Primary central nervous system lymphomas: clinico-pathologic and immunohistochemical analysis of 30 cases.

AIMS AND BACKGROUND: Primary Central Nervous System lymphomas are attracting mounting interest because of their increasing incidence in an immunocompetent population and as sporadic tumors. A new lymphoma classification has been proposed, based on new morphologic entities and on advanced immunologic and molecular techniques. METHODS AND RESULTS: The study concerns the clinical and pathologic characterization of 30 cases of primary central nervous system non-Hodgkin's lymphomas in non-HIV patients using a wide monoclonal antibodies panel. Comparative evaluation of effectiveness and reliability between surgery and stereotactic biopsies was made according to Kiel and Real lymphoma classifications. There were 24 high-grade and only 3 low-grade lymphomas. Three stereotactic biopsies were not diagnostic. CONCLUSIONS: Stereotactic procedures were confirmed as the most immediate and least aggressive approach to CNS tumors, but inadequate sampling caused a deadlock to a full lymphoma diagnosis, which requires immunohistochemical and sometimes also molecular studies. However, it should be stressed that morphologic criteria (tumor cell cytology and neoplastic cuffing of the vascular walls) maintain their diagnostic effectiveness.

Benign cystic mesothelioma of peritoneum: a case report.

A case of multicystic peritoneal mesothelioma involving the pelvic serosal surface is reported. Morphological and immunohistochemical findings agree with the suggested mesothelial origin of this lesion. Lymphangioma was excluded by the unreactivity to Factor VIII related antigen, ULEX-E1 and CD31. Recurrence after a few months from the first surgical resection disagrees with the reactive hyperplastic nature proposed; a tendency to recur was independent from the absence of an aggressive growth pattern and cytologic atypia.

[Diagnostic value of labial salivary biopsy in Sjogren's syndrome: report of 182 cases]. / Valore diagnostico della biopsia delle ghiandole salivari minori nella sindrome di Sjögren (Studio su 182 casi).

Various sets of criteria have been suggested in order to establish a diagnosis of Sjögren's syndrome (SS) in as much as evaluation of the salivary component is highly controversial. Our study was aimed at investigating both sensitivity and specificity of labial salivary gland biopsy (LSGB), as well as at comparing this method with other diagnostic procedures commonly employed in SS. LSGB was performed in 182 patients (174 female and 8 male, mean age 51.2) with xerostomia, dry eyes, parotid swelling and/or serological abnormalities such as positive rheumatoid factors, antinuclear antibodies, leukopenia and hypergammaglobulinemia. Diagnosis of SS was made according to the criteria recently proposed by Vitali et al. (1993). Severity of histologic changes was graded according to the Chisholm and Mason scoring system. Bioptic samples were considered abnormal when at least one focus of mononuclear cells/4mm2 was observed. The following parameters were also assessed in each patient: questionnaire of symptoms, Saxon test, sialography, salivary dynamic scintiscan, Schirmer-I-test, rose Bengal score, ANA, anti-SSA/SSB antibodies and rheumatoid factors. According to the above diagnostic criteria, 108 out of 182 patients had SS, 90 primary and 18 secondary. For 74 there were not enough data for a definite diagnosis of SS. In 9 cases (4 with and 5 without SS) LSGB was excluded because no glandular tissue was found in the specimens. Among the remaining 173, Grades 3 or 4 were found in 74 patients (71.2%) with SS and only in 1 case (1.4%) without SS. LSGB showed a very high specificity (98.6%) and a rather good sensitivity (72.5%). However, biopsy was crucial for diagnosis in only 11 cases (14.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Ultrastructural analysis of the liver with portal vein agenesis: a case report.

Congenital absence of portal vein (CAPV) is a rare vascular malformation: all 16 cases up to now reported are associated with other congenital anomalies and with benign or malignant hepatic neoplasms. Our report concerns a girl with a complex malformative syndrome consisting of CAPV, nodular tumor-like hyperplasia of the liver, and multicystic kidney dysplasia. CAPV was diagnosed by angiography, showing the splenic vein and superior mesenteric vein joined to form a "common trunk" directly entering the inferior vena cava above the liver. The liver maintained the normal lobular architecture, but immunohistochemical and ultrastructural observations revealed abnormalities of the hepatocyte membranes and diffuse capillarization of the sinusoids. In this paper, we present the relationship between the tissue modification and the lobular microcirculation changes due to CAPV, with exclusive perfusion of arterial blood flow.