[Lethal rupture of an echinococcal cyst of the liver]. / Perforation eines Leberechinokokkus mit Todesfolge.

A 50-year-old man is admitted to the hospital emergency service because of a 24-hour history of right abdominal pain. Ultrasound examination and laboratory tests suggest the perforation of an Echinococcal cyst situated in the subcapsular area of the right hepatic lobe. The patient and his family refuse the recommended hospitalisation and operation and leave the hospital on their own responsibility. 60 hours later the patient dies. Post-mortem examination confirms the diagnosis of a perforated hydatid cyst of the right hepatic lobe. The cause of death was a partly fibrino-purulent, partly nodular peritonitis including the area of liver rupture.

A case of visceral leishmaniasis in the Northern Adriatic region.

A 33-year-old male patient with fever, splenomegaly, pancytopenia and lymphocytosis was admitted to the Department of Hematology in Rijeka. Laboratory findings, bone marrow aspiration and biopsy excluded hemoblastosis and aplastic anemia. To exclude primary splenic lymphoma we performed splenic aspiration where Leishmania amastigotes were found. No cases of visceral leishmaniasis have been previously described in the Northern Adriatic region. Considering epidemiology, a contraction of the disease in the Velebit mountain range could be possible despite the current non-endemic status of the region.

[Preleukemia]. / Preleukoze.

The six cases of Preleukemia (or Preleukemic States) are described. The peripheral blood was characterised with Pancythopoenia in 5 and bicytopoenia in 1 patient. Morphological alterations of Erythrocytes were present in all cases. The Bone Marrow was hypercellular in 3 and hypocellular in 3 patients. Erythropoiesis was megaloblastic or partly megaloblastic in 5 cases, with "ring" sideroblasts present in all cases. The percentage of Leukemic blast cells was as follow: 0, 5, 6, 10, 30 and 33. The duration of the preleukemic phase varied from 3-53 months. With the manifestations of overt Acute Nonlymphatic Leukemia the agressive therapy was applied. The results were poor in 5 patients (the survival 1, 5-4 m.). Only one survived more than 60 months and is still in full remission.

[Acute erythremic myelosis as a terminal phase of polycythemia rubra vera]. / Akutna eritremicna mijeloza kao terminalna faza policitemije rubre vere

A male, 66, developed Acute Erythremic Myelosis in the course of Polycythemia Vera. The time of onset of Polycythemia Vera could not be determined, his first symptoms being vascular complications. He received treatment with Phlebotomies and Myleran. Five years later he became ill with malaise, fever, splenomegaly; in the peripheral blood profound pancytopoenia with immature, bizzare erythro-and megaloblasts have been found. Bone marrow was full of atypical megaloblasts, some of them having two or more nuclei. The number of mitoses was increased. Chromosomal abnormalities consisted of ane-uploid cells, chromatid breakes and translocations (G to A-1). The therapy with B12, Cytosin-Arabinoside, Oncovin and Blood transfusions was unsuccessful. He died 21 days after being admitted to the Hospital.