Hyperaldosteronism from adrenal carcinoma.

criteria for a diagnosis of infectious mononucleosis. In a more recent report of an outbreak of the disease Dunnet (1963) described 80 cases; the diagnostic criteria used were stringent. Though almost all of the 80 cases had evidence of hepatic involvement and 13 (16%) had electrocardiographic changes, only a few had the radiological appearances of enlarged hilar lymph nodes and none had pulmonary lesions. The present case satisfied the accepted diagnostic criteria for infectious mononucleosis. There was no direct evidence of infection other than of infectious mononucleosis, and the pulmonary changes coincided with the development and remission of the primary disease. It seems likely that the pulmonary opacities were due to foci of infiltration by mononuclear cells or atypical lymphocytes, as has been described in a minority of the few cases coming to necropsy (Ziegler, 1944; Allen and Kellner, 1947; Natvig, 1962). If these pulmonary opacities were indeed due to lymphocytic proliferation, we are reminded that the mechanism of proliferation and above all the limitation of lymphocytic proliferation in infectious mononucleosis is inadequately understood (Dameshek and Gunz, 1964).