Evaluation of internal reference genes for quantitative expression analysis by real-time reverse transcription-PCR in somatic cells from goat milk.

Reverse transcription (RT) quantitative real-time PCR (qPCR) is the most accurate and easy-to-perform technique to measure the expression level of a selected gene of interest by quantifying mRNA transcripts. The use of reference genes is commonly accepted as the most reliable approach to normalize RT-qPCR data and reduce possible errors generated in the quantification of gene expression. The optimal number and choice of reference genes are experimentally validated for specific tissues or cell types and experimental designs. To date, data on qPCR normalization in goats are scarce and the most suitable reference genes in this species have been identified for only a limited number of tissues. The aim of this study was to determine an optimal combination of stably expressed reference genes in caprine milk somatic cells (MSC) from healthy and infected mammary glands. For the purpose, we performed RT-qPCR for 10 commonly used reference genes from various functional classes and then determined their expression level in MSC from goats intramammary challenged with Staphylococcus aureus and in MSC from healthy controls, with a view to select genes whose stability would be unaffected under infection conditions. The geNorm and NormFinder algorithms were used for validating the reference genes. Furthermore, to demonstrate the importance of normalization of gene expression with appropriate reference genes, we tested the effect of using a combination of the least stable genes for expression analysis evaluation. On the basis of our evaluation, we recommend the use of a panel of reference genes that should include G6PD, YWHAZ, and ACTB for caprine MSC gene expression profiling. The expression of the 2 genes of interest, pentraxin-related protein (PTX3) and secreted phosphoprotein 1 (SPP1), was evaluated by RT-qPCR in all samples collected pre- and postinfection, and the recommended reference genes were used to normalize the data. Our study provides a validated panel of optimal reference genes for the identification of genes differentially expressed by qRT-PCR in caprine MSC. Moreover, we provided a set of intron-spanning primer sequences that could be suitable for gene expression experiments using SYBR Green chemistry on other caprine tissues and cells.

Effect on quarter milk somatic cell count and antimicrobial susceptibility of Staphylococcus rostri causing intramammary infection in dairy water buffaloes.

In many parts of the world, coagulase-negative staphylococci (CNS) are the predominant cause of intramammary infections (IMI) in dairy cows and in water buffaloes, as well. A longitudinal field study was carried out on one well-managed dairy water buffalo herd to determine the prevalence and distribution of CNS and a recently described CNS-species, Staphylococcus rostri, in milk samples to explore its relevance for buffaloes' udder health throughout lactation, and to gain insight into the susceptibility of the latter species toward commonly used antimicrobials. Twice weekly quarter milk samples from a cohort of 11 lactating water buffaloes were collected over an 8-mo period. The CNS (n=109; 76.2% of all culture-positive samples) were the predominant pathogens causing IMI, followed by Corynebacterium bovis (n=11; 7.6%) and Streptococcus spp. (n=9; 6.2%) other than Stretococcus uberis (n=2; 1.4%). Thirty-seven hemolytic staphylococci suspected to be Staphylococcus aureus were further differentiated using transfer DNA-intergenic spacer-PCR and rpoB-gene sequencing because they were coagulase-negative. Thirty-three of those isolates were identified as Staph. rostri, whereas 2 others were identified as Staphylococcus epidermidis. None of the Staph. rostri isolates displayed resistance to the antimicrobial agents tested. Mean quarter milk somatic cell count (qSCC) of all samples collected throughout lactation was 20,970 cells/mL. The qSCC at sampling of quarters infected with Staph. rostri (34,466 cells/mL) and CNS other than Staph. rostri (34,813 cells/mL) were significantly higher than the qSCC of noninfected quarters (20,287 cells/mL), yet not significantly different from each other. These findings provide novel insight into the prevalence and distribution, antimicrobial susceptibility, and relevance of Staph. rostri compared with other CNS species causing IMI in water buffaloes. Further studies are needed to pinpoint the relevance, niches, and transmission routes of Staph. rostri, as well as other CNS in water buffaloes.

Short communication: Epidemiology and genotyping of Candida rugosa strains responsible for persistent intramammary infections in dairy cows.

The present study was undertaken during an outbreak of clinical and subclinical mastitis in 14 dairy cows caused by Candida rugosa, in which high somatic cell counts were seen and cases did not respond to antibiotic treatment. Intramammary infection cured spontaneously in 10 cows, whereas 4 cows were culled as a result of persistent infections. Repeated sampling of these cows and biomolecular analysis of the isolates showed that the infections were caused by the same genotype, even over a period of 2 lactations. Random amplification of the genome of C. rugosa milk isolates gave 3 different DNA banding patterns (genotypes G1, G2, and G3). Viable cells of C. rugosa were also isolated from various environmental sources and were present in high concentrations in total mixed ration samples, which could be considered the primary source of diffusion of viable yeast cells in the environment, as demonstrated by genotyping. The proven capacity of these microorganisms to survive in the environment of the cow, such as the total mixed ration, bedding, water, and cow skin, and to cause persistent intramammary infections highlights the importance of mycotic spread in dairy herds.

Epidemiological investigation of Streptococcus equi subspecies zooepidemicus involved in clinical mastitis in dairy goats.

An outbreak of clinical mastitis was observed in dairy goats due to the zoonotic pathogen Streptococcus equi ssp. zooepidemicus. Affected goats were culled to prevent transmission of infection to other animals or humans. The objective of the study was to determine whether horses on the same farm were the source of the pathogen. Streptococcus equi ssp. zooepidemicus was obtained from milk of 10% of goats in the herd and from feces of 3 of 7 healthy horses that shared pasture and housing with the goats. Isolates of caprine and equine origin had identical biochemical profiles, including the ability to ferment sorbitol and lactose, which distinguishes S. equi ssp. zooepidemicus from S. equi ssp. equi. Sequencing of the 16S-23S intergenic spacer region and results from sodA-seeI multiplex PCR supported identification of isolates as S. equi ssp. zooepidemicus. Based on random amplified polymorphic DNA typing and rpoB and sodA sequencing, caprine isolates were indistinguishable from each other, but distinct from equine isolates. Further analysis of equine fecal samples showed that multiple strains of S. equi ssp. zooepidemicus can be present in a single sample or in sequential samples obtained from a single horse. Failure to detect the mastitis-causing strain in equine feces may indicate that horses were not the source of the mastitis outbreak in goats. Alternatively, the outbreak may be due to presence of multiple S. equi ssp. zooepidemicus strains in equine feces and a failure to detect all strains when analyzing a limited number of isolates per sample.

Pathogen detection in milk samples by ligation detection reaction-mediated universal array method.

This paper describes a new DNA chip, based on the use of a ligation detection reaction coupled to a universal array, developed to detect and analyze, directly from milk samples, microbial pathogens known to cause bovine, ovine, and caprine mastitis or to be responsible for foodborne intoxication or infection, or both. Probes were designed for the identification of 15 different bacterial groups: Staphylococcus aureus, Streptococcus agalactiae, nonaureus staphylococci, Streptococcus bovis, Streptococcus equi, Streptococcus canis, Streptococcus dysgalactiae, Streptococcus parauberis, Streptococcus uberis, Streptococcus pyogenes, Mycoplasma spp., Salmonella spp., Bacillus spp., Campylobacter spp., and Escherichia coli and related species. These groups were identified based on the 16S rRNA gene. For microarray validation, 22 strains from the American Type Culture Collection or other culture collections and 50 milk samples were tested. The results demonstrated high specificity, with sensitivity as low as 6 fmol. Moreover, the ligation detection reaction-universal array assay allowed for the identification of Mycoplasma spp. in a few hours, avoiding the long incubation times of traditional microbiological identification methods. The universal array described here is a versatile tool able to identify milk pathogens efficiently and rapidly.

Rhabdomyosarcoma of the pectoral muscles of a free-living European robin (Erithacus rubecula).

An adult free-living European robin (Erithacus rubecula) with a large, firm, subcutaneous mass on the pectoral muscle was examined. The bird was unable to fly and died spontaneously. Necropsy revealed a yellowish, bilobate mass almost completely replacing the pectoral muscles with extensive osteolysis of the keel bone. Histopathology revealed a poorly demarcated, highly cellular sarcomatous tumour with metastases to the lungs, pulmonary blood vessels and heart. Immunohistochemistry was negative for neuron-specific enolase, S-100 protein and the p-27 major capsid protein of avian leukosis viruses. The homogeneously positive immunolabelling for vimentin and scattered positivity for myoglobin and desmin suggested a diagnosis of rhabdomyosarcoma. A retrospective examination of the records for 194 birds of the thrush family, including 64 robins submitted over a 20-year period, showed no diagnoses of neoplasia.

Short communication: isolation of Prototheca species strains from environmental sources in dairy herds.

Composite milk samples from 548 cows, and samples from feces, feed, bedding, water, liners (before and after milking), and the postdipping product were aseptically collected from 2 Italian dairy herds from February to November of 2006. Prototheca zopfii was isolated from 11.9% of milk samples, 15% of feces, and 33.3% of bedding samples. No viable cells of P. zopfii were observed in water before washing procedures, whereas 25 to 28.6% of samples from water used for washing both refrigeration tanks and milking equipment were contaminated with this yeast-like microalga. Analogously, the presence of P. zopfii was detected only on swabs collected from the liners after milking. Interestingly, in 1 of the 2 herds, water from the drinking trough was contaminated by viable cells of both P. zopfii and the related environmental species Prototheca stagnora. No viable cells were observed in cow feed. On the basis of the results presented herein, P. zopfii seemed to be widespread throughout the environments of dairy herds where outbreaks of bovine mastitis had occurred.

Short communication: Outbreak of Nocardia neocaledoniensis mastitis in an Italian dairy herd.

Nocardia spp. are an uncommon cause of mastitis, and outbreaks have typically been reported in dairy farms with poor hygienic and management conditions. The outbreak described herein involved a dairy farm with 43 lactating cows that, after a long period with low bulk milk somatic cell counts (<180,000 cells/mL), experienced an increasing incidence of clinical mastitis with bulk milk somatic cell counts greater than 300,000 cells/mL. Fifteen mastitic quarters milk samples from 9 dairy cows were found to be infected by a member of the genus Nocardia, as identified on the basis of selected phenotypic and chemotaxonomic characteristics. The isolates were confirmed as Nocardia neocaledoniensis by 16S rDNA gene sequencing. Average quarter milk somatic cell count for infected udders was 863,057 cells/mL, significantly greater than the average value in noninfected quarters (189,710 cells/mL).

Pentraxin 3 is up-regulated in epithelial mammary cells during Staphylococcus aureus intra-mammary infection in goat.

Pentraxin 3 is the prototypic long pentraxin and is produced by different cell populations (dendritic cells, monocytes/macrophages, endothelial cells, and fibroblasts) after pro-inflammatory stimulation. Different studies demonstrated the up-regulation of PTX3 during mastitis in ruminants, but its role is still unknown. We first investigated the conservation of PTX3 sequence among different species and its pattern of expression in a wide panel of organs from healthy goats. We studied the modulation of PTX3 during natural and experimental mammary infection, comparing its expression in blood, milk and mammary tissues from healthy and Staphylococcus aureus infected animals. We confirmed the high conservation of the molecule among different species. Goat PTX3 was expressed at high levels in bone marrow, mammary gland, aorta, rectum, pancreas, skin and lungs. PTX3 was up-regulated in epithelial mammary cells and in milk cells after S. aureus infection, suggesting that it represents a first line of defense in goat udder.

Influence of estrus of dairy goats on somatic cell count, milk traits, and sex steroid receptors in the mammary gland.

Two experiments were conducted to study the effect of the stage of a spontaneous estrus cycle on milk yield and constituents [somatic cell count (SCC), fat, protein, caseins, lactose, and urea content] and on estrogen receptor-alpha (ERalpha ) and progesterone receptor (PR) immunostaining in the mammary gland. In experiment I, the major components of milk and SCC were monitored weekly in 80 lactating Saanen goats for 6 wk, whereas detection of estrus was daily. In experiment II, milk samples were collected daily for SCC determination during 1 spontaneous estrus (d 0) until the second spontaneous estrus in 14 Saanen goats. The day of the estrous cycle was confirmed by plasma progesterone and 17beta-estradiol levels. Immunoreactivity of ERalpha and PR was analyzed in mammary gland samples of 8 Saanen goats (d 0, n = 4; d 10, n = 4) and the number of positive nuclei and intensity of the staining were evaluated in 1,000 cells. In experiment I, milk casein and protein percentages were significantly affected by the stage of estrous cycle; during proestrus and estrus, these variables were higher (3.32 +/- 0.06 and 4.44 +/- 0.08) than during metestrus (3.03 +/- 0.07 and 4.07 +/- 0.10), but not higher than during diestrus (3.23 +/- 0.06 and 4.35 +/- 0.09, respectively). In experiment II, daily measurement of SCC revealed higher levels at estrus (7,195 +/- 672 x 10(3) cells/mL) and a decline toward the luteal phase (1,694 +/- 672 +/- 10(3) cells/mL). Estrogen receptor-alpha and PR immunostaining were exclusively detected on epithelial cells. The percentage of positive nuclei to ERalpha was higher on d 0 than on d 10 (75.4 +/- 8.8 vs. 68.3 +/- 8.8%), but no change was observed for PR (4.0 +/- 0.3 vs. 3.5 +/- 0.4%). The average immunostaining intensity for both receptors was greater on d 0 than on d 10 (ERalpha : 1.44 +/- 0.02 vs. 1.35 +/- 0.02; PR: 0.079 +/- 0.008 vs. 0.057 +/- 0.008). The high SCC at estrus in experiment II was associated with high plasma estradiol and low progesterone, suggesting that the increased SCC could be brought about by the estrogen-induced proliferation and exfoliation of epithelial cells. In addition, this action may be supported by the higher sensitivity to estrogens (ERalpha content) found at d 0.

Short communication: antimicrobial drug susceptibility of Staphylococcus aureus from subclinical bovine mastitis in Italy.

The antimicrobial susceptibility of 68 Staphylococcus aureus isolates collected during 2004 from milk of cows affected by subclinical mastitis was examined. The antimicrobial agents tested were the beta-lactams, penicillin G, amoxicillin, ampicillin, cloxacillin, amoxicillin + clavulanate, cephalonium, and cefoperazone; and other drugs including lincomycin, oxytetracycline, doxycycline, and kanamycin. Minimum inhibitory concentrations recorded show that only certain beta-lactamase-resistant penicillins (specifically cloxacillin) or penicillin combinations (amoxicillin + clavulanate) were consistently effective against Staph. aureus, whereas the other beta-lactam derivatives and drugs from other pharmacological groups were either moderately effective or ineffective. Thus, beta-lactamase-resistant penicillins are to be considered the antimicrobial agents of choice for treatment of bovine mastitis resulting from infection by Staph. aureus.

Relationships between somatic cell count and intramammary infection in buffaloes.

The objectives of this study were to evaluate the presence of intramammary infections (IMI) in dairy buffaloes and to examine the relationships among IMI, somatic cell counts (SCC), and milk production traits. Two farms in northern Italy were visited monthly for a complete milking season. Quarter-based milk samples were collected at each visit from 46 buffaloes. A total of 1,912 samples were assessed in this experiment. Samples were cultured for bacterial presence and were tested for SCC and percentages of milk protein and fat. In addition, daily milk yield was recorded from each buffalo. Prevalence of IMI was large; 63% of quarters were infected. No buffalo remained free from IMI throughout the course of the study. Coagulase-negative staphylococci were the most common pathogen (66% of positive samples). The SCC was distinctly greater in infected quarters; 100% of quarters with SCC >200,000 cell/mL had IMI, whereas 98% of quarters with SCC below this threshold were uninfected. The somatic cell scores (SCS) in these buffaloes were much lower than those commonly observed in dairy cattle. The mean SCS from quarters with IMI was only 2.93. The highest SCS was observed in quarters infected by streptococci. No drastic decrease in milk yield was observed among infected buffaloes relative to healthy contemporaries. The relatively low SCS and lack of a strong effect on milk yield provide evidence to discourage antibiotic treatment of buffaloes for subclinical IMI during lactation.

Risk factors for intramammary infections and relationship with somatic-cell counts in Italian dairy goats.

Routine examination of milk was performed on five herds of lactating goats in northern Italy as part of a milk quality-monitoring program in the year 2000. As part of the study, aseptic samples of foremilk were collected monthly from both half udders during the entire lactation for 305 goats, resulting in a total of 4571 samples. The samples were tested with cytological and bacteriological analyses to evaluate the relationship between mammary infections and somatic-cell count (SCC; Fossomatic (TM) method). Prevalence of intramammary infection (IMI) was 40.2% (n = 1837) of all udder-half samples examined. The most-prevalent mastitis agents were coagulase-negative Staphylococci (CNS), 80% (n = 1474 udder-half samples); within this group, Staphylococcus epidermidis was the most-prevalent species (38%). Other prevalence were Staphylococcus aureus 6% (n = 112 udder-half samples) and environmental pathogens 14% of infected udder-half samples (n = 251) with a diverse mixture of species, none of which had a frequency of > 4%. Enterococcus faecalis was the most-frequently isolated among this group. Neither Salmonella spp. nor Listeria monocytogenes were detected. The risk (sample level) of infection differed across herds, parities, and stage of lactation according to results from logistic multiple regression. Infection was more common among goats in third and fourth parities and during the later stages of lactation. Of the 2734 samples from uninfected udder halves, the mean log2 SCC was 3.9 cell/ml; of the 1837 bacteriological positive samples, the mean log2 SCC was 5.6 cell/ml. According to results from a linear mixed model, concentrations of somatic cells tended to increase with increasing age and days in milk and with the presence of bacteria. Infection with S. aureus was associated with the highest SCS.

Application of a finite mixture model to somatic cell scores of Italian goats.

The objectives of this study were to apply a finite mixture model (FMM) to data for somatic cell count in goats and to compare the fit of the FMM with that of a standard linear mixed effects model. Bacteriological information was used to assess the ability of the model to classify records from healthy or infected goats. Data were 4518 observations of somatic cell score (SCS) and bacterial infection from both udder halves of 310 goats from 5 herds in Northern Italy. The records were from a complete production season, and were taken monthly from February to November 2000. Explanatory factors in both models included a 3-parameter regression on days in milk (DIM); fixed class effects of herd-test-day, parity group, and udder side (left or right); and random effects of goat and udder half within goat. In addition, the 2-component FMM included a fixed mean for the second component of the model (theoretically corresponding to infected udder halves), as well as an unknown probability of membership to a given putative infection status. A Bayesian statistical approach was used for the analysis with Gibbs sampling used to obtain draws from posterior distributions of parameters of interest. Two sampling chains of 200,000 cycles each were generated for each model. The FMM yielded a much lower estimate of residual variance than the standard model (1.28 vs. 3.02 SCS2), and a slightly higher estimate for the between-goat variance (1.79 vs. 1.48). The deviance information criterion (DIC) was used to compare the fit of the 2 models. The DIC was much lower for the FMM, indicating a better fit to the data. The FMM was able to classify correctly 60 and 48% of the healthy and infected observations, respectively. This was slightly higher than what would be expected from random classification, but not high enough for useful mastitis diagnosis. Nevertheless, increased precision of genetic evaluation is the goal of applying the FMM, rather than timely and accurate mastitis diagnosis. The results suggest that more research on FMM for SCS is merited and necessary for proper application.

Characterization of Staphylococcus aureus isolated from chronically infected dairy goats.

A herd of 88 Alpine goats in Northern Italy was monitored for a complete lactation. Milk samples were taken from each udder half during 8 monthly visits. Goats (n = 28) with > or =2 consecutive positive tests for Staphylococcus aureus in the same udder half were identified as chronically infected, and all of those had > or =4 positive tests of the 8 samples. Goats with no infections in either udder half during any visit were considered healthy (n = 26). Linear mixed models were used to examine the relationship between chronic infection by S. aureus and SCC and production traits. The bacteria isolated from one sample from each infected goat were genotyped on the basis of polymorphism in several genes and evaluated for the presence of genes encoding for enterotoxins. The bacteria isolated from each animal were also subject to a test for beta-lactamase production and to minimum inhibitory concentration tests for 11 antimicrobial agents. As expected, SCC (log2) was significantly higher in infected goats than in healthy goats (7.55 vs. 5.50). Also, mean log SCC from infected udder halves (8.02) was greater than that in uninfected udder halves from the same goats (6.44). No significant differences were observed in milk yield or for fat and protein percentages between infected and healthy goats. No genetic variability was observed among the bacteria isolated, suggesting that all were from the same strain, although isolates did vary in susceptibility to various antimicrobial agents. All S. aureus isolates were negative for the beta-lactamase production test. The most effective drugs when tested in vitro were benzylpenicillin, amoxicillin plus clavulanic acid, cloxacillin, and cephalosporins.

Simultaneous polymerase chain reaction detection and restriction typing for the diagnosis of human genital papillomavirus infection.

A polymerase chain reaction method has been developed which allows the simultaneous detection of the majority of clinically relevant HPV types. Degenerate HPV-specific primers direct the one-step amplification of a DNA region spanning E1 and E7 genes. This enables an immediate distinction between the two groups of papillomaviruses, characterized by high or low oncogenic potential, simply from the size of amplified DNA. The PCR product can be subjected to a second round of amplification with internal primers, which are specific for 7 high-risk HPV types, HPV-16, -18, -31, -33, -35, -45 and -58. Precise identification of one-step or two-step amplified DNA is done by endonuclease digestion with one or two enzymes. The detection sensitivity, which has been assessed using cloned HPV genomes and HeLa and CaSki cell lines, varies from a few tens to a few hundreds of viral genome equivalents. The accuracy of the method has been confirmed by examining cervical scrapings of 44 patients.

A cooperative study on ProMACE-CytaBOM in aggressive non-Hodgkin's lymphomas.

Chemotherapy using cyclophosphamide, doxorubicin, etoposide, cytarabine, bleomycin, vincristine, methotrexate with leucovorin, and prednisone (ProMACE-CytaBOM) for patients with intermediate or high grade non-Hodgkin lymphomas (G, H and K according to the Working Formulation), was tested by the Gruppo Cooperativo Lombardo to confirm the activity of the regimen and to test the feasibility and safety of administering third-generation drug regimen in a cooperative group setting. Among 64 previously untreated patients, aged between 20 and 71 years, 7 had stage IB-IIB, 12 had stage IIIA-B, 45 (67%) had stage IVA-B. There were 44 complete remissions (CRs) (69%) and 14 partial remissions (22%); the difference between patients in stage I-II-III (84% complete remissions) and those in stage IV (62% complete remissions) was statistically significant. The median length of follow up was 20 months (range 1-60 months), with 56% of patients alive at 60 months and 53% of CRs patients free of disease at 60 months. Patients in stage I-II-III have the best survival and disease free survival compared to stage IV, 87% versus 42% and 72% versus 32% respectively (both with high statistical significance). Grade 3-4 (WHO) haematological toxicity was observed in 39% of patients, with 3 septic deaths. Two more patients died with chemotherapy related toxicity (1 stroke and 1 acute renal insufficiency). Administration of ProMACE-CytaBOM is a feasible and safe regimen although it presents moderate toxicity. ProMACE-CytaBOM may represent improved treatment for aggressive lymphomas, in terms of duration of response and survival, but a longer follow up is needed.

[Primary lymphoma of the kidney. Description of a case and brief review of the literature]. / Il linfoma primitivo del rene. Descrizione di un caso e breve revisione della letteratura.

Stage IV disseminated non-Hodgkin lymphomas show kidney involvement with frequency; on the contrary, primary kidney lymphoma, as the sole presenting feature, is a very rare disease. Non-Hodgkin histological pattern, atypical symptoms, marked discrepancy between parenchymal involvement and impairment of renal function are the main features of this tumor. A case-report of a primary kidney non-Hodgkin lymphoma will be described; a short review of literature on this subject will be discussed.

[Splenic lymphoma with villous lymphocytes. A clinical case]. / Linfoma splenico con linfociti villosi. Caso clinico.

Splenic lymphoma with circulating villous lymphocytes is a rare B-lymphoproliferative disorder of the elderly which has been only recently defined. Clinical features are spleen enlargement of various degree without lymphadenopathy and an indolent course, with a long survival, in most cases. Absolute lymphocytosis is present; atypical circulating lymphocytes show a medium or large size, a small prominent nucleolus and a few short and thin cytoplasmic protrusions and projections (villi), which are distributed at one or both poles of cell surface. Reaction for tartrate-resistant acid phosphatase is almost always negative. Immunological markers are as follows: CD 19+, CD 20+, CD 22+, CD 11c+/-, CD 5-, CD 23-, CD 25-, HLA DR+, SmIg+. Differential diagnosis with other chronic lymphoproliferative disorders, particularly chronic lymphocytic leukemia, hairy cell leukemia, prolymphocytic leukemia, follicular and mantle-cell lymphoma in leukemic phase, is based on clinical and immunocytomorphologic criteria. Bone marrow biopsy shows involvement of different degree and pattern; splenic involvement mostly occurs in the white pulp; hepatic nodules in portal areas may be present. Cytogenetic alterations are often present but not specific, such as increased serum LDH and monoclonal gammopathy. No therapy should be made in asymptomatic patients. In case of systemic symptoms, symptomatic splenomegaly or cytopenias, treatment may consist on splenectomy, splenic irradiation or alkylating agents. A case of splenic lymphoma with circulating villous lymphocytes is reported; differential diagnosis, particularly with other B lymphoproliferative disorders, is discussed.

[Malignant histiocytosis. Clinical contribution and review of the subject]. / L'istiocitosi maligna. Contributo clinico e revisione dell'argomento.

Malignant histiocytosis (MH) is a rare and severe disease caused by malignant histiocyte degeneration in the sinuses of the reticuloendothelial system. The clinical picture presents fever, wasting, enlargement of the liver and spleen and lymphoadenopathy. Diagnosis is based on histological criteria and it may prove very difficult to differentiate between MH and malignant lymphomas, acute monocytic leukemia and the histiocytoses considered benign. The main features of the disease are described with comments on two personally experienced clinical cases. Emphasis is placed on the leukaemic aspect, the involvement of the CNS, the association, in one case, with sarcoidosis and the poor prognosis.