Primary T-cell lymphoma of the central nervous system.

A series of 6 patients with primary T-cell lymphomas of the central nervous system (PTCLCNS) is presented. The clinical, histological and immunohistological findings are shown. The lesions were infratentorial in the 34% and sopratentorial in the 66% of the cases. Of the 5 cases with an available follow-up only one died in the first year after diagnosis and one is alive and well after 42 months. These data agree with those of others series of PTCLCNS in the literature. In conclusion our data and those of the literature suggest that immunophenotyping should routinely be carried in primary non-Hodgkin's lymphomas of the CNS (PNHLCNS), because the T-cell forms run a more favourable course than the B-cell varieties.

Meningeal sarcoma with rhabdomyoblastic differentiation: case report.

A case of primary neoplasm of the meninges with unusual histological and clinical features, which occurred in a 61-year-old man is described. Although conventional light microscopy revealed an undifferentiated tumor consisting of small- to medium-sized elements, it did not allow any definitive histogenetic interpretation. Immunohistochemistry showed that the neoplastic cells were positive for actin, desmin, myoglobin, and vimentin, thus leading to the diagnosis of meningeal sarcoma with rhabdomyoblastic differentiation. This interpretation was also supported by electron microscopy, in dewaxed tissue samples, which revealed the presence of abortive Z-lines. It is noteworthy that retrospective microscopic examination of all the slides obtained both at initial presentation and at relapses demonstrated in some fields that the undifferentiated population was associated with typical meningiomatous features, as was also shown by the staining for the epithelial membrane antigen. Clinically, the tumor was characterized by an exceedingly long course (10 years). The histogenesis of the tumor and the diagnostic relevance of immunohistochemical techniques are discussed.

[Mexiletine in patients with progressive infarction and reduced ventricular function: anti-arrhythmic efficacy and hemodynamic effects]. / Mexiletina per os in pazienti con pregresso infarto e ridotta funzione ventricolare: efficacia antiaritmica ed effetti emodinamici.

Reduced left ventricular function and ventricular arrhythmias are the main risk factors associated with sudden death in patients with previous acute myocardial infarction. Antiarrhythmic therapy may have side-effects on myocardial contractility and sometimes makes the arrhythmia itself worse, especially when the pump function is seriously compromised. The aim of this study was to evaluate the efficacy of oral mexiletine as well as any modifications in left ventricular function by means of ambulatory ECG monitoring and angiocardiography with Tc 99m, at rest and after the handgrip test, in 20 patients with previous myocardial infarction and ventricular arrhythmias who were grouped into NYHA class II and class III. The mexiletine therapy lasted three weeks. Both classes showed a significant decrease in the number of ventricular extrasystoles/hour and in the number of couples (p less than 0.01). The decrease in the number of the ventricular runs proved to be higher in the general analysis (p less than 0.01) than in each NYHA class (p less than 0.05). At the end of the study, significant modifications were not observed either in the end-diastolic and end-systolic volumes, or in the ventricular ejection fraction.