Undifferentiated gastric carcinoma with lymphoid stroma (lymphoepithelioma-like carcinoma/medullary carcinoma).

Undifferentiated gastric carcinoma with lymphoid stroma is a histological type of gastric cancer with favourable prognosis, microscopically characterised by nests of neoplastic epithelial cells intermingled with a dense lymphoid proliferation. Various studies have shown a close relationship between undifferentiated gastric carcinoma with lymphoid stroma and Epstein-Barr virus infection; the presence of viral DNA in tumour cell nuclei has been demonstrated using polymerase chain reaction and Epstein-Barr virus-encoded small RNA in neoplastic cell nuclei have been found using in situ hybridization. We describe two cases of undifferentiated gastric carcinoma with lymphoid stroma, one infiltrating the submucosa of the gastric body and the other invading the muscularis propria of the antrum. No lymph node neoplastic invasion was documented in either case. Epstein-Barr virus was detected in the neoplastic cell nuclei in both cases with in situ hybridization.

A rare case of malignant diaphragmatic hemangiopericytoma in a patient with pleural effusion.

This paper reports a case of primary malignant diaphragmatic hemangiopericytoma in a 30-year-old male patient operated on for a diaphragmatic mass. The tumour was discovered on a TC scanning performed to explain the etiology of an exudative pleural effusion in a patient admitted for dyspnea, fever and thoracic pain. Given the rarity of this disease, the histological and pathological features of hemangiopericytoma are discussed in the light of the new classification system for soft tissue and bone tumours, as well as its currently accepted therapeutical guidelines.

[Carcinoma of the small intestine localized in the ileum. Report of a case]. / Il carcinoma del tenue a localizzazione ileale. Descrizione di un caso.

On the basis of a case of adenocarcinoma of the small intestine which brought to their attention, the authors analyse the etiopathogenetic and clinical aspect of these tumours in the light of the international literature. In particular, they focus on the difficulty of making an early diagnosis due to the fact that the initial symptoms are vague and aspecific and instrumental tests often do not allow a differential diagnosis to be made between adenocarcinoma and chronic inflammatory disease of the small intestine, benign tumours and other neoplasias. Lastly, the authors underline the prime role of surgery in the treatment of this form of cancer despite the fact that the concept of oncological radicality is drastically reduced in relation to the lymphoglandular layout of the jejunum and ileum since it should include the sacrifice of the superior mesenteric artery with imaginable consequences.

[Leiomyosarcoma of the duodenum]. / Il leiomiosarcoma del duodeno.

The paper reports the case of a patient with leiomyosarcoma of the duodenum who underwent radical duodenocephalopancreatectomy and survived for 22 months after the operation. Following a review of the international literature on the topic, the diagnostic procedures and prognostic criteria of this uncommon tumour are discussed. In conclusion, leiomyosarcoma always presents considerable problems of diagnosis even with the aid of biopsy and only surgery can lead to recovery in a limited number of cases.