[Cytomorphological study of the cerebrospinal fluid. II. Leukemias and lymphomas (author's transl)]. / Citomorfología del líquido cefalorraquídeo. II. Leucemias y linfomas.

A cytological study of the cerebrospinal fluid from 25 patients with acute leukemias and five patients with malignant lymphomas (Hodgkin's disease and non-Hodgkin's lymphoma) has been performed. All patients had clinical manifestations of central nervous system involvement at the time of lumbar puncture. Cytological abnormalities were observed in 13 out of the 30 samples examined (positivity: 44 percent). The group of 17 patients with lymphoblastic leukemia accounted for the highest cytological positivity (12 our of 17 cases --70.5 percent--). Cerebrospinal fluid from eight patients with acute myeloblastic leukemia and from four patients with Hodgkin's disease was normal. Numerous cell atypias were found in a case of lymphocytic lymphoma. The importance of systematic cytological study of the cerebrospinal fluid in patients with leukemia in order to prevent recurrences and to control intrathecal administration of cytostatics and/or radiotherapy is stressed.

[Behçet's disease: report of ten cases and of a new clinical manifestation (portal vein thrombosis) (author's transl)]. / Enfermedad de Behçet: presentación de 10 casos y de una nueva manifestación clínica (trombosis portal).

Ten patients (seven males and three females) with the diagnostic criteria for Behçet's disease are reported. Symptoms began between ages 14 and 37 (mean age 27.9 years), and the time of evolution of the disease varied between one and 23 years (mean 5.7 years). Initial presentation was aphthous stomatitis (three cases), ocular inflammation (three cases), erythema nodosum (one case), arthritis (one case), thrombophlebitis (one case), and hemorrhagic proctocolitis (one case). During the course of the disease the commonest clinical manifestations were oral and genital ulcerations (100%) and ocular (70%), cutaneous (70%), articular (40%), neurological (40%), venous (40%), gastrointestinal (40%) and arterial (10%) involvement. Increased erythrocyte sedimentation rate was a constant feature in all patients. HLA-B5 antigen was determined in four patients, being positive in two of them. Cerebrospinal fluid alterations were present in the four patients with neurological involvement even though three of them never had meningeal symptoms. One patient developed portal hypertension secondary to portal vein thrombosis, and its clinical manifestations are described.

[Spinal epidural abscess secondary to pharyngeal trauma due to food]. / Absceso epidural espinal secundario a traumatismo faríngeo alimentario.

INTRODUCTION: In recent years the incidence of spinal epidural abscesses has increased. Early diagnosis is very important, since once neurological deficit has become established this is often permanent. The commonest aetiological agent is Staphylococcus. Pain and fever are often the only symptoms before acute neurological deterioration. CASE REPORT: A 76 year old hypersensitive, diabetic man presented complaining of pain and a sensation of warmth in both arms. He had no fever or other symptoms. Some three weeks before admission to hospital a fish bone had become stuck in his pharynx, causing a purulent lesion there. This was treated with antibiotics. Cervical MR showed a mass at the level of C4 C5, compatible with epidural abscess. Following drainage and antibiotic treatment he recovered, with no sequelas. Staphylococcus was isolated from the purulent fluid. CONCLUSIONS: The possibility of epidural infection must be remembered in patients with fever and nerve root pain. Early diagnosis and suitable treatment, combining both surgery and prolonged treatment with antibiotics, are essential to prevent permanent neurological damage.

[Magnetic resonance of the brain and Achilles tendon in cerebrotendinous xanthomatosis]. / Resonancia magnética de encéfalo y tendón de Aquiles en la xantomatosis cerebrotendinosa.

We report a 31 year old patient with cerebrotendinous xanthomatosis who presented with dementia, tendinous xanthomas, cataracts, pyramidal involvement, cerebellar ataxia and peripheral neuropathy. Cerebral CT scan demonstrated diffuse hypodensity in the white matter in both cerebellar hemispheres while MR detected additional focal alterations in both frontal lobes. MR study of the Achilles tendon showed a diffuse enlargement of the tendon with multiple areas of hypersignals in T1 and T2 demonstrative of the lipid deposits, interpossed between the isosignal zones that may correspond to the inflammatory reaction secondary to the accumulation of cholesterol and cholestanol.