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In 1973, a 10 year old boy presented with numerous bilateral lung nodules, diagnosed as histiocytosis X by open lung biopsy. The patient was treated with prednisone until 1984. In 1993, he developed severe pain in the neck. A biopsy of the spine revealed the same tumour morphology as was seen in the lung in 1973. Immunohistological examination of the former and present biopsy led to the definitive diagnosis of epithelioid haemangioendothelioma of the lung with metastases to spine and liver. Epithelioid haemangioendothelioma of the lung is a rare soft tissue tumour of vascular origin, readily mistaken for carcinoma or, as in this case, histiocytosis. The tumour has an intermediate malignant potential. Although metastases of epithelioid haemangioendothelioma of the lung are well-known, metastatic spread to bones, as in our case, has not previously been mentioned in the literature.

Oral ketotifen (Zaditen®) 1 mg twice daily was compared with inhaled disodium cromoglycate (DSCG; Lomudal®) 20 mg four times a day in an open study with two matched groups of patients treated for protection against allergen-induced bronchoconstriction. 9 patients were treated with ketotifen and 9 patients with DSCG for 4 weeks. The comparison of the differences between the mean values at provocation, at the start of the study, and after a 4-week drug treatment shows that the drugs are equally effective on the forced expiratory volume at 1 s. Ketotifen is less effective on the vital capacity than DSCG. Patients’ and investigator’s assessment of tolerability and efficacy of the two therapies were similar. It is concluded that ketotifen is as effective as DSCG in protecting asthmatic patients antigen bronchial challenge and is tolerated as well as DSCG

The comparative efficacy and patient compliance with treatment using three sustained-release theophylline preparations currently available in The Netherlands were evaluated by measuring the plasma concentration achieved in a survey of 282 hospital and 185 out-patients. Compliance was dramatically better amongst in-patients than those attending out-patient clinics. Complete treatment avoidance was higher than expected. Compliance was better among non-smokers than among patients who were still smoking. Patients clearly preferred preparations which permitted a simple daily dosing schedule requiring the minimum number of tablets. On this basis and that of the parameters measured, Theolair Retard was the preparation of choice. Plasma concentration should be monitored during long-term theophylline treatment.

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