[Chronic lymphatic leukemia and large granular lymphocytes]. / Leucemia linfatica cronica a grandi linfociti granulari.

Chronic large granular lymphocyte leukemia is a rather rare disorder (less than 5% of LLC). Its subtype CD3+/CD8+ is often a clonal disease and without malignant characteristics. This kind of disease shows a clinical and laboratory heterogeneity, probably due to the immunological and functional variety of granular lymphocytes. In some cases of LGL leukemia an associated pathology, especially rheumatoid arthritis and chronic infections, has been reported. On the contrary, the relationship with neoplasms has been rarely proved in literature: only occasional studies have been reported and anyway they are not supported by a sufficient number of cases. Two cases of LGL leukemia are here delineated: a woman with advanced breast adenocarcinoma and another one with Sjögren disease. The first one had a rapidly fatal course, while the other one had a prolonged clinical course with chronic neutropenia (13 years follow-up). The association between carcinoma and LGL leukemia may be just a casual finding but the hypothesis of a possible relationship is however very interesting on account of the important role of granular lymphocytes in controlling tumoral growth. Moreover, both patients had concomitant chronic HCV-correlated infection: maybe it will worth making a prevalence study with a greater number of cases, in order to evaluate a probable relationship between these pathologies. The growth factor G-CSF may be useful in the treatment of infections that often occur in patients with severe neutropenia.

[Giant-cell arteritis. Comments on the case histories of 30 patients]. / Arterite a cellule giganti. Riflessioni su una casistica di 30 pazienti.

This survey deals with the main clinical aspects at the diagnosis and during the follow-up of thirty consecutive patients with giant-cell arteritis (temporal arteritis and rheumatic polymyalgia), controlled over a period of 15 years. The work aimed at verifying the diagnostic accuracy with regard to a more underestimated than rare disease. We believe that such a consideration is a useful introduction to a wider research into the epidemiological and biological aspects of the disease which are still to be determined.

[IgD myeloma: an aggressive variant. Description of a clinical case and review of the literature]. / Mieloma IgD: una variante aggressiva. Descrizione di un caso clinico e revisione della letteratura.

It is shown a case of IgD myeloma, a rare type of myeloma having often an aggressive course. Besides to confirm clinical and laboratory aspects already known in literature, this case seems to make in evidence a rapid neoplastic proliferation kinetic, difficult to be controlled by conventional chemotherapy. The Authors show that the M component low concentration and the unbalance of the synthesis of the immunoglobulin heavy and light chains may confuse IgD myeloma with light chain myeloma.