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and in serum obtained on the same day. The results showed that (i) in serum, only CEA

levels were significantly higher in malig- nancy; (2) in lavage fluids, all 4 markers were abnormally high in cancer patients when compared with control subjects (p< 0.05); (3) there was no correlation between the levels in lavage and those in the blood- stream. When the mean levels in lavage of the normal control subjects were designa- ted as the limits for a positive test, sig- nificant association was found between ma- lignancy and abnormally elevated marker concentration (p < 0.01). The particular combination of CEA-BAL > 35 ng/mg, CEA- serum > 4 ng/ml, and calcitonin-BAL > 120 pg/mg taken together with the results of bronchoscopy (histologic and cytologic) showed the highest discriminating power between malignant and benign lung disease. The sensitivity of the bronchoscopy proce- dure increased from 50 to 89%, with at least 2 positive markers, and had a spe- cificity of 71%. When both bronchoscopy and all 3 markers were negative, the re- sults showed a negative predictive value of 100%. We conclude that tumor marker levels in lavage are a useful aid in the diagnosis of malignancy in patients under- going bronchoscopy.

Adenosquamous Carcinoma of the Lung: A Clinical and Pathologic Study of Seven Cases. Fitzgibbons, P.L., Kern, W.H. Department of Pathology, Room 2900, L.A° County, U.S.C. Medical Center, Los Angeles, CA 90033, U.S.A. Hum. Pathol. 16: 463-466, 1985.

Adenosquamous carcinoma is a rare, but pathologically distinct, form of lung cancer. Seven cases involving unequivocal squamous and glandular differentiation were studied. These cases accounted for 0.6 per cent of the 1,125 primary lung can- cers examined at a metropolitan hospital during a 15-year period. The tumors measu- red from 1.3 to 5.5 cm in diameter. Five were peripheral, and two were associated with scars. Three of five resected specimens had regional lymph node metastases. Five patients had died of the disease within two years of diagnosis, and two were short- term survivors.

Remission of a Parane0plastic Cerebellar Syndrome. Eekhof, J.L.A. Department of Neurology, Academic Hospital, University of Amsterdam, 1105 AZ Amsterdam, Netherlands. Clin. Neurol. Neurosurg. 87: 133-134, 1985.

A case history is reported of spontane- ous improvement of a sub-acute paraneoplas- tic cerebellar syndrome, that is before

treatment of the orimary (lung) tumour.

Transbronchial Needle Aspiration of a Bronchi- al Carcinoid T~n0r.

Delp-Givens, C. Jr., Marini, J.J. Division of Pulmonary Medicine, Department of Internal Medicine, Vanderbilt Univesity Medical Center, Nashville, TN, U.S.A. Chest 88: 152-153, 1985.

We biopsied a suspected bronchial carcinoid tumor with transbronchial aspiration needle and obtained cytologic diagnosis without sig- nificant hemorrhage. This technique may prove valuable in sampling highly vascular endobron- chial neoplasms.

Surgical Treatment of Spinal Cord Compression in Patients with Lung Cancer. Sundaresan, N., Bains, M., McCormack, P. Memo- rial Sloan-Kettering Cancer Center, New York, NY, U.S.A. Neurosurgery 16: 350-356, 1985.

We analyzed the clinical features, radio- logical findings, and results of surgical treatment in a series of 25 patients with lung cancer and invasion of the spine. In 12 of the 25 (40%) patients, involvement of the spine was present at the time of initial presenta- tion of malignancy. Computed tomography revea- led the presence of a large paravertebral soft tissue mass with destruction of adjacent ribs in the majority. The surgical approach consisted of an anterolateral exposure through a formal thoracotomy in 22 patients and a tho- racoabdominal flank approach in the 3 patients with lumbar lesions. All gross tumor was resec- ted from the involved paravertebral tissues, vertebral body, and epidural space. Immediate stabilization of the spine was then achieved with methyl methacrylate. Local brachytherapy (iridium-192 implants) was used in 19 patients. After treatment, 87% were ambulatory, and 67% maintained ambulation for more than 6 months. Our data suggest that compression of the spinal cord in many patients with lung cancer results from direct extension of'tumor through the chest wall. Because the majority of such patients often have localized disease invol- ving the spine, aggressive surgical treatment is indicated.

Detection of Bone Marrow.Metastasis in Small- Cell Lung Cancer by Monoclonal Antibody. Stahel, R.A., Mabry, M., Skarin, A.T., et al. Division of Medicine, Dana Farber Cancer In- stitute, Boston, MA 02115, U.S.A.J. Clin. Oncol. 3: 455-461, 1985.

A murine monoclonal antibody against a surface antigen of small-cell carcinoma of the lung (SMI antibody) was investigated for its use in detecting bone marrow metastasis. Bone marrow cells of healthy volunteers and of patients with small-cell carcinoma of the lung (SCCL) were examined for reactivity with SMI antibody and indirect immunofluorescence and the results compared to conventional hi- stochemical staining (Wright-Giemsa stain of bone marrow aspirates and hematoxylin-eosin

stains of bone marrow biopsies). No SMI reac-