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We detected Epstein-Barr virus (EBV) reactivation in a patient with mantle cell lymphoma (MCL). The patient, a 53-year-old Japanese man, had been referred to our hospital because of generalized lymphadenopathy, hepatosplenomegaly and lymphocytosis and gave a history of intense skin reactions to mosquito bites. The biopsied lymph node contained a monotonous proliferation of medium-sized lymphocytes with scant cytoplasm and slightly irregular nuclei that were CD5 + , CD20 + and CD23 -. Antibody titers of IgG against EBV viral capsid antigen and early antigen were increased, and EBV was detected in the lymphoma cells. This case may suggest a relationship between EBV and MCL.

Studies were made on a case of well-differentiated adenocarcinoma of the lung in which the serum levels of secretory IgA (sIgA) were very high. Immunotluorescent studies showed that secretory component (SC) was found to be diffusely distributed in cancer cells. The SC was detected in the supernatant of homogenates of cancer tissues from the primary site and lymph node with metastases. The SC extracted from cancer tissue and purified colostral SC were antigenically identical. The authors conclude that the adenocarcinoma cells produced SC and secreted it into the bloodstream and that the binding of SC with polymeric IgA resulted in the hypergammaglobulinemia of sIgA. This appears to be the first reported case of SC-producing lung cancer. The authors' findings suggest that the high serum levels of sIgA in cancer patients may be due to the production and secretion of SC by tumor cells themselves rather than the reabsorption of intralurninal slgA into the circulation through a damaged epithelium.

The case of a patient with HELLP syndrome, who was unresponsive to supportive management but successfully treated with plasma exchange, is presented. The significance of plasma exchange in the treatment of HELLP syndrome is discussed.

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