patient were measured and proved to be 160 and 20 times higher than the control level,respectively. When 0.5 ml ofplasma from each patient was given intravenously into Balb/c mice, the mice died within 5 min. The multiple thrombosis mainly composed of aggregated platelets and present in the lungs of these mice probably led to death of these animals. On the contrary, no such activity was found in plasma from healthy subjects or other patients with lung cancer who showed no manifesta- tions of cnhanccment in the coagulation system.

Thallium-201 accumulation in an unsuspected bronchogenic carci- noma Fakicr DR, Strauss EB. Deportmenr ofRadiology, Section ofNuclear Medicme. NonvalkIIo.~pital, Norwalk, CTO6856. Clin Nucl Med 1989; 14:460-l.

Lung tumors are frcqucntly thallium avid and, indeed, Thallium-201 maybemorespecificthanGallium-67inevaluationofmanyneoplasms. The authors present a case of unsuspected lung carcinoma detected on stress thallium Imaging performed for evaluation of coronary artery discasc

Acute phase reaction during chemotherapy in small cell lung cancer Mdroy R, Shapiro D, Shenkin A, Banham SW. Department ofRespira- tory Medicine, Royal Infirmary, Glasgow G31 2.5. Br J Cancer 1989:59:933-S.

We have measured the serum concentranon of the acute phase reactant, C-reactive protein (CRP), in 20 patients with histologically proven small cell lung cancer undergoing their fist pulse of induction cytotoxicchemotberapy. BaselineCRPconcentrationswereraisedin 16 of 20 patients (median baselme CRP 18.5 mg I ‘; normal range ~10 mg I ‘). CRP levels more than doubled in I 1 of 20 patients during inductIon chcmothcrapy. Ttns acute phase reaction was seen m seven of the 10 chemosensiuve patients, but was not observed in any of the five non- responding patients. Five patients were non-cvaluable for chemorc- sponse. These data indxate that there is a previously undescribed quantlfiablc acute phase response during chemotherapy for small cell lung cancer winch has potential for predicting chemoresponse.

Thallium-201 single photon emission computed tomography in the evaluation of suspected lung cancer Tonami N, Shukc N, Yokoyama K et al. Department qf Nuclear Medrcme. Kanazawa lintversity School of Medicine. Kanazawa 920. J Nucl Med 1989;30:997-1004.

Thallium-201 SPECT was performed in 30 patlcnrs with suspected lung cancer. Both early and delayed scans demonstrated abnormal accumulation inallof23 mal~gnantpulmonarylesionsincluding21 lung cancer and in two of seven benign conditions. There were significant dlffercnccs m delayed ratio (uptake ratio of the lesion to the normal lung on dclaycd scan) and rctcntion Index (degree of retention m the lesion) between lung cancer and benign conditions, respectively (p < 0.01, p < 0.05). The delayed ratio and rctcntion index revealed that adenocar- Cmoma showed higher “‘Taccumulationthan squamouscellcarcinoma and small ccl1 carcinoma (p < 0.05) and U’T clearance in squamous cell carcinoma was faster than in the other two (p < 0.05). Medlasdnal involvement wasdetected mfivcofsevenpadcntsondelayedscans.The smallcstlesiondepictcd was I .5 cm indiamctcr. Twofalscnegatives had small mciastaxs < 1 .O cm in diameter. This method seems to be useful todetectlungcancer.todiffcrcntiatcmal~gnantfromhen~gn lesions.and to c>aluatc mediastmal involvement from lung cancer.

Pre- and postoperative sequential study on the immunosuppressive activity of serum and cell-free skin bleb fluid of patients with lung cancer and esophageal cancer Zhou Q. Yang Z, Zhang H, Yang I. Xlao Y. Department of Thoractc Cardwvasrular Surgery. The First A@lrated IIosIxral. Wesl Chma (lnrwrztr~ oj Medrul S~~wnccs, Chengdu, Slchuan J Surg Oncol I989:ll:l?l-7

Serial changes of tmmunosupprcsslvc acuvlty of xxml and cell-fret skin bleb fluid that can suppress the actlvlty of aLId a naphthyl acetate csterasc (ANAE) of lymphocytes and phagocytoslc of macrophages were detected by immunoregulatory tests in vmo in SO lung cancer and 42 esophageal cancer patienls. In comparmg these tests with those of 53 cases of noncancerous thoracic lesion and 69 normal adults, the Immu- nosuppressive acuvity of serum and skm blcb fhnd from cancer patients IS sigmficantly higher than that of noncancerous thoraclc lesions and normal individuals (P < .Ol ). The acuvity is related to the stages of cancer, the sue of primary tumor, the prcscncc of lymph node mctasta- ~1% and tumor resectabihty, but not to histologIca classrflcation, sex, and age. The immunosuppressive acti\lty of serum and \km bleh flmd dccreascd gradually after the removal of the tumor and was climmarcd on the 30th postoperatlvc day. Thcsc rc\ultb suggest th.u serum and skin bleb flmd from cancerpatxntb may contam unmunosupprcsslve lactors thatcan suppress the Immune rcsponalrc functions ol lymphocytesand macrophages m vitro ma manner similar to that seen or. v~vo. Thereforc, complctc surgical removal of cancer IS likely the ~most cfl?ctlve Immu- nothcrapy.

Uptakeand kineticsofTc-YYm hexakis 2-methory isobutyl ionitrile in benign and malignant lesions in the lungs Hassan IM, Sahweil A, Constantimdc> C 1-t al. Dcp<xm~~nf ofNuclear Medicine, Faculty ofMedicine. Chcsr Ilospual. K,AHUI (‘:mrerControl Center. 13110 Safat Clin Nucl Med 1989:14:333J0

KineticsofTc-99m MlBI uptake was studlcd m I9 paucnu with lung lesions (6 benign, 13 mahgnant). Two dynamic studlcs were acquired after the I.V. injectionof IO-15 mCi (370-550 MB@: the firstwasevery second for 60 seconds. followed by a second on? every mmute for 30 minutes. Delayed images were acquired at two and three hours. By assigning regions of interest (ROI) over the lurlg Icl;lons (TRI. con- tralatcral normal lung (NL) and the heart (HI), Llrnc activity curves (TAC) were generated and time to peak actlvtty wa\ <alculated as well as the rauos of TR/NL. HllrR and HI/IIL.. The HI/NL rat10 w;t5 also assessed m five patrents rcfcrrcd wlrh dlagnosi\ 01 lxhacrnlr heart disease (IHD) for myocardlal nnagmg. There wa\ d Iocall/cd mcreasc of Tc-99m MlBl uptake in ten patlcnts with untreated maltgnant tumours of the lung. No Itxalt/rd uplahc wa\ found m one patient with untreated poorly differentlatcd squamous czll carcmoma. two treated lung cancer and four patlent? with non-mallgnant Irblon\ of the lungs. Two pahems with tibrosmg alvcohtl\ hhowcd ~dlffusc Incrcasc lung uptake In all posrtlvc \tudlc\ peak tumour was rcachc,d wltlun the first mmute. ThcreHaz,noslallsllcal dlffcrence lnthc ratloc,fHI/NL~twccn all groups cxccpt in patient\ with flbro\mg alvl:ohtl5. rhcre was no \Ignlficantdlffcrcnccb~t~‘~cn thcratlosTK/NL, HI/TRand HmLat S- IOminute~and75-.~Ominut~~.Thcrat~c~ofTR/N1.~t~5 .3Ominuteswas lSX*O.36m thcposmvccases verhus I +(I.?1 Inthenzg;ltlvcon~s.l’he mean H0R ratlo was I .7 + (1.35 m the poaitlbc one\ \ er\u\ 1.14 + 0.54 I” those with benign Ic~onsofthc lung,. Thl\ mltlal \tud! dcmonctrates the uptake of Tc-09m MIBI rn malignant tumourx alth prommcnt dlffcrcncc between hcnlgn and maltcnant lc’;mn\ ‘t I\ cvldcnt that radmthcrapy mhlhlt% this uptake.

Rronchogenic carcinoma in patients under age 10 Antkowiak JG, Regal A-M, Takita H. fleportm~r!t o/ I’h~racrc Sur@‘~ and Oncology, Rowe11 Park Memorial Inttltutr B&al/~ .SY I Q6.J. AnnThordcSurg 1989:47:391-3.

Eighty-nine patients aged I9 to 39 1 cx\ wcrc ueatcd Ior bnlncho- Sentc carcinoma at Roswell Park Mcmorlal Inatltutc hctwccn 1971 and 10X3. The malt to fcmalc ratlo was I .6: 1. T’hc vast maJorit) ofpaoenti wcrc habuual clgarcttc \mohcrs. Forty tour paurnt\ (4’J(; 1 had adrn- ocarcmoma or bronchoalveolar ccl1 ~arcmoma r&f. ntk-xeven (30% 1 had large ccl1 und~flcrcntlatcd carcmoma. hmc I IO”+) had sm.dl ccl1 carcmoma and 6 (7%). squamous ccl1 c:u~uxxna. At the taut ofdw~m~~~s, 7patients(2%) hadstage I disease, 3 (3%) hadstagc II &%asc,30(34%) had~la~clllAd1~~a~c,~~~3~~~ ~hads~;r~cllll~d~~c.~~c.an~llf~(lo“i~had