Subacute necrotizing lymphadenitis is pathologically characterized by focal proliferations of histiocytes or reticulum cells, necrosis of lymphocytes and proliferating cells and phagocytosis of nuclear debris by histiocytes in paracortical areas of lymph nodes. As previous reports were chiefly described by pathologists, few clinicians are interested in this disease. But this disease is relatively frequent, so should be noticed by clinicians.
Thirty-eight reported cases and our cases were summarized and discussed clinically. This disease is frequently seen in 20 and 30 years of age. Clinically this disease is characterezid by fever and swelling of lymph nodes, chiefly in the neck and sometimes in general. Sometimes exanthem, hepatomegaly and splenomegaly are seen. Examinations show leucopenia, lymphopenia, raised ESR and positive CRP frequently. Sometimes GOT, GPT and LDH are raised. Clinical course is benign, fever is naturally subsided within a month and swelling of lymph nodes disappears within half a year from onset. Pathogenesis is still unknown, but titers of anti-EB virus antibodies are frequently abnormally high. This disease should be differentiated from infectious mononucleosis, but Paul-Bunnell test is negative and biopsy of lymph nodes confirms diagnosis

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Comparative studies between palliative chemotherapy, intermittent consolidation therapy and immunotherapy in 12 cases with malignant lymphoma in remission, were performed.
In the palliative chemotherapy, small doses of L-asparaginase with argimate to prevent side effect were most efficacy in some chemical drugs, L-asp., chlorambucil, cyclophosph-amide, procarbazine, 6MP, thiouracil and 5FU.
As to immunotherapy, small doses of OK432 sincrease and activate T cell. Cepha-rantin elevates immunoglobulin level and stimulates the function of RES. Transfer factor brought positive PPD reaction in negative patients.
It was suggested that immunotherapy prolonged remmission period but did not reduce tumor proliferation so much. The purpose of immunotherapy is the raise of the immune function in these patients and the protection from infection as well as maintenance of remission

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Twenty-four patients with non-Hodgkin's lymphomas were classified histologically according to the new histological LSG classification of non-Hodgkin's lymphoma. With these 24 patients the correlation of this histological classification with clinical stage, laboratory findings and chemotherapeutic response were studied. Six of 24 cases were categorized as follicular lymphoma, 5 of which were classified as medium sized cell type and one as large cell type. Eighteen were classified diffuse lymphoma, which consisted of one with small cell type, three with medium sized cell type, another three with mixed type, seven with large cell type, three with pleomorphic type and one with lymphoblastic type. Fifteen of 24 patients were staged clinical stage III. Five were staged stage N, four of which were leukemic.
None with follicular lymphoma developed leukemic manifestation. Polyclonal hyper-gammagloburinemia was observed in four patients, of whom 2 patients were pleomorphic type. Lymphocyte counts of peripheral blood in these patients were not related to histological classification. The patients with follicular lymphoma had particularly good response to chemotherapy, and 5 of them are still alive. Eleven of 18 patients with diffuse lymphoma obtained a complete remission. Patients with mixed type and small cell type were also good responders. Of the patients with large cell type, three obtained a complete remission, three partial remission and one no response. In contrast, only one out of three patients with medium sized cell type obtained a complete remission. Fifty per cent survival time of these 18 patients with diffuse lymphomas was 15 months

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Four cases of Hodgkin's disease from 1975 to 1980 were examined cytologically and compared with 38 cases of non Hodgkin's lymphoma, 2 cases of multiple myeloma, 2 cases of immunoblastic lymphadenopathy, 1 case of erythroleukemia, materials from ascites and pleural fluid, T cell line (molt), and B cell line (Raji).
Although the diagnosis of Hodgkin's disease is based upon the findings of characteristic Sternberg-Reed cells and mononuclear so-called Hodgkin cells, closely resembling cells could be found in almost all the cases other than Hodgkin's disease. Especially those cells of both T and B cell type immunoblastic sarcoma and of B cell line (Raji) were indis-tinguishable morphologically from Hodgkin cells.
We think a fairly large number of cases in immunoblastic sarcoma and immunoblastic lymphadenopathy have been misdiagnosed for Hodgkin's disease, so the frequency of Hodgkin's disease is not so much as has been mentioned.
Hodgkin cells showed morphological variations from normal looking cells to very atypical pleomorphic cells, and they transformed from typical Hodgkin cells to more atypical pleomorphic cells as the histological process of Hodgkin's disease evolved. So it seems to be difficult to distinguish diagnostic Hodgkin cells from other resembling cells.
Hodgkin cells and resembling cells were also studied with immunohistochemical techniques. And from the result of these studies, we think that Hodgkin cell originated from immunoblasts which are transformed from T and B immunoblasts

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It is not so difficult to diagnose usual type of malignant lymphomas presenting with general swelling of lymph nodes and hepatosplenomegaly, but diagnosis of malignant lymphomas occurred with extranodal manifestation is not always easy. About one fifth to one quarter of malignant lymphomas arise in extranodal sites, so diagnosis of such cases is very important in diagnosis and treatment of malignant lymphomas. However, as the literature in Japan on diagnosis of malignant lymphomas occurred with extranodal manifestation is sparce, review of such cases will be discussed by presenting our cases.
Extranodal lymphomas may occur in any organ of the body. As they are found most commonly in Waldeyer's ring, in the gastrointestinal tract, in the skin and others, cases of such sites are chiefly discussed and lesions of other sites will be mentioned briefly.
Generally speaking, when the tumor of unknown origin is found, possibility of malignant lymphoma should be considered and examined carefully

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Conventional radiographic techniques have been unable to evaluate primary abdominal malignant lymphomas, especially arisen from the retroperitoneum or the peritoneum. Therefore case reports of malignant lymphomas arisen from such locations are rare. Recently computed tomography (CT) has been known a useful technique to detect such cases.
We have encountered and reported two cases of malignant lymphomas suspected arisen primarily from the mesenterium. Case, E. S., 60-years-old man, was first seen at the 2nd Tokyo National Hospital in June 1980, suffered from the swelling of his abdomen. X-ray examinations of the gastrointestinal tract and abdominal angiography suspected and abdominal CT revealed the tumor of the mesenterium. Laparotomy and surgical biopsy confirmed malignant lymphoma of this location. Case, Y. F., 64-years-old man, was first seen at our hospital in November 1979, suffered from the tumor of his upper abdomen recognized from 1976. Bipedal lymphography and X-ray examinations of the gastrointestinal tract showed no abnormalities, but abdominal CT suspected the tumor of the mesenterium. Malignant lymphoma of this location was detected by laparotomy and surgical biopsy

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Clinical studies on four cases of malignant lymphoma originated in the nose and paranasal sinuses were reported.
1) Four cases, 3 males and one female, aged from 12 to 70 years, are presented. There were 4 cases (25%) of malignant lymphoma of the nose and paranasal sinuses out of 16 malignant lymphoma patients admitted to our hospital from 1977 to 1980.
2) There were one case similar to inflammatory process and another rare case diagnosed as trauma due to traffic accident. Careful attention should be paid to diagnose because lymphoma resembles other diseases clinically.
3) Malignant lymphoma of the nose and paranasal sinuses differs from cancer in its late diagnosis and treatment.
4) Out of 4 cases, 2 cases are alive. There are 2 cases with recurrence. One had involvement of skin and testis and was treated by surgical removal and chemotherapy. This patient has been followed up for 2 years. The other, who was first treated by only irradiation, had skin involvement generally and died 10 months after the initial consultation

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A 38-years-old male was admitted to Iwakuni National Hospital on the 28th of August in 1978, complaining of headache, sweating, and numbness on the left upper limb. At the time of admission, neurological examination indicated a left upper quadrantanopia but no other neurological deficit was found.
By means of RI brain scan and C. T. scan with contrast medium enhancement, the tumor was found, which was locarized in the medial region of the right occipital lobe, though the cerebral angiography and ventriculography did not show any abnormal findings.
Laboratory examination at the time of admission revealed erythrocytosis as follows: red blood cell (RBC); 5.79 million per cmm, hemoglobin (Hb): 18.9 gm per dl, hematocrit (Ht); 54 per cent. No significance were noted in white blood cell and platelet. Though the erythropoietin value in the urine was elevated to 113 milliimmuno chemical unit per ml, none of abnormal finding was detected after through examination of liver, kidney and bone marrow.
At surgery on the 9th of November, a right occipital craniotomy revealed a large solid tumor in the right occipital lobe, which was in contact with falx and tentorium and was totally removed with surrounding brain tissue.
The microscopic picture of the tumor was characterized by striking vascularity and diagnosed as hemangioma. Following surgical removal of the tumor, erythrocytosis disappeared and abnormally elevated erythropoietin value in urine recovered into normal range.
Erythrocytosis and abnormally elevated erythropoietin value are often associated with hemangioblastoma of the posterior fossa, but are rarely associated with the histologically other types of the tumor. In this reported case, it was strongly suggested that the occipital hemangioma had been the cause of erythrocytosis and elevated erythropoietin value in the urine, because those abnormality disappeared after the removal of the tumor

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Experiences of two rare ocular complications of malignant diseases were reported in this study.
Case 1. Y. A. This 14-years-old Japanese boy with leukemic lymphsarcoma complained of total loss of his left visual acuity and severe right ocular pain at three months after the development of meningeal leukemia. Ophthalmoscopic examinations revealed swollen left optic disc and normal right ocular fundus. His left visual acuity recovered after irradiation of 3, 000 rad by a Linac to the left retrobulbar space.
At post-mortem examination, leukemic infiltration to the left orbital fatty tissues and to the right optic nerve sheath as well as to the right extraocular muscles were demonstrated. His loss of left visual acuity was considered to be leukemic infiltration to the left optic nerve sheath. His right visual acuity and fundus were normal prior to his death but at autopsy there were infiltration of leukemic cells in the sheath spase around the right optic nerve and extraocular muscles.
Case 2. M. K. This 43-years-old Japanese man had a recurrent gastric cancer for which he underwent gastrectomy. The histological diagnosis was signet ring cell carcinoma.
Signs and symptoms of recurrence of cancer appeard two years after the gastrectomy. He developed carcinomatous meningitis and subsequent progressive bilateral visual loss and proptosis in four months of the recuurence.
Infiltrations of the signet ring cells to the both optic nerve sheath spase as well as the orbital fatty tissues were demonstrated at post-mortem histolgical examination. Although meningeal involvement of tumor cells was extensive, no infiltration to the cerebral parenchyma was demonstrated.
These two patients were considered to be worthy of reporting since optic nerve sheath infiltration by malignant cells has been known to be an extremely rare occurence

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It is about 30 years ago that adrenocortical hormone preparations began to be used for acute leukemia in Japan.
At present, however, the monotherapy with these preparations is administered only in a certain period of infantile acute lymphatic leukemia because of a low remission rate, short remission period in leukemia and it's side-effects.
We experienced a 67-years-old housewife with ALL suspected of the null cell type who showed a sharp hematological remission and improvement in general symptoms after monotherapy with adrenocortical hormone in a daily dose of 60mg. Forty days after she had recurrence but improved markedly. After that, the effectiveness of the therapy decreased gradually and the patient died of meningeal leukemia.
There was a distinct cytomorphological difference in terms of Giemsa staining and electron microscopic observations between the pathologic cells at the onset of this disease and those at the time when steroid became no longer effective

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As diseases in which the blood picture shows no appearance of atypical cells, neither splenomegaly nor lymphadenoma is present and the bone marrow shows the blood tap or dry tap in despite of marked anemia with both leukocytes and platelets decreased, mention can be made of acute myelofibrosis, hypoplastic leukemia or sometimes atypical aplastic anemia, though differential diagnosis of these diseases is difficult to make clinically and sometimes pathoanatomically.
We encountered two cases, who were, a 28-years-old man and a 51-years-old man who showed a decrease in all blood corpuscles, fever, tendency to bleeding and blood tap but they were free of splenomegaly and lymphadenoma. They were treated with adrenocortical hormone and anabolic hormone but died of sepsis and post-pneumonic D. I. C. respectively.
On the basis of clinical course and histopathological findings, the former was diagnosed as acute myelofibrosis and the latter as hypoplastic leukemia.
In this paper we reported these two cases and discussed their pathology and etiology in reference to literature and other hyperplastic diseases of the bone marrow

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