[Quantitative analysis of DNA using flow cytometry and immunocytochemical findings in 16 cases of cardiac myxomas]. / Analisi quantitativa del DNA mediante citometria a flusso e rilievi immunocitochimici in 16 casi di mixomi cardiaci.

Recently some Authors focused nosological and biological aspects of the cardiac mixomas. Their neoplastic nature and origin from undifferentiated mesencymal cell with multipotential capability have been confirmed. Morphological and immunocytochemical aspects alone are not able to screen "sporadic" from "non-sporadic" mixomas. The last are associated with local recurrence and distant embolization. "Non-sporadic" mixomas are also part of a heritable syndrome involving skin, endocrine tumors and lentiginosis. It seems that this kind of mixomas display a DNA tetrapoid pattern at DNA flow cytometry. In the series of the Authors, consisting of 16 operative mixomas, all but one showed a DNA diploid pattern. Only in one case the pattern was tetraploid.

[Does the analysis of DNA in myocytes have meaning?]. / Ha significato l'analisi del DNA nei miociti?

It seems that polyploidisation of the heart muscle nuclei is a physiological phenomenon that increases in pathological conditions such as muscolar dystrophy, myocardial hypertrophy. We studied the nuclear DNA content of myocites, by means of cytofluorimetric determinations in different sites of the left free ventricular wall in five hearts affected by dilatative myocardiopathy. In all the different sites examined we revealed diploid and tetraploid nuclear content. Variable was the presence of 8N poliploid peaks: specifically 40% in the external third, 47% in the medium third and 73% in the inner third. 16N polyploid peaks were revealed only twice, and exactly in one medium third and in one inner third. These data, even if quite preliminary, suggest the presence of an increasing gradient of ploydisation from the external toward the inner part of the left ventricular wall.

[Atheroembolism: a form of systemic vascular disease]. / L'ateroembolismo: una forma di vasculopatia sistemica.

Atheroembolism, a systemic vascular disease. Cholesterol crystal embolization (CCE) is an infrequent but serious disorder that is often an unrecognized medical problem. CCE may occur spontaneously from eroded atherosclerotic plaques or most frequently following procedures such as angiography, angioplasty, cardiac catheterization, anticoagulant therapy and aortic surgery. CCE predominantly affects elderly males with a frequent history of hypertension, atherosclerotic vascular diseases and renal insufficiency. CCE may result in protean clinical manifestations and may produce a spectrum of functional impairment. Confusion over the disease's natural history arises because the difficulty of establishing an antemortem diagnosis, and because the laboratory findings are non-diagnostic and non-specific. The mortality was 81% and the causes of death was most often due to multiorgan failure especially renal involvement. The definitive diagnosis depends upon finding the presence of intravascular cholesterol crystal in biopsy or autopsy specimens. The skin, muscle and kidney were the three most common sites for obtaining a premortem diagnostic biopsy.

[Melanoblastoma of the meninges. Immunohistochemical and ultrastructural study of a case]. / Il melanoblastoma delle meningi. Studio immunoistochimico ed ultrastrutturale di un caso.

Primary diffuse melanoblastomatosis of the leptomeninges is an uncommon disease and are not associated with any specific clinical or radiologic features. Diagnosis is usually post-mortem and first regard the interpretation of malignant melanoblastomatosis as a primary neoplasm; the situation is complicated by the fact that a primary melanoma, in this site, may metastasize to extraneural organs and a detailed dissection of the entire body, including the orbital contents, aims to reveal no primary tumor outside the nervous system. Differential diagnosis is V.S. others pigmented tumors of the C.N.S. Electronmicroscopic and immunohistochemical analysis were performed and confirmed the diagnosis.

Malignant change in a benign pulmonary hamartoma.

Sarcomatous transformation in a longstanding, clinically silent hamartoma is reported. Malignant change occurred shortly after resection, suggesting that surgical manipulation may have played a part.

Parietal centripetal and centrifugal thickening neovascularization in the descending anterior coronary artery. Possible relations with the problem of collateral circulation.

Left coronary arteries of 30 human hearts, obtained at autopsy, were injected with contrast medium. A control group was formed from anterior descending coronary arteries free of atherosclerosis and a study group from anterior descending coronary arteries with areas of atherosclerotic injury. The following differences in the two groups were noted. The control group did not show successfully injected vessels in intima and media, while cases with atherosclerotic injury have them; the number of injected vessels in presence of atherosclerotic injury was three times greater than in healthy coronary arteries; there was a decreasing gradient from outside to in, in the number of injected vessels in both groups; and finally in atherosclerotic vessels we noted a lack of balance between parietal thickening and the residual lumen (conspicuous thickening was accompanied by a small reduction in the lumen). We interpret centrifugal thickening as a possible compensatory mechanism in the major branches for an inadequate canalization of vessel, and suggest possible formation, of coronary collateral circulation from vasa vasorum by a process of neovascularization.

[Angioimmunoblastic lymphadenopathy. Anatomoclinical and immunological study of a case]. / Linfoadenopatia angioimmunoblastica. Studio anatomoclinico ed immunologico di un caso.

The clinical course of a 54-year-old man with generalized lymphadenopathy bearing all physical, laboratory and histologic characteristics of angioimmunoblastic lymphadenopathy with dysproteinemia is described. Morphologic and laboratory features of a hyperimmune state with autoimmune hemolytic anemia, elevated cold agglutinin levels and polyclonal gammopathy, but with paradoxical cutaneous anergy and decrease in blood T-lymphocytes, were found. Therapy with levamisole was without significant benefit and the patient died 2 months after initial diagnosis. Our findings give further support to the contention that this disease is an abnormal, but non-neoplastic, immune reaction resulting from a loss of suppressor T cells with hyperfunction of the B lymphocyte system.

Course and prognosis of bone cystinosis in adolescent and or adults.

The authors refer to their observations on a case reported five years ago. On the basis of electron microscopy findings it was classified as benign bone cystinosis of the adolescent or of the adult. His subsequent clinical recovery, and the present radiographic findings, which show spontaneous and almost complete repair, confirm the validity of the diagnosis and the importance of electron microscopy in the etiology of this rare bone lesion.

Cystinosis of bone.

The authors describe a case of cystinosis of bone that presented initial difficulties in diagnosis. They discuss the clinical features and the radiographic appearances, which demonstrated numerous zones of osteoporosis with a markedly monomelic distribution in the left leg. The condition arose as a result of trauma. Numerous accumulations of intracellular cystine crystals were revealed by the ultramicroscopic study of bone fragments obtained by biopsy, and this led the authors to diagnose the case as cystine thesaurismosis of bone. The case is of interest not only because of its exceptional rarity (it is, perhaps, the first reported case of cystinosis localized exclusively in bone), but also because it was only possible to arrive at a diagnosis by means of ultramicroscopic investigation.