[Gynecomastia]. / La ginecomastia.

Gynecomastia is a benign pathology due to the increased volume of the mammary glands. The various etiological factors lead to an imbalanced estrogen/androgen ratio or to a greater local receptivity to the former with consequent hypertrophy of the mammary stromal gland components. Although the majority of cases are benign and/or transient, gynecomastia must be carefully examined using thorough anamnesis, hormone assays and instrumental tests in order to exclude local or further removed pathology. At present, medical or surgical therapy is reserved for those cases in which this condition is painful and/or psychologically damaging. In this study, following a review of the literature, the Authors focus on the etiological, diagnostic and therapeutic aspects of gynecomastia and illustrate the cases they have observed.

[Ultrasonography and ultrasound-guided biopsy in lymphomas]. / Ecografia e biopsia ecoguidata nei linfomi.

The authors have reviewed the literature on imaging techniques for the diagnosis of lymphoma. Lymphography, axial computerized tomography (CT) and echotomography have been compared as to their sensitivity and specificity. Lymphography allows diagnosis of the disease even in lymph nodes of less than 0.5 cm diameter, but this technique cannot be applied to all lymphatic station. Echotomography and CT are equivalent as to the accuracy of diagnosis and are both helpful for guided needle biopsy. In view of its low cost, echotomography is considered by most workers the first-line approach to the evaluation of lymphoma patients. In spite of its advantages over other methods, echotomography must, nevertheless, be integrated by CT, lymphography, and nuclear magnetic resonance.

[Echography in the diagnosis of breast cancer]. / L'ecografia nella diagnosi del cancro mammario.

Fifty-one patients with clinically palpable breast cancer were examined using small-parts echotomography. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of overall diagnosis were assessed in the two groups of patients: T1 (diameter less than 2 cm) and T2-T3-T4 (diameter greater than 2 cm). The frequency of the main echographic signs associated with breast cancer was also investigated. Diagnostic accuracy was found to be high in the T2-T3-T4 group (93%), but very low in the T1 group (71%). The study confirms the importance of ultrasound as an additional test in the study of breast cancer. However, this method becomes increasingly less sensitive and specific as the size of the tumour decreases.

[Arterial hypertension with hypokalemia]. / Ipertensione arteriosa con ipopotassiemia.

After a careful review of the literature on physiopathological role of the renin-angiotensin-aldosterone system in cases of arterial hypertension with hypokalaemia, a simple diagnostic procedure is suggested to differentiate between this and secondary hypertensions which, though few, are often curable. Three clinical cases examined in the medical department of Casalpusterlengo Hospital are presented in which the study of the renin-angiotensin system proved decisive for a correct diagnosis of the hypertension.