[Thymoma and pancytopenia]. / Tymom og pancytopeni.

Thymomas are often associated with a variety of autoimmune disorders including various cytopenias. Rare cases have been associated with pancytopenia. We describe a patient with an invasive thymoma treated with thymectomy and subsequent radiation therapy. A few months later, rapidly progressing pancytopenia developed. Treatment with antibiotics, immunoglobulin, high-dose steroids and granulocyte-colony stimulating factor (G-CSF) had no effect, and the patient died within two months of overwhelming septicaemia complicated with intracranial haemorrhage. We review the literature and discuss therapies.

Systemic and deep-seated infections caused by Arcanobacterium haemolyticum.

Arcanobacterium haemolyticum has been implicated mainly in non-streptococcal pharyngitis and wound infections. Rarely, it has been reported to cause systemic infection, often in combination with other pathogens. Two cases of systemic and deep-seated infections caused by Arcanobacterium haemolyticum are reported, and the literature is reviewed. Sixteen cases of bacteremia and seven cases of non-bacteremic deep-seated have been published previously. Eight of the bacteremic and two of the non-bacteremic cases occurred in younger, apparently healthy immunocompetent patients. Six patients had infections of the central nervous system. The optimal treatment of infections caused by Arcanobacterium haemolyticum is not known. Although in vitro susceptibility tests have demonstrated tolerance of Arcanobacterium haemolyticum to penicillin, penicillins with or without aminoglycosides have been the most widely used antibiotics, in most cases with success.

[Intravascular malignant lymphomatosis]. / Intravaskulaer malign lymfomatose.

Intravascular malignant lymphomatosis (IML) is a rare form of extranodal non-Hodgkin lymphoma characterized by proliferation of malignant lymphoid cells within the lumen of small blood vessels. We describe a case of IML presenting with non-specific pulmonary symptoms, weight loss, intermittent fever and a confusing collection of laboratory findings. Later on the patient developed cardiac symptoms, and finally diffuse cerebral symptoms and skin lesions. His condition deteriorated and he died within six months. The diagnosis of IML was made at autopsy. Complete remission and long-term disease-free survival may be obtained with standard chemotherapy directed at high-grade lymphomas. It is important to remember IML in the differential diagnosis of patients with confusing and changing ischaemic symptoms and signs from several organs.