Oxaliplatin-induced increase in splenic volume: experiences from multicenter study in Japan.

BACKGROUND: Chemotherapy with oxaliplatin is known to induce sinusoidal obstruction syndrome (SOS). In a previous single-center study, we reported that oxaliplatin-induced increase in splenic volume (SV) is strongly indicative of SOS, and that this increase in SV persisted for > 1 year after completing chemotherapy. The aim of this study was to confirm the oxaliplatin-induced SV change in a multicenter study in patients with stage III colon cancer in Japan. METHODS: We enrolled 59 patients who underwent curative resection for stage III colon cancer in the FACOS study in a phase II multi-center clinical study. Participants received mFOLFOX6 or CAPOX as adjuvant chemotherapy. SV change was assessed three times by computed tomographic volumetry: before surgery, on completion of adjuvant chemotherapy, and 1 year after completing adjuvant chemotherapy. RESULTS: SV on completing and 1 year after chemotherapy was significantly higher than that before surgery (P < 0.001). Oxaliplatin-induced SOS persisted for > 1 year after the completion of adjuvant chemotherapy in half of the patients. There was no difference in 3-year disease-free survival with respect to the presence or absence of increased SV. An increase in SV was observed in 72% of patients treated with mFOLFOX6 and 94% of patients treated with CAPOX (P = 0.13). CONCLUSION: This study can be verified the findings observed in our previous single-center study, oxaliplatin-based adjuvant chemotherapy was associated with an increase in SV. Furthermore, this increase can persist for > 1 year. The continuous presence of SOS may have a negative impact on prognosis in patients that develop recurrent disease.

Actinomycotic splenic abscesses presenting with arthritis.

An 18-month-old Caucasian female began with a high fever. She developed swelling in one finger and one toe. Abdominal ultrasound revealed multiple abscesses in her spleen. Multiple blood culture and splenic abscess aspirations grew no pathogens. She had transient response to multiple antibiotics and splenic abscess drainage, but fever returned along with subcutaneous nodules. Culture of splenic tissue from her second splenic drainage eventually grew one organism identified as Actinomyces naeslundii. Therapy with high dose penicillin followed by amoxicillin p.o. and total splenectomy led to complete recovery.

Computed tomography of the liver and spleen with intravenous lipoid contrast material: review of 60 examinations.

In 60 computed tomographic examinations of the liver and spleen in 55 patients, a new intravenous lipoid contrast material, Ethiodized Oil Emulsion 13, was used. This organ-specific contrast material, retained by the reticuloendothelial cells of the liver and spleen, caused marked increase in the attenuation of the liver and spleen, but did not appreciably change the attenuation of the tumor involving these organs, thereby significantly increasing the density differential between normal and abnormal tissue. Toxicity was considered to be well within tolerable limits with the most frequently noted untoward side effects of chills, fever, headaches, and foul metallic taste. Ethiodized Oil Emulsion 13 holds the promise to become a valuable clinical tool by which hepatic and splenic imaging may be significantly improved and lesions less than 1 cm in diameter demonstrated in the liver and spleen.

The use of iodolipids in hepatosplenic computed tomography.

Iodolipids have been used as a contrast medium for hepatosplenic computed tomography (CT) in 148 patients. In all but two of these cases, the contrast material was injected by the intravenous route. The method appears to be safe due to the marked reduction of dosage in CT compared with conventional radiographic iodolipid hepatography. This decreased dosage is made possible by the improved density and spatial resolution of CT. Pictorial and histographic densitometric analysis of normal and abnormal liver after iodolipid administration yields considerable diagnostic improvement.

Torsion of the wandering spleen seen as a migratory abdominal mass.

Torsion of the wandering spleen is an unusual cause of an acute abdomen, rarely diagnosed preoperatively. The authors describe a case which was suspected prior to surgery and confirmed by radionuclide imaging. Radiographic findings include an extrinsic mass on barium-enema examination and absence of the splenic shadow in the left upper quadrant.

AG 60.99: A promising contrast agent for computed tomography of the liver and spleen.

AG 60.99, an emulsion of poppy-seed oil, is proposed as a promising organ-specific agent for computed tomography (CT) of the liver and spleen. This agent not only opacifies the hepatic parenchyma enough to enhance visualization of the bile ducts but also demonstrates the vascular anatomy with smaller doses than those required for conventional studies.