[Neoplastic angioendotheliosis with Roth's spots]

A 81-year-old woman was admitted with fever, anemia and an elevation of serum LDH on September, 1995. She had anasarca and various abnormalities of the ocular fundus including Roth's spots. Skin eruption and psycho-neurological abnormalities were not seen. Laboratory data exhibited Hb 7.6g/dl, Plt 9.3 x 10(4)/microliters, WBC 6,300/microliters and LDH 1932 IU/l. Antibiotics, antituberculotic drugs and steroids were not effective and she died on October, 1995 with heart failure. An autopsy revealed that the small vessels of lungs, kidneys and the mucosa of the bladder and the gastrointestinal tract were filled with large mononuclear cells. Immunohistochemically these cells were positive in LCA and L26 stains, and negative in UCHL-1 stains. There fore this case was finally diagnosed as neoplastic angioendotheliosis (NAE). Although there has been no case report of NAE with Roth's spots previously, there is the possibility that Roth's spots appeared as a sign of vascular occlusion due to NAE. Roth's spots may be noteworthy as a sign of NAE that has few clinical features.