Edward D. Crum

Fatal radiation hepatitis: A case report and review of the literature

A case of fatal radiation hepatitis occurring after treatment with 2200 rad given by the moving strip technique is presented. This fatality occurred in a 28-year-old woman with persistent ovarian carcinoma despite prolonged chemotherapy. Scans of the liver using computerized tomography, 99mTc sulfur colloid, and 99mTc diisopropyl iminodiacetic acid showed abnormalities only in sulfur colloid uptake and these resolved late in the course. Death was caused by progressive hepatic and renal failure. Postmortem examination showed changes typical of radiation hepatitis. Only 32 cases of radiation hepatitis have been previously reported and they are reviewed. The possible role of prolonged prior chemotherapy in enhancing sensitivity to radiotherapy is considered.

Two primary carcinomas of the lung: Adenocarcinoma and a metachronous squamous cell carcinoma. A case report and review of the literature

The case of a patient who underwent a left lower lobe lobectomy for adenocarcinoma of the lung and developed a metachronous squamous cell carcinoma of the right lung eight years later, is presented. The unusual nature of the case is emphasized utilizing a review of the literature. The criteria for diagnosing metachronous carcinomas are presented and a unified terminology for such cases is proposed. The requirement for life‐long follow‐up of any patient with cancer is emphasized.

Atypical Presentations of Thrombotic Thrombocytopenic Purpura

Thrombotic thrombocytopenic purpura (TTP) usually presents in a fulminant fashion with marked hematologic abnormalities often associated with fever and neurologic and renal abnormalities. Two cases of TTP are reported in which neurologic deficits were initially the dominant findings, followed weeks later by the pronounced hematologic manifestations. Young patients with unexplained neurologic findings, even if there is only minimal anemia or thrombocytopenia, should be monitored for subsequent manifestations of TTP so that treatment may be instituted promptly. Int J Hematol. 2002;76:471-473.

Case Report: Sarcoidosis, Hodgkin’s Disease, and Autoimmune Hemolytic Anemia

ABSTRACT Reported is the unique occurrence of sarcoidosis, Hodgkin’s disease, and autoimmune hemolytic anemia in the same patient. Although the diagnosis of sarcoidosis preceded that of Hodgkin’s disease by 29 years, massive splenomegaly had been present for 13 years before Hodgkin’s disease was diagnosed following splenectomy. The known associations of sarcoidosis and Hodgkin’s disease as well as each disease with autoimmune hemolytic anemia are reviewed.

Well‐differentiated lymphocytic lymphoma with peripheral blood involvement, osteolytic bone lesions, and hypercalcemia. A case report and review of the literature

It is rare for small lymphocytic B‐cell malignancies to be associated with osteolytic bone lesions and/or hypercalcemia. The authors present an unusual case of well‐differentiated lymphocytic lymphoma (DWDL) in a 70‐year‐old man who had osteolytic bone lesions and subsequently developed severe refractory hypercalcemia. The possible etiologic mechanisms responsible for these findings are discussed, and a brief review of the literature is presented.