Central nervous system (CNS) involvement was reviewed in 99 patients with adult T-cell leukemia/lymphoma (ATLL). Fifteen episodes of CNS involvement developed in ten of 99 patients (10.1%); nine had leptomeningeal involvement, whereas two developed intracerebral invasion, one developed cord involvement, and one developed both. CNS involvement was more frequent in the lymphoma type than in the other types of ATLL. Nuchal rigidity was not common (33%) and a syndrome of inappropriate secretion of antidiuretic hormone (ADH) occurred in association with CNS involvement (40%). Three episodes of marked hypoglycorrhachia also were noticed. The systemic progression of ATLL was the most common setting of CNS involvement (80%) and the major cause of death (80%). As for the acute and lymphoma types of ATLL, no significant difference was observed in survival between patients with and those without CNS involvement. These results indicate that CNS involvement is not an essential prognostic factor of ATLL and that it should be treated with systemic chemotherapy coupled with intrathecal chemotherapy. The control of systemic ATLL is important for the prophylaxis of CNS involvement.

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A case of allergic bronchopulmonary aspergillosis (ABPA) is described which presents left upper lobe collapse caused by Aspergillus terreus, an organism rarely found in ABPA. It is unusual for initial radiographic findings of ABPA to include extensive collapse.

A family with δ-thalassemia has been discovered, in which five members are thought to be δ-thalassemia homozygotes with complete deficiency of Hb A2, and three members are probably heterozygotes with low levels of Hb A2 (1.2-1.6%). In four members among these, persistence of fetal hemoglobin of Swiss type was observed. The formal genetics of these two entities was discussed. The proposita showed first thalassemia-like stigmata with iron deficiency anemia, but after iron therapy administered over 2 months, the stigmata disappeared. All the other members of the family were free from clinical symptoms with normal morphology, MCH, and osmotic fragility of the red cells.

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