Ole Paaske Hansen

Primary hemangiosarcoma of the spleen with angioscintigraphic demonstration of metastases

A case of primary hemangiosarcoma of the spleen in a 48‐year‐old woman is presented. Twenty‐eight months after splenectomy the patient developed a severe anemia of the microangiopathic type, thrombocytopenia, and a leukoerythroblastic peripheral blood picture. In contrast to x‐ray and conventional 99mTc‐methylene‐diphosphonate (MDP) bone scintigraphy, which showed only a few minor focal changes in the spine and ribs, angioscintigraphy with in vitro labeled 99mTc‐erythrocytes revealed extensive pathologic accumulations throughout the spine, femurs, and the liver, indicating the presence of extremely vascular metastases. Autopsy 15 months later confirmed the scintigraphic findings. Angiography with 99mTc‐labeled erythrocytes seems to be useful for monitoring metastases from hemangiosarcomas.

Increased myelosuppression during cytostatic treatment and pleural effusion in patients with small cell lung cancer

30 patients with small cell lung cancer (SCLC) and malignant pleural effusion were compared with 30 matched patients with SCLC but without pleural effusion. In the 30 with pleural effusion, white blood cell and platelet counts fell significantly after initial chemotherapy, necessitating dose reduction. Of the patients with pleural effusion, 16 developed severe (WHO grade IV) leukopenia, 7 had severe thrombocytopenia, and 2 patients died of infection. Accordingly, exhaustive aspiration of radiologically verified pleural effusion before starting chemotherapy in patients with SCLC is recommended.