Eosinophilic granuloma of bladder.

Eosinophilic granuloma of the bladder, a rare and certainly poorly known disease, simulates bladder neoplasms. Clinical aspects, histology, and therapy in a young boy are described.

Hypertrophic lymphocytic gastritis with a gastric carcinoma.

Lymphocytic gastritis is a recently described gastric inflammation, characterized by an increased intraepithelial lymphocytic infiltrate mainly composed of T-lymphocytes. Endoscopically it correlates mainly with diffuse varioliform gastritis. Ménétrier's disease is a hypertrophic gastropathy with enlarged gastric folds. The histological picture is that of foveolar hyperplasia and glandular cysts of the mucosa. A few small series of lymphocytic gastritis with microscopic and endoscopic features of Ménétrier's disease have been published previously. We describe a similar case associated with a gastric adenocarcinoma.

Chondrosarcoma of the skull base: CT, MR and pathological features.

We report on CT and MR image findings of a skull base chondrosarcoma. Chondroid mineralisation, a histological feature of chondrosarcoma, can be recognised on CT and is, together with the off-midline position of the tumour, the most characteristic finding. Differentiation is usually made by histological and immunocytochemical staining. Surgery, proton radiation therapy and stereotactic single high-dose irradiation have been used to treat patients with chondrosarcoma. It is worth mentioning that it was likely that the chondrosarcoma in our patient represented a malignant degeneration of an enchondroma that had been resected 30 years earlier.

[Malignant degeneration of the intestine in Crohn's disease]. / Maligne ontaarding van de darm bij ziekte van Crohn.

A woman suffering more than ten years with Crohn disease, makes one day a small intestinal obstruction. She undergoes a laparotomy in which a resection of 30 cm terminal ileum is done. Surprisingly the anatomo-pathologic diagnosis is adenocarcinoma between the Crohn's inflammatory lesions. Weedom and Greenstein have proven that Crohn disease and colon carcinoma are related in their follow-ups. But to find such a relationship between Crohn and carcinoma of the small intestine tumours is very small: +/- 0,3/100.000 in a year and so the cases in literature too. We have found 38 cases with enough information. This people with Crohn and carcinoma of the small intestine have an age of 43 years and more than 10 years Crohn symptoms before tumour was found. The tumours are localized in more than 70% in the ileum; 85% are adenocarcinoma. Such differences in localization, age and anatomopathology between Crohn's patients and a normal population let us presume that malign degeneration in Crohn disease is more than accidentally. A casual connection can't be given. For therapeutic use a resection is to prefer because many dysplasias are found in bypass segments.

[Squamous esophageal papillomas]. / Squameuze slokdarmpapillomen.

In three patients, two women of 37 and 58 and a man of 68 years, a papillomatous lesion was incidentally detected in the distal part of the oesophagus. Microscopically a squamous papilloma was seen with parakeratosis and in two patients poikilocytosis, indicating an infection with human papilloma virus (HPV). The lesions were removed endoscopically, in one patient with laser photocoagulation. Squamous papillomas of the oesophagus are benign tumours with a very low incidence. The pathogenesis still remains unclear. Some authors suggest local irritation as a possible mechanism. On the other hand there is growing evidence of an aetiological role of HPV. In several studies the presence of viral antigen or DNA has been demonstrated. These papillomas may undergo malignant transformation, which means that they are best removed preventively.

Fibrous mesothelioma. Case report.

A case of fibrous mesothelioma is presented. Chest films suggested an elevation of the left diaphragm and a limited pleural effusion, which was confirmed on computed tomography. Percutaneous needle biopsy showed mesothelial cells. At thoracotomy the tumor was attached to the pleura of the mediastinum by a pedicle. Complete surgical resection was possible. Clinical, radiological and histological data in literature are summarized. The radiological features of the presented case correspond to those described in the literature.

Telangiectatic osteogenic sarcoma: an unusual presentation.

The authors present a case of telangiectatic osteogenic sarcoma of unusual radiographic presentation. The lesion presents as a slow growing, rather "benign" tumor, while most osteosarcomas usually present as osteolytic lesions of which the radiological aspect allows the diagnosis of malignancy with certainty.

[Otologic manifestations of Wegener's disease]. / Otologische manifestaties van de ziekte van Wegener.

Two cases of otologic involvement in Wegener's granulomatosis are reported. Symptoms are referable to those of an acute otitis media with impaired hearing. The ANCA test is helpful in the diagnosis. Immunosuppressive therapy in association with corticosteroids is the treatment of choice.

[Sialadenoma papilliferum]. / Sialadenoma papilliferum.

In this article we described a case of sialadenoma papilliferum detected in an old lady during a complete clinical survey for unrelated causes. This tumor did not produce any symptoms. The sialadenoma papilliferum was first described as a separate entity in 1969. Since several other reports have been made but the tumor is definitely rare, usually an accidental finding and most commonly localized in the mouth in the transition zone of soft and hard palate. Our case is the first published in a woman and as yet also the oldest. A survey of the literature is given.

[Collagen colitis: separate illness or syndrome?]. / Collageencolitis: aparte ziekte of syndroom?

Six patients with collagenous colitis are described and the literature is reviewed. Collagenous colitis is not a rare disease. Its most prominent feature is profuse watery diarrhoea. Although the endoscopic picture of the mucosa is usually normal, there is a microscopic thickening of the (subepithelial) basement membrane. For diagnostic purposes, multiple colon biopsies are warranted in patients with chronic or relapsing diarrhoea. There is no established therapy for this disease.