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Desquamative interstitial pneumonia is a disease characterized by massive alveolar cell proliferation and desquamation with sparse interstitial involvement. The reported case shows an unusually widespread radiographic reticulo-nodular image and abundant alveolar cells in the sputum. Functional studies reveal the expected diffusion defect with practically normal mechanical properties of the lung, in contrast with interstitial fibrosing lung diseases. On the basis of the pathological findings, especially the behaviour of alveolar cells, the individuality of this disease is discussed. We think that it is different from other diseases classed as varieties of a single disease or as different entities under the names of primary interstitial fibrosis or chronic fibrosing alveolitis.

THE unpleasant fact emerging from the treatment of metastatic carcinoma of the thyroid with I131 is that the results are frequently unsatisfactory. Freedberg, Ureles, Lesses and Gargill (1) have reported a single spectacular apparent cure, and Rawson (2) has seen 2 similar cases which were more advanced and in which the results were even more dramatic. We have also seen similar cases but they have been the exceptions. Yet the fact remains that large amounts of I131 may be concentrated in certain metastases. Why then are the results unsatisfactory? Certainly a partial answer is that the isotope is not concentrated uniformly in different metastases or even within the same metastasis. Perhaps part of the answer also is that insufficient dosage has been used. Increasing the dosage of I131 beyond certain limits will certainly lead to bone marrow damage. Rawson (2) has reported a single fatality in a patient who received 638 millicuries of I131 over a fourteen-month period, from which she received a calculated ...