We recently defined functional asplenia in children with sickle-cell anemia as impaired splenic reticuloendothelial function despite clinical enlargement of the organ. In three children infusions of fresh plasma did not restore function, indicating that functional asplenia probably is not a consequence of a contracted plasma volume or deficient opsonins or other humoral factors. Transfusions of normal red cells were given, and in five young children, splenic function was restored. Seri al studies suggested that a level of normal red cells of about 50 per cent was necessary for function. The best explanation for functional asplenia is that the high viscosity of sickle-cell blood causes a diversion of splenic blood flow through intrasplenic shunts, thus bypassing the phagocytic reticuloendothelial elements of the organ. When sickled cells are replaced by normal red cells through transfusion, splenic circulation and function are temporarily restored.
A 58-year-old woman, with nonsmall cell carcinoma, had multiple metastasis on 2-F-18 FDG positron emission tomography imaging. The right hemitongue had increased activity as compared with the left. This was not the result of the presence of a metastasis to the tongue, as shown by a negative computed tomography scan of the region and failure to demonstrate a lesion over a period of weeks. Uptake was likely related to right hemiglossal muscle activity. This was made more apparent by decreased uptake on the opposite side of the tongue (up to the midline) as a result of left cranial nerve XII paralysis.
A 48-year-old man had multiple Intrahepatic lesions on both CT and liver scans. However, they were relatively unchanged from those detected 10 years previously. Blood pool imaging demonstrated that they were hemangiomas.
Upon coculture of peripheral blood lymphocytes (PBL) in the presence of irradiated autologous tumour cells, the PBL can be sensitized to the tumour (or perhaps more correctly resensitized), as shown by in vitro cytotoxic properties. The cells can be proliferated in the presence of inter-leukin-2, radiolabelled with 111In and injected back into the cell donor. Using this technique, tumour deposits were localized in five out of seven patients. Possible technique's for increasing the specificity of this form of adoptive immunocytotherapy are pointed out.
