Long-term survival in primary amyloidosis of the laryngotracheobronchial tract by treating complications only.

Primary amyloidosis limited to the laryngotracheobronchial tract is relatively uncommon; therefore, knowledge of survival in these patients is poor and consensus regarding appropriate therapy unreached. The case is reported of a patient affected by primary amyloidosis limited to the laryngotracheobronchial tract who had a long survival and a good quality of life after only medical and neodymium-yttrium aluminium garnet (Nd-YAG) laser therapy. The patient had amyloidosis first detected in the larynx, which, 4 yrs later, progressed to involve the tracheobronchial tract, without pulmonary involvement. The patient was treated three times with Nd-YAG laser to obtain the recanalization of obstructed bronchi, with evident improvement of symptoms and pulmonary function. In conclusion, laryngotracheobronchial amyloidosis survival may be lengthened and quality of life made more acceptable by treating potential complications only.

Colonic disease in cirrhotic patients with portal hypertension: an endoscopic and clinical evaluation.

Fifty cirrhotic patients with portal hypertension but without colonic or systemic disease underwent lower gastrointestinal endoscopy in order to investigate the effects, if any, of portal hypertension on the colon. Fifty patients without liver or systemic disease, examined by colonoscopy because of irritable bowel syndrome in the same period served as controls. Rectosigmoid varices were observed in 34% of the cirrhotic patients and 2% of the controls. Hemorrhoids were observed in 70% of the cirrhotic patients and 48% of the controls. Multiple vascular-appearing lesions were found in 16% of the cirrhotic patients and 6% of the controls. Nonspecific inflammatory changes were noted in 10% of the cirrhotic patients and 4% of the controls. Simultaneous presence, in the same patient, of rectosigmoid varices, hemorrhoids, multiple vascular-appearing lesions, and nonspecific inflammatory changes, was observed in only five (10%) of the cirrhotic patients. We found polyps in 12% of the cirrhotic patients and 14% of the controls, and a malignant tumor in 4% of the cirrhotic patients. The patients with normal colonoscopic findings were 8% of the cirrhotic patients and 36% of the controls. All patients and controls were followed up for 1 year; there was no gastrointestinal hemorrhage among controls, whereas 34% of the cirrhotic patients had an upper gastrointestinal hemorrhage (88% from esophageal varices, 12% from the stomach) and 4% had a lower gastrointestinal hemorrhage (one from rectosigmoid varices and one from nonspecific inflammatory lesions). Colonic lesions were significantly more frequent in the cirrhotic patients (92%) than in the control group (64%); however, such lesions did not seem specific to the disease and were not statistically correlated with the degree of esophageal varices by Child's grading, the etiology of cirrhosis, or the bleeding risk from the lower gastrointestinal tract.

An unusual neck mass: the Warthin tumor.

The cystoadenolymphoma or Warthin's tumor is a benign lesion of the salivary glands and principally of the parotid gland. We report a case of a 62 year old white male seen at our Institute for evaluation of an asymptomatic right neck mass located 2 cm below the mandible at the anterior margin of the sternocleidomastoid muscle. The echography showed a lymphoid structure simulating a lymphoproliferative process. Histologic examination of the surgical specimen revealed a Warthin's tumor. We discuss the importance of considering Warthin's tumor in the differential diagnosis of an isolated neck mass, and report our experience over a ten year period in the surgical management of neck masses. Additionally, the literature concerning extraparotid Warthin's tumors is reviewed.

[Human muscle dirofilariasis of difficult diagnosis]. / Dirofilariasi muscolare umana di difficile diagnosi.

A case of Dirofilariasis by Dirofilaria repens localized in the left temporalis muscle, in a 43-year-old woman, is described. It was acquired in South-western Sicily but became apparent in Pisa. It is the seventh case of human Dirofilariasis reported from this area, confirming the existence of an endemic focus. In spite of the numerous investigations to identify clinically the illness (needle-aspirate, Echography, CTScan) the diagnosis was possible only upon discovery of the nematode in the histological sections of the surgically removed nodule.

Multiple and reversible osteolytic lesions: an unusual manifestation of behcet's disease.

We describe a patient with Behcet's disease (BD) who developed multiple and reversible osteolytic lesions during the course of disease. The possible relationships between BD and this very unusual manifestation are discussed.

Cholesterol granuloma of the frontal sinus. A case report.

A rare case of cholesterol granuloma of the frontal sinus is reported. The pathogenetical mechanisms and the tumour's behaviour are discussed on the basis of the patient's, the radiologic examination and the pathologist's finding's. A follow-up of three years is given.

Hibernoma of the larynx. Review of the literature and a new case.

Hibernoma is a rare, benign, soft-tissue tumour composed of cells similar to those of brown adipose tissue. Only seven cases in the cervical area have been reported and none in the larynx. A case of hibernoma of the pre-epiglottic area is presented and the histological, histogenetical and clinical features are discussed.

Leiomyoma of the nose. A case report.

A case of leiomyoma of the nose is reported. The nose is a very rare site for tumours of myogenic origin. Up to date, only seven cases have been published. Anatomopathological considerations and etiopathogenetic hypotheses are discussed.