In 69 patients, hepatic scans with gold Au 198 and determinations of serum alkaline phosphatase (SAP) levels were 78% accurate (in 14 of 18 patients) and 80% accurate (in 12 of 15), respectively, in detecting hepatic neoplasm and 93% accurate (in 14 of 15) when used together. When results of both studies were normal, hepatic neoplasm was present in 4% (one of 23 patients). The likelihood of hepatic neoplasm in the presence of a positive scan and elevated SAP level was 92% (in 11 of 12). No liver-function studies were helpful in eliminating the problem of false-negative scans. The presence of multiple space-occupying lesions without associated increased extrahepatic uptake was effective in differentiating hepatic neoplasm from cirrhosis. In 11 patients with lymphoma, increased splenic uptake of gold Au 198 occurred in seven. In some instances, this may have been related to hepatic involvement with lymphoma, and, in others, to increased phagocytic activity of the reticuloendothelial system of the spleen with or without splenomegaly.