A patient with leukemic reticuloendotheliosis is described who two years following splenectomy developed massive retroperitoneal, abdominal, and mediastinal lymphadenopathy. Therapeutic intervention was necessary because the bulky tumor masses produced disabling pain in the back and chest regions. Low-dose radiation to the involved fields produced prompt regression of the adenopathy along with dramatic pain relief. This case suggests that hairy cells may be quite sensitive to radiation, and this therapeutic modality should be considered, especially when local problems are present.
Cancer 452047-2050, 1980.
EUKEMIC RETICULOENDOTHELIOSIS (LRE) was
L originally described as a distinct clinical and pathological entity in 1958.2 Since then it has been recognized with increasing frequency and numerous reviews have appeared in the medical l i t e r a t ~r e . ~~~~~~~' ~~~~ Although lymphadenopathy has been observed in approximately 20% of the cases, it has rarely been considered clinically significant. Splenectomy is presently accepted as the primary modality of therapy for LRE, and a definite role for radiation has yet to be established. We have recently had the opportunity to observe a patient who two years following splenectomy developed massive abdominal, retroperitoneal, and mediastinal adenopathy . These nodes produced severe pain in the lumbosacral and retrosternal regions. The patient was given low-dose radiation to the involved fields that produced rapid regression of the tumor masses coupled with dramatic relief of his symptoms. The response of this patient suggests that LRE can be a highly radiosensitive disease and local radiation may be used to provide effective palliation by the elimination of bulky tumor masses.