A patient with typical chronic lymphocytic leukemia (CLL) who developed central nervous system involvement is presented. The CLL was of B-cell origin and the neurological involvement consisted of perivascular infiltration in the spinal cord.
A group of seven children with different malignant processes presenting with hypercalcemia was studied. Bone destruction, diffuse metabolic abnormalities, abnormal acid-base homeostasis and recurrent hypercalcemia characterized these patients. A different mechanism leading to the production of hypercalcemia and/or bone destruction by cancer cells is considered. The results of this report suggest that parathyroid hormone production (P.T.H.) by the parathyroid glands is normal and that ectopic secretion of PTH or PTH-like material is negligible in these cases.
Two patients with anaplastic carcinoma of the thyroid following irradiation for Hodgkin's disease are presented, and the previously reported cases briefly reviewed. The risk of late development of thyroid carcinoma is life-long and high-dose irradiation in patients with prolonged life expectancy may result in anaplastic carcinoma as well as less malignant histological forms.
SummaryThe authors in this article record their experience with eighty-four patients with abdominal aortic aneurysms. Twenty-seven patients (32%) presented with ruptured aneurysms with an overall mortality of 56%. Of the unruptured aneurysms, 67% were operable with a mortality of 5-3%o. The highest mortality amongst the patients with ruptured aneurysms was in the group who was shocked.In the group with ruptured aneurysms, of those in whom platelet counts were performed, 50%o were abnormally low, and 56% had evidence of abnormal coagulation. Seventy per cent of those with coagulation abnormalities died. In the unruptured group 28-2% had thrombocytopenia but no other abnormalities of coagulation.All patients undergoing aneurysm resection should have a platelet count and a full clotting screen. Therapy should be directed to normalization of the coagulation system.
IntroductionSince the report of Dubost, Allary and Oeconomos (1952) aneurysmectomy with homograft replacement has become commonplace. There have been occasional reports of coagulation disorders associated with aortic aneurysms, but more recently ten Cate, Timmers and Becker (1975) reported four patients with ruptured or dissecting aortic aneurysms in whom a consumptive type of coagulopathy was demonstrated. In this paper eighty-four patients with the diagnosis of aortic aneurysm seen during an interval of eighteen months are reviewed, and the association between coagulopathy and aortic aneurysms is emphasized.
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