[3 cases of paraneoplastic syndrome caused by lymphoma of the small intestine]. / Osservazioni su tre casi di sindromi paraneoplastiche da linfomi del tenue.

Three cases of lymphoma of the small intestine accompanied by numerous aspecific signs related to probable paraneoplastic syndromes are reported. All patients presented watch glass nails and drumstick fingers. These were associated, in the first patient, with initial pruritus followed by a picture of ichthyosis and, in the second, with a polyneuritic syndrome localised initially at the nerves of the lumbosacral plexus, later extended to the right facial nerve. The practical importance of such signs, which often precede and dominate, at least initially, symptomatology in the gastroenteric apparatus, is pointed out. Their early recognition may lead to a suspicion of the fundamental condition, thus avoiding diagnostic errors and permitting earlier diagnosis and faster treatment.

[2 cases of hairy cell leukemia]. / Osservazioni su due casi di tricoleucemia.

Two cases of tricholeukaemia are reported. In both, onset and course of the disease were dominated by infectious episodes of varying gravity. Diagnosis was based on the finding in the blood and bone marrow of mononucleate cells containing the characteristic cytoplasmatic projections, best recognised in the phase contrast microscope, and on the cytochemical finding of intense positivity of the acid phosphatase reaction, that a very serious septic state starting from a dental abscess was possible in a patients by associating infusions of paps of leucocyte concentrates with massive target antibiotic therapy. Splenectomy carried out in the same patient led to an increase in the number of circulating platelets and leukocytes. After operation, two episodes of cutaneous inflammation presented by the same patient were less serious than similar previous infectious episodes.

[The diagnosis of chronic pyelonephritis in internal medicine]. / La diagnosi di pielonefrite cronica in medicina interna.

All those clinical, laboratory, radiological and radioisotopic elements of importance in the diagnosis of chronic pyelonephritis in internal medicine have been examined. Anamnestic indications of chronic pyelonephritis include previous infections episodes of the urinary ways, pain in the lumbar and suprapubic region and micturition disturbances. Less significant are objective findings such as pain at percussion of the lumber region, hypertension and possible signs of renal insufficiency. Important diagnostically among laboratory examinations are leucocyturia higher than 1,000.000 in 24 hours, a findings of leucocyte cylinders, bacteriuria higher than 100.000 per cc of urine and the observation of immunoantibodies covering bacteria isolated from the urine. X-ray and radioisotopic examinations are recognised as having considerable diagnostic usefulness. None of the clinical, laboratory, X-ray or radioisotopic findings is, however, strictly specific. Confirmation of a diagnostic suspicion is only possible when scrupulous accumulation of the most typical subjective and objective findings regarding the disease is accompanied by the positivity of diagnostic tests. The results of these tests must in all cases be assessed critically in the context of the clinical picture for, taken singly, they have no decisive value.