Metastatic disease was present in all patients with solid neoplasms, and two of those had lung involvement by tumor. All patients had atrophic or nonreactive white pulp in the spleen (Figure 3 ). In the lymph nodes, nonreactive follicles and sinusoidal erythrophagocytosis were found. The liver showed erythrophagocytosis and a few mononuclear inflammatory cells in the sinusoids in all patients and variable degrees of shockrelated centrilobular necrosis. The bone marrow was hypocellular in four of five patients. All patients had mild/ moderate kidney acute tubular necrosis. No patient had histological signs of encephalitis, myocarditis or myositis.