[Epithelioid hemangioendothelioma of the liver. A case report]. / Emangioendotelioma epitelioide del fegato. Descrizione di un caso.

One case of epithelioid hemangioendothelioma (EHE) of the liver is reported. The problems of a correct diagnosis of this unusual type of vascular tumor are discussed. A final diagnosis can be established only by histologic examination of appropriate material and may be helped by immunohistochemistry and ultrastructural examination. Tumor cells are vasoformative and synthesized Factor VIII-related antigen. The accurate diagnosis of EHE of the liver is of clinical and therapeutic relevance, for the favourable prognosis, also without therapy, nevertheless liver transplantation represents in selected cases (patients exhibiting a rapidly progressive liver failure) the only possible treatment. The case studied in our Department is very interesting, because it represents a summary of knowledge regarding this type of neoplasm in a 20-year period.

Benign multicystic mesothelial proliferation of the peritoneum: immunohistochemical and electron microscopical study of a case and review of the literature.

We report a case of benign multicystic mesothelial proliferation (the so-called multicystic peritoneal mesothelioma) arising multifocally in the abdomen of a 46-year-old white man. His anamnesis showed an 8-year history of intermittent pain in the right lower abdominal quadrant. Mucin stains, immunohistochemistry, and electron microscopy confirmed the mesothelial origin of the lesion. Review of the available literature allowed us to find another 85 reported cases of benign multicystic mesothelial proliferations of the peritoneum. Out of these cases, eighteen only occurred in men, the majority being reported in middle-aged women mostly with complaints of abdominal pain. Electron microscopy or immunohistochemistry are needed to make a differential diagnosis towards other multicystic lesions, such as peritoneal cystic lymphangioma. Although multicystic mesothelial proliferations of the peritoneum have often been regarded as benign neoplasms, the true nature--neoplastic or hyperplastic--of these lesions still remains greatly elusive. Therefore, we believe that the unbinding term benign multicystic mesothelial proliferation (first used with regard to the unique hitherto reported case arisen in the pleural cavity) should be considered at present more appropriate to indicate even these peritoneal lesions.

[Malignant neoplastic pathology in patients given a kidney transplant]. / La patologia neoplastica maligna nel paziente sottoposto a trapianto renale.

The incidence of malignant neoplasms in patients subjected to pharmacological immunosuppression following kidney transplantation is higher than that observed in the control population at large. In our unit, in a study population of 451 patients undergoing a total of 462 kidney transplants over the period from 1968 to 1986, four malignant neoplasms (0.9%) were observed in 3/369 (0.8%) patients treated with azathioprine (1 ovarian papilliferous cystoadenoma, 1 embryonal carcinoma of the testicle and 1 Kaposi's sarcoma) and in 1/93 (1.1%) patients treated with cyclosporin (1 Kaposi's sarcoma). The neoplasm was successfully controlled only in the first case after bilateral extended adnexectomy.

[Hyperparathyroidism in patients having undergone a kidney transplant]. / Iperparatiroidismo in pazienti sottoposti a trapianto renale.

The persistence or onset of hyperparathyroidism following kidney transplant is characterized by an incidence ranging from 2.6 to 70% according to the various statistics available. In a total of 462 kidney transplants performed in our department, hyperparathyroidism was detected in 9 patients. Surgery took the form of parathyroidectomy 8/8 plus autograft in 3 cases, parathyroidectomy 3/4 in 2 cases, 7/8 in 2 cases, and 4/8 in 1 case. Serum calcium values returned to normal in all patients after the operation.

[Cyclosporin A in immunosuppressive therapy of kidney transplants (clinical results in 55 patients)]. / La ciclosporina A nella terapia immunosoppressiva del trapianto di rene (risultati clinici su 55 pazienti).

The authors report the results of a clinical study of the use of cyclosporin A plus low-dose steroids in a consecutive series of 55 kidney transplants with follow-up ranging from 6 to 20 months. The clinical results (rejects, immunosuppressant side effects, 12-month survival of transplant and patient) are compared with those of a similar group of patients on "traditional" therapy (azathioprine plus high-dose steroids). The results of the study confirm the efficacy of cyclosporin A in preventing and controlling acute reject crises in the course of allogenic transplant, though many of the problematic issues related its clinico-therapeutic management remain open questions.

[Spontaneous perirenal extravasation of urine]. / Lo stravaso perirenale spontaneo d'urina.

Perirenal urinary extravasation in the course of violent renal colic appears to occur much more frequently than is reported in the literature. In this study, the authors report on three such cases observed personally in the space of one year and discuss the pathophysiological factors which may give rise to this phenomenon.