in the damage of the sensory neurons.

A 19-year-old man with paroxysmal nocturnal hemoglobinuria treated for 3 years with Methandienone was admitted to the hospital with hemoperitoneum due to the rupture of an hepatic tumor. Histology revealed that it was a benign liver cell adenoma, with a pathologic appearance and mode of clinical presentation closely resembling those of cases observed to develop in association to contraceptive steroids. " Doubt has been raised about the histologic diagnosis of the latter, for the data presented are not always convincing as to the malignant nature of these growths.' Recently, a patient with a hepatic adenoma after prolonged treatment with oxymetholone was described. 2 ' We report a patient with a benign liver cell adenoma associated with Methandienone treatment, who seems to be the second recorded case of adenoma associated with androgenicanabolic steroids. CASE REPORTA 19-year-old man, treated for paroxysmal nocturnal hemoglobinuria (PNH) with Methandienone for 3 years, was admitted to hospital in May, 1975 patient was included in a cooperative therapeutic trial of the effect of androgenic-anabolic steroids on bone marrow insufficiency* and administered Methandienone in a dose of 65 mg daily. After 20 months of treatment a slight improvement of the pancytopenia was noted. In January, 1975, he had the first crisis of PNH, which reappeared in April, in spite of the treatment. In May, 1975, he was readmitted to the hospital complaining of left hypocondrial pain. Physical examination showed signs of peritonitis and an abdominal tap revealed the presence of blood. At laparotomy two small tumors were found in the left lobe of the liver. One of the tumors was ruptured and was responsible for the hemoperitoneum. Resection of the affected liver was done and the postoperative course was uneventful. Serum alpha-1-fetoprotein was negative in blood taken immediately after operation. Histological ExaminationAt microscopic examination both tumors, 10 X 60 X 30 cm and 80 X 45 X 25 mm in size, were pale and capsulated. The larger one had an extensive area of hemorrhagic necrosis at the surface.Microscopic examination showed a well-differentiated lesion, composed of liver cells resembling normal hepatocytes, arranged in plates thicker than in normal liver. Within the tumor there were no portal tracts, or biliary structures. Many dilated sinusoids and large spaces containing blood were seen, some of them with endothelium layer and other with no wall, as well as large areas of hemorrhagic necrosis (Fig.

Molecular, kinetic, and functional studies were carried out on erythrocytes and leukocytes in a Spanish male with G6PD deficiency, congenital nonspherocytic hemolytic anemia (CNSHA), and increased susceptibility to infections. G6PD activity was absent in patient's red cells and was about 2% of normal in leukocytes. Molecular studies using standard methods (WHO, 1967) showed G6PD in the patient to have a slightly fast electrophoretic mobility at pH 8.0 with otherwise normal properties (heat stability at 46 degrees C, apparent affinity for substrates, optimum pH, and utilization of substrate analogues). Other tests showed the patient's granulocytes to engulf latex particles normally, but to have impaired reduction of nitroblue tetrazolium and ferricytochrome-c as well as reduced iodination. Chemotaxis and random migration of the patient's granulocytes were normal as were myeloperoxidase, leukocyte alkaline phosphatase (LAP), and ultrastructural features. The molecular characteristics of G6PD in the patient differed from those of all previously reported variants associated with CNSHA, so the present variant was provisionally called G6PD Barcelona to distinguish it from other G6PD variants previously described. Possible mechanisms for the severe deficiency of G6PD in erythrocytes and granulocytes was investigated by studies on the immunologic specific activity of the mutant enzyme.

A patient with acute leukaemia presenting with superior vena cava syndrome due to a large mediastinal mass is reported. The presence of blast cells with Auer rods in peripheral blood and bone marrow allowed the diagnosis of acute myeloblastic leukaemia. Following intensive chemotherapy the patient achieved a complete remission, with disappearance of the signs of venous obstruction and normalization of the chest roentgenogram. Although no histopathological documentation of the mediastinal tumor was available, its myeloblastic origin was assumed in view of the clinical course.

X 0 br m 2 1 5 0 -c 1 0 0i r A . post 0 4 Values are pvtm as mean 5 SD Fig 1. Effect of leukapheresis on peripheral blood lymphocyte (A) and platelet (6) counts.collection by apheresis rarely requires a central vein access and results in a rapidly reversible thrombocytopenia and lymphocytopenia, which tends to resolve within the 3 months after the procedure.