[A case of mesothelioma of the pleura with pneumothorax].

A 49-year old man underwent an operation for pneumothorax, during which a tiny tumor on internal surface of the thoracic wall was extirpated. As the tumor proved to be malignant mesothelioma postoperatively, it was planned to be followed up strictly after discharge, but the patient did not visit for 6 months after discharge. When he was admitted again because of cough and fever, the mesothelioma had already disseminated diffusely in the whole thoracic cavity. So he underwent total pleuropneumonectomy, but died 49 days after operation.

Alpha-interferon treatment for adult T cell leukemia: low levels of circulating alpha-interferon and it's clinical effectiveness.

We describe a patient with adult T cell Leukemia to whom alpha-interferon therapy was highly effective. Although a combination chemotherapy (ACVP) first introduced was effective in reducing total leukocyte counts, the percentage of leukemic cells relative to total leukocyte counts was decreased first after the institution of alpha-interferon therapy. The patient is now under complete remission for four years. It was noted in this patient that circulating alpha-interferon, measured by a sensitive radioimmunoassay, was consistently low as compared with the value found in the age-, sex-matched healthy control (p less than 0.001). Since adult T cell leukemia is pathogenetically related to the retrovirus infection, low levels of circulating alpha-interferon of the patient may be important from both pathogenetic and therapeutic standpoints. Alpha-interferon therapy may be an useful additive for the chemotherapy of adult T cell leukemia.

Immunohistochemical and ultrastructural studies on histiocytosis in children.

Thirty-four cases of eosinophilic granulomas, 18 cases of diffuse histiocytosis-X, 2 cases of Letterer-Siwe-like syndrome with immunodeficiency, 4 cases of malignant histiocytosis and virus associated hemophagocytic syndrome were studied. On paraffin section, S100 protein, lysozyme, alpha-1-anti-trypsin, alpha-1-antichymotrypsin, alpha-2-macroglobulin, Transferrin, Ferritin, peanuts agglutinin, Concanavalin-A, and dolichos biflorus associated antigen were stained by the immunoperoxidase method. In a few fresh materials, T-cell subpopulation by use of monoclonal antibodies (OKT-3, 4, 6, and OK-M1) was examined by the immunoperoxidase method. Two types of Langerhans' cells were found, one is positive for Ferritin and alpha-2-macroglobulin in diffuse histiocytosis-X cells, and another is negative for them in both eosinophilic granulomas. Diffuse histiocytosis-X cell resembled the transformed type of Langerhans cell more than eosinophilic granuloma cells in cellular differentiation. It seemed that the term prolangerhans' cell proliferation disorder might be responsible for it.

[Adult T cell leukemia accompanied by marked swelling of the left thigh].

A patient with adult T cell leukemia (ATL) whose chief complaint was marked swelling of left thigh is reported. A 72-year-old woman was diagnosed as having ATL based on a high titer of anti-ATLA antibody and abnormal lymphocytes with convoluted nuclei. Computed tomography revealed swelling of her left thigh and a large low-attenuation mass in its muscles. Aspirate from her thigh contained many abnormal cells. Though chemotherapy reduced the swelling for two weeks, she had a relapse and died. This is the first case of ATL having such an onset reported in Japan.

[Transitory abnormal myelopoiesis of the monoblastic form in a newborn infant with Down's syndrome and liver cirrhosis]. / Myélopoïèse transitoire anormale à forme monoblastique chez un nouveau-né trisomique 21 avec cirrhose hépatique.

A case of 5-day old newborn infant with trisomy 21, who presented a leucocytosis (151 000/ml) with 60% of monoblasts and marked hepatosplenomegaly is reported. Transient abnormal myelopoiesis (TAM) was retained. TAM regressed spontaneously. However the baby died at the age of 50 days. The autopsy showed extramedullary hematopoiesis with marked monocytosis and liver cirrhosis of neonatal hepatitic origin. The pathogenesis of TAM in this case was discussed.