[Is hypereosinophilic syndrome a potentially malignant condition?]. / E la sindrome ipereosinofila una condizione potenzialmente maligna?

The existence of eosinophilic leukemia (EL) has been controversial since it was first described. Recently, some authors have suggested that EL is part of a spectrum of eosinophilic diseases termed hypereosinophilic syndrome (HS). EL diagnosis is very difficult, especially if abnormal chromosome are not present, because HS comprises multiple disease entities of unclear etiology with the common features of prolonged eosinophilia of undetectable cause and organ system dysfunction. We present a case of HS whose findings are consistent with a leukemic process. For two years the patient showed only sharp hypereosinophilia; his clinical course was then marked by signs and symptoms of granulocytic sarcoma (GS), an extramedullary tumor composed of granulocytic precursor cells. GS as a complication of EL was described and in some cases the diagnosis of leukemia was made only on the basis of the GS complication. The formation of eosinophilic GS also suggests a diagnosis of LE in our case of HS. Finally, we always consider HS as a potential malignant disease.

[Idiopathic hepatosplenic granulomatosis]. / Granulomatosi epatosplenica idiopatica.

Granulomas in the liver are identified in 3-10% of all liver biopsies. Although granulomas frequently represent a sign of either infectious or non infectious disease, 20% of the hepatic granulomas lack an identifiable etiology. These cases are defined as idiopathic granulomatous hepatitides (IG). We describe four cases of disease resembling a lymphoid malignance in which IG could be diagnosed by laboratory, radiological (XR, CT), ultrasonographic, histological and follow-up studies of the patients. We suggest that IG may be suspected in patients with granulomas in the liver, self-limited fever of unknown origin, low epatosplenomegaly, eosinophilia less than 5%, in the absence of infectious, lymphoid or sarcoid diseases. We recommend laparascopy as an important diagnostic tool.

Color Doppler US and CEUS in colorectal cancer: A case report.

Colorectal cancer is the third most common cancer diagnosed in the world and the most frequently diagnosed gastrointestinal cancer. However, in the literature there are only a few studies which have evaluated the role of ultrasound (US) in the diagnosis of colorectal cancer and there is no evidence related to the use of contrast-enhanced US (CEUS). The following describes US, color-Doppler and CEUS appearance of a lesion of the large bowel.

Lymphocyte populations in patients with myasthenia gravis. Influence of thymectomy and immunosuppressive drugs.

The T/B peripheral blood lymphocyte ratio was evaluated in 51 patients with myasthenia gravis by means of the rosette test and HTLA. Total T cells and T gamma and Tmu were decreased while B lymphocytes were increased. E-active rosettes were also above the normal range. The previous thymectomy and/or immunosuppressive treatment restored the T lymphocytes identified by HTLA to normal range while those identified by E rosettes were still reduced. This difference may be due to the different stages of T lymphocyte maturation.