Anatomopathological Characteristics Research Articles

Sonographic Interstitial Syndrome

Ultrasound lung comets (ULCs) now have an acknowledged correlation with extravascular lung water, but they present in different orders and numbers in different pathologic pulmonary entities. How these artifacts are created is not yet known, and the literature gives discordant hypotheses. Understanding their formation is the first step in understanding lung disease. The purpose of this study was to show the morphologic and genetic variability of interstitial lung disease studied with echography and thus to propose a unitary mechanism for the formation of ULCs. This study included 3 parts: (1) a retrospective analysis of echographic lung images of patients with interstitial syndrome; (2) an analysis of the literature for definitions of the size of the pulmonary lobule; and (3) an experimental model of different air-water interfaces scanned with varying ultrasonic frequencies. The retrospective analysis of echographic lung images included 176 patients with diffuse ULCs: 118 patients had acute pulmonary edema; 18 had acute lung injury/acute respiratory distress syndrome; and 40 were premature neonates with respiratory distress syndrome. Experimental models permitted us to discover that ring-down artifacts are produced only by single and double layers of bubbles in specific structural settings. Reverberation between bubbles with a critical radius seems to be at the origin of ring-down artifacts. Echographic manifestations of interstitial lung disease, whose genesis lies in the partial air loss of lobes and segments, are acoustic phenomena originating from variations in the tissue-fluid relationship of the lung. A correlation between anatomopathologic characteristics and structures of sonographic artifacts could allow more rapid and noninvasive diagnoses.

Cysticercosis in the elderly

The immunosenescence, a peculiarity of the aging process, increases the susceptibility of elderly individuals to neoplasia, infections, and parasitosis, among them, cysticercosis. The aim of this study was to compare the epidemiological and anatomopathological characteristics of cysticercosis in elderly or nonelderly patients. We reviewed 72 autopsies, protocols and specimens, performed in the School Hospital of the Triangulo Mineiro Federal University. We selected 3 groups: elderly with cysticercosis, nonelderly with cysticercosis, and control group without cysticercosis. From the patients with cysticercosis, 27.8% were elderly. Of these, 80% presented with neurocysticercosis and 20% cardiac cysticercosis. In the elderly, the early stages of the parasitic development, vesicular and colloidal vesicular, prevailed (75%). In relationship with the causes of death, death in 40% of the elderly was by neoplasic and 35% by cardiovascular, whereas for the nonelderly, death in 63.5% was by cardiovascular and 25% by infectious. There was a significant difference between groups with relation to neoplasic and cardiovascular causes. Therefore, cysticercosis was frequent in elderly patients, and probably patients are continuously infected with cysticercosis as they age. Perhaps, decurrence of the immunosenescence associated with immunological alterations caused by cysticercosis form favorable conditions to the development of neoplasias in the elderly attacked by the parasitosis.

Effects of acetylsalicylic acid and acetic acid solutions on VX2 liver carcinoma in rabbits: in vivo analysis

To analyze, in vitro, the effects of acetylsalicylic acid (aspirin) and acetic acid solutions on VX2 carcinoma cells in the liver of rabbits with VX2 hepatic tumors; to determine the histolytic and anatomopathological characteristics of the solutions; and to evaluate the eventual biochemical and hepatic changes. A total of 48 rabbits were evaluated. The animals were randomized into two groups, protocol 3 (study group) and protocol 4 (controls), and each group was then subdivided into 3 subgroups. Four days after implantation of the tumor in the liver, median laparotomy was performed with a 0.4-ml injection of a solution of either aspirin (5.0%), acetic acid (5.0%) or saline. The animals were sacrificed after 24 hours (protocol 3) or after 11 days (protocol 4). Body weight, clinical evolution and biochemical levels, as well as the abdominal and thoracic cavities, were evaluated, and liver microscopy was performed. No changes in clinical evolution, body weight or biochemical levels were reported. However, an increase in alkaline phosphatase was observed in protocol 4 (controls). The tumor was eliminated in both protocols. Acetylsalicylic acid and acetic acid solutions cause the destruction of experimental hepatic tumors.

Estudio de la progresión del cáncer de próstata incidental según el tipo de tratamiento aplicado

Introduction and objectives:Prostate cancer is a common neoplasm, with a significant burden of mortality. Since it’s diagnosed at old ages and usually growths slowly, agresive treatment of localised cancer of prostate could be of little benefit. The study of the evolution of incidental prostate cancer diagnosed 20 years ago could give directions for present decision-making Methods:We performed a time survival analysis of patients diagnosed of incidental prostate cancer between 1980 and 2000, and followed them until april 2005. We analysed overall and disease-specific mortality, related to the kind of treatment and some anatomopathological characteristics. Results:We included 80 cases. Treatment was hormonotherapy in 34 cases, surgery in 4, radiotherapy in 3 and watchful waiting in 39. Overall average survival was 8.87 years. Disease-specific survival in low risk group (Gleason lower than 6) was 16 years, and in high risk group (Gleason higher than 7) was 6 years. No differences were found between hormonotherapy and watchful waiting. Conclusions:While in low risk patients watchful waiting represents an acceptable aproaching, it could not be adequate in high risk cases. Hormonotherapy showed no benefit in incidental prostate cancer.

Endogenous Expression of C-Reactive Protein Is Increased in Active (Ulcerated Noncomplicated) Human Carotid Artery Plaques

There is growing evidence suggesting that C-reactive protein (CRP) is an effecter molecule able to induce and promote atherothrombosis. The presence of CRP in atherosclerotic plaques may reflect local production or infiltration from circulating CRP increased in general inflammatory responses. Our aim was to analyze the presence of CRP in human advanced carotid artery plaques with differential anatomo-pathological characteristics and to assess local expression of CRP and other proinflammatory genes in these lesions. Human carotid artery specimens from 38 patients undergoing scheduled endarterectomy were classified into 3 groups: ulcerated (noncomplicated) (UNC, n=19), fibrous (F, n=12) and ulcerated (complicated/hemorrhagic) plaques (UC, n=7). The presence of CRP was evaluated by immunohistochemistry, and plasma samples were screened for circulating high-sensitivity C-reactive protein. TaqMan Low-density Arrays were used for study of genes related to inflammation (CRP, interleukin-6, macrophage colony-stimulating factor-1, monocyte chemotactic protein-1, cyclooxygenase-2). CRP mRNA levels were predominantly detected in UNC-high risk plaques but not in UC (P=0.001). UNC also exhibit the highest expression levels of other genes involved in the inflammatory responses: cyclooxygenase-2 (P<0.005 versus F and versus UC), IL-6 (P<0.005 versus F and versus UC) and monocyte chemoattractant protein-1 (P<0.01 versus F and versus UC). Plaque CRP mRNA levels correlated with immunohistochemical findings but were independent of plasma high-sensitivity CRP. In UNC plaques endothelial cells and inflammatory cells were strongly positive for CRP around areas of newly formed microvessels. In human high-risk carotid artery plaques (UNC) CRP expression reflects an active proinflammatory stage. Local synthesis of CRP could be involved in plaque neovascularization and increased risk of hemorrhagic transformation.

Patients with chronic hepatitis C and normal transaminases

Hepatitis C virus infection evolves progressively persisting in the majority of patients (85%). Most patients have high ALT (alanine aminotransferase) levels and approximately 25% normal ALT. The latter are usually female and there is no association between genotype and severity of hepatic lesion. Histologic analysis usually shows small lesion and absence or low amount of fibrosis, despite cirrhosis having been reported. Aiming at assessing prevalence, demographic, genotypical and anatomopathological characteristics in patients with normal ALT levels, we have carried out a study of 68 chronic hepatitis C patients between January 1997 and April 2000. There was a prevalence of 13.8% chronic hepatitis C patients with normal ALT levels, 45.6% of which were male and 54.4% female, the mean age being 38 +/- 13 years. We found a predominance of genotype 1 in 84.7% of the patients, genotype 2 in 6.8% and genotype 3 in 10.7%. In 52.9% of the cases liver biopsies revealed liver reaction, periportal activity score 0-1 was observed in 85.3% of the patients and score 2-4 was seen in 14.7%. Structural activity score 0-1 was seen in 73.5% of the patients and score 2-4 in 26.5% of them. Periportal activity > or = 2 and structural activity > 1 was seen in 29%, but steatosis was not seen in 73.5%. Our results suggest the need to revisit for liver biopsy practice in patients with chronic hepatitis C and normal transaminases.

Carcinome à cellules claires de la glande parotide

Clear cell carcinomas of the parotid gland are hardly reported only fifty cases are known. They are characterized by a proliferation of acinic epithelial cells and of clear myo epithelial cells. What makes them remarkable is a slow process of evolution. Three cases which were treated in the Ibn Rochd center of oncology are gathered from the 1999-2003 period into a review in order to discover the epidemic and anatomopathological characteristics of these tumours. The goal of study is to contribute to a best knowledge of the clinical features, pare clinical, anatomopathological and therapeutic characteristic of this tumour. Two men, aged of 62 and 71 and a 82-years-old-woman were concerned. Growing cervical mass was the most revealing symptom. The diagnosis was established by the parotid biopsy in 2 cases and after surgery in the third case. The treatment consisted in a total parotidectomy with conservation of the facial nerve and postoperative radiation at the extend of 65 Gy for the first patient. After 12 months the patient is still alive. As for the two other patients, given the extend of advancement of the tumour, palliative treatment was decided. It resulted in stabilization of the disease and a receding of 22 months for one patient and no trace of the second one because of a loss of the evolutionary pursuit. With an in-depth analysis we can notice that clear cell carcinomas of the parotid gland are rare and mostly occur to old patients. Immunohistochemistry is the essential first step to sort these tumour with other salivary ones. Basic treatment is surgery. Radiation therapy linked to surgery seems to improve the local control of the disease. The prognosis remains relatively good despite discusses. Because of the few published cases, it's hard to analyze these tumours.

Mesotelioma pleural com metástase renal em gato

It has been described the anatomopathological and immunohistochemical characteristics of a multinodular neoplasm distributed in the parietal and visceral pleurae, pericardium, thoracic portion of the diaphragm and renal cortex of an eight year-old, female, mixed breed, cat. Based on the anatomopathological and immunohistochemical findings it was firmed the diagnosis of biphasic pleural mesotelioma with renal metastasis.

Estudo de 11 casos de fibroelastose endocárdica primária

INTRODUCAO: A fibroelastose endocardica (FEE) e definida como espessamento difuso do endocardio ventricular em funcao da proliferacao de fibras colagenas e elasticas. Pode ser classificada como primaria ou secundaria. A FEE primaria apresenta-se na forma dilatada, mais comum, ou na forma restritiva. Geralmente manifesta-se como insuficiencia cardiaca inexplicada, em criancas com menos de 12 meses de idade. OBJEIVOS: Avaliar aspectos epidemiologicos, clinicos e anatomopatologicos da FEE primaria. MATERIAL E METODO: Foram pesquisadas, entre 1960 e 2000, 6.211 necropsias perinatais e pediatricas do Hospital de Clinicas da Universidade Federal do Parana (UFPR), tendo sido verificados 11 casos de FEE. RESULTADOS: Em nove casos (81,8%), o surgimento dos sintomas ocorreu antes de 1 ano de idade. Em oito (72,7%), o obito ocorreu antes de 1 ano de idade. Dentre os sinais clinicos, destacaram-se taquipneia (54,5%), hepatomegalia (45,5%), tosse (36,4%), cianose (36,4%) e febre (36,4%). Todas as radiografias (n = 6) apresentavam cardiomegalia. O espessamento endocardico predominou no coracao esquerdo (90,9%). A causa de obito foi insuficiencia respiratoria aguda em cinco casos (45,5%) e choque cardiogenico em quatro (36,4%). DISCUSSAO E CONCLUSOES: Os resultados mostram acometimento predominante de criancas com menos de 1 ano de idade e rapida progressao para obito. Sinais clinicos frequentes, como taquipneia, tosse e febre, sugeriram infeccao respiratoria, que foi confirmada por necropsia em tres casos (27,3%). Os exames complementares mostraram apenas achados sugestivos de insuficiencia cardiaca. Os dados analisados neste estudo mostram que, em nosso meio, a FEE primaria nao difere significativamente do que e apresentado na literatura internacional em relacao a caracteristicas epidemiologicas, clinicas e anatomopatologicas.

Reacciones granulomatosas secundarias a herpes zóster

Abstract—Skin lesions that develop over the sites of resolved herpes zoster are infrequent and diverse. The most frequent ones are granuloma annulare and other types of granulomatous diseases, although others have been described, such as solid malignant tumors, leukemic or lymphomatous infiltrations, infections and comedonic reactions. We review four patients (2 women and 2 men) aged between 34 and 78 years (mean age 61) with granulomatous skin lesions that appeared at the sites of prior herpes zoster. In all of them, a skin biopsy was performed, and the epidemiological, clinical and anatomopathological characteristics were reviewed. The clinical lesions were highly variable, including erythematous papules, depressed scars, infiltrated maculopapular lesions and nodules. In all four cases, the presence of granulomatous infiltration made up of epithelioid-cell granulomas and multinuclear giant cells with no caseous necrosis was observed as a common histological finding. Three of the patients showed a lichenoid infiltrate. There were no signs of herpes infection in the histology.We would like to emphasize the variable clinical presentation of the skin lesions. In the histopathological findings, apart from the granulomatous infiltrate, three patients showed a lichenoid reaction rarely described in literature.

Tumeurs rénales malignes avant l’âge d’un an: Expérience d’un service de chirurgie pédiatrique nord africain

The malignant tumours of the kidney are not very frequent during the first year of life and pose diagnostic and therapeutic problems. The aim of this work is to make an analysis of the epidemiologic, clinical and anatomo-pathological characteristics of these tumours during the first year of life and a development on the therapeutic methods and their results. Materiel and methods. – This is a retrospective study of 8 observations of malignant tumours of the kidney whose first symptomatology appeared during the first year of life. Results. – The malignant tumours of the kidneyobserved before the one year age constituted 18% of the tumours of the kidney in the child. A female prevalence was noted with a sex-ratio of 0,6. The assessment of extension found cutaneous (one case), ganglionic (one case) and pulmonary (two cases) metastases. First chemotherapy was prescribed to five patients. The surgery consisted on a widened nephrectomy in seven cases and a tumorectomy for an infant presenting a nephroblastomatosis. The tumour corresponded to a nephroblastoma in seven cases and a rhabdoide tumour in the last case. Mortality was high (50%) caused by the toxicity of chemotherapy in three cases and an advanced stage of cancer in one case. Conclusion. – Renal tumoral pathology occurring in infants less than one year of age poses true etiologic and therapeutic problems. The high frequency of the nephroblastoma and the absence of benign tumour in our series encourage us to evocate more often the malignant renal tumours and to practice per cutaneous biopsies in case of diagnostic doubt.

Anatomopathological lesions of bladder endometriosis are heterogeneous

Objective: To present the anatomopathological characteristics of deep bladder endometriosis. Design: Descriptive anatomapathological study. Setting: A university hospital department of gynecological surgery. Patient(s): Eleven consecutive patients complaining of pelvic pain and painful urinary functional symptoms. Intervention(s): Laparoscopic partial cystectomy. Main Outcome Measure(s): Macroscopic and microscopic characteristics of deep bladder endometriosis lesions. Result(s): Deep bladder endometriosis lesions were extremely heterogeneous, not only in any one patient but also from one patient to another. Bladder muscularis propria presented three aspects: [1] hyperplasia of the fibromuscular tissue (4/11); [2] simple dissociation of the smooth muscle fiber bundles with no veritable “disorganization” (4/11); [3] simple thickening of the interstitial collagen network, or sclerosis (3/11). A histological adenomyotic nodule aspect was only observed in one patient (9%). Conclusion(s): Bladder endometriosis is an enigmatic disease. No hypothesis can be proposed as a single explanation for its pathogenesis.

Multivariate analysis of the morphometric characteristics of tumours as prognostic factors in the survival of patients with uterine cervix cancer treated with radical surgery

Objectives: To analyse the influence of tumour size and anatomopathological characteristics in the prognosis of patients with early-stage cancer of the uterine cervix treated with radical surgery. Study design: A historical study of 114 patients treated at the Maternity Hospital “La Fe” in Valencia was undertaken during the period 1971–1989. The influence of the principal risk factors on prognosis were studied and their effect adjusted using a multivariate analysis based on the Cox proportional hazards model. Results: A greater dimension of the tumour, tumour area, tumour volume, tumour-cervix quotient and stromal invasion depth all have a highly significant and negative correlation with survival and disease-free survival intervals. In the multivariate analysis, tumour volume and stromal invasion depth maintained their significance as indicators of an adverse prognosis regarding the disease-free survival interval, as did the stromal invasion depth in the case of survival. Conclusions: The most important prognostic factor in the evolution of patients with a cervical carcinoma is the stromal invasion depth followed by tumour size.

Mixomas cardíacos: correlación anatomoclínica

Myxomas are the most common type of primary cardiac tumors. The aim of this study was to analyze the clinical forms of presentation of cardiac myxoma, the postoperative evolution, and the possibility of recurrence and tumoral embolism. From July 1992 to March 1999, 31 patients with myxoma were studied. Cell cycles (ploidy pattern of the tumoral DNA) were studied in 12 patients to evaluate the risk of recurrence and tumoral embolism. The most frequent clinical manifestations were constitutional symptoms (74%), dyspnea (45%), and embolism (41%). Smaller-diameter myxomas correlated independently with tumoral embolism (45%). The in-hospital mortality was 3.2%, no deaths were observed during follow-up (mean: 4.8 years). No patients had clinical or echocardiographic signs of tumoral recurrence. Patients with tumoral embolism (n = 8) were compared with patients without embolism (n = 4). Patients who suffered embolism had higher S phase > 7 and/or DNA index > 1.2 (4/4 patients [100%], p= 0.061) than patients without embolism (2/8 patients [25%]). Cytometry of the only recurrent tumor (second operation) revealed a diploid tumor with a significantly more frequent S phase (10%) than in sporadic myxomas (4.27 2.32%, p = 0.039). Constitutional symptoms, dyspnea, and tumor embolism were the most frequent clinical manifestations. Clinical and anatomopathologic characteristics and the cell cycle were not significantly related to tumoral embolism, but there was a tendency toward a higher proportion of cells in S phase and a higher DNA index in tumors associated with embolism. The S phase was significantly more frequent in the only case of recurrent myxoma and could be a potential marker of recurrence.

Incidental and symptomatic renal tumors: impact on patient survival.

Renal cell carcinoma is the third most frequent genitourinary neoplasia, and there is currently an increase in the incidental diagnosis of tumors confined to the kidneys. To study the survival of patients with incidental and symptomatic renal tumors who have undergone nephrectomy. Retrospective. Hospital Sírio Libanês and Hospital Beneficência Portuguesa de São Paulo. 115 patients with diagnosis of renal cell carcinoma, operated on by the same group of surgeons and evaluated by a single pathologist. Sex, age and diagnosis method, analyzed in two groups, according to the tumor diagnosis: Group 1 with incidental diagnosis and Group 2 with symptomatic tumors. The anatomopathological characteristics and patient survival in both groups were evaluated. A statistical analysis was performed using the Student t, chi-squared, log rank and Kaplan-Meyer tests. Among the studied patients, 59(51%) had an incidental diagnosis, with 78% diagnosed by ultrasonography, 20% by computerized tomography scan and 2% during surgeries; 56 patients (49%) were symptomatic. Tumor locations were equally distributed between the two kidneys, and the surgery was conservative for 24% of the incidental and 9% of the symptomatic group. In the incidental group only one patient had tumor progression and there was no death, while in the symptomatic group there were 5 progressions and 10 deaths. The 5-year specific cancer-free survival was 100% in the incidental and 80% in the symptomatic group (p = 0.001) while the disease-free rate was 98% in the incidental and 62% in the symptomatic group (p < 0001). Incidental renal tumor diagnosis offers better prognosis, providing longer disease-free survival.

Neuropatía por vasculitis necrotizante: estudio anatomoclínico, neurofisiológico y evolución terapéutica de 26 pacientes

Peripheral neuropathy is usually one of the initial symptoms of necrotizing vasculitis. Early diagnosis is essential for good prognosis.To determine which parameters are useful for early diagnosis and selection of tissue for biopsy.We analyzed the clinical, biological, electromyographic and anatomopathological characteristics of 26 patients with necrotizing vasculitis and peripheral neuropathy.Twelve patients had panarteritis nodosa, three Churg Strauss syndrome, two Wegener s syndrome, two disseminated lupus erythematosis, one sarcoidosis and one Walderstrom s macroglobulinemia. Fifteen patients had multineuritis and the remainder distal mixed polyneuropathy which was symmetrical in three cases. In five cases biopsy was normal. Sural nerve biopsy showed the diagnosis to be correct in 20% of the patients. However, when this was done on a neurophysiologically affected nerve, the tissue was seen to be altered in 61%. Biopsy of the gastrocnemius increased the degree of usefulness to 73% when electromyographic anomalies were detected in this muscle.Neurophysiological study is essential for detection of alterations in patients clinically suspected of having necrotizing vasculitis, even in cases where there is apparently no neuropathy. We recommend biopsy of the gastrocnemius muscle as the first choice in cases where sural nerve neurography is found to be normal. If the sural nerve is not normal, it is the site of choice for biopsy, and muscle biopsy is the site of second choice. When both biopsies are normal, renal biopsy should be considered to establish the diagnosis, as a third alternative.

Estudio de las características anatomopatológicas y la seguridad de las lesiones producidas en la aurícula con dos diferentes sistemas de catéteres de punta irrigada en un modelo experimental

We performed this study to evaluate the security and efficacy in the lesions produced on the atrial wall by different irrigated catheters in an experimental model. We evaluated the anatomopathologic characteristics of the lesions produced by two different systems of irrigated tip catheters, with opened or closed circuit. This study was performed in 16 pigs applying 60 sec radiofrequency pulses with three different energy levels (15, 25 y 50 Watts). Two different systems of radiofrequency ablation irrigated catheters were used, opened and closed. We used 4 pigs in which we performed ablation with a standard catheter as a control group. Under fluoroscopic guidance, catheters were placed on the high and low right atrial lateral wall, where lesions were produced. After 7 days, animals were sacrificed for anatomopathological study. A total of 27 lesions were performed with irrigated catheters (11 closed circuit and 16 opened) and 6 with standard catheters in the control group. We did not find significant differences in the lesion characteristics between the two different systems of irrigated tip catheter used, nevertheless lesions performed with the closed system were slightly greater. Th lesions produced with irrigated catheters were always superior in the control group. Transmurality in the free atrial wall is frequent with both systems. We did not see any perforation in the atrial wall. We did not find significant differences in the size of the lesions produced with the two systems of irrigated catheters used. These data from an experimental model can provide useful information for atrial tachycardia radiofrequency ablation procedures in humans.

Jaccoud's arthropathy

Jaccoud's arthropathy, which was first described in 1869, is a rare syndrome that is characterized by a painless or relatively painless deformity of the digits II, II, IV and V with a dislocation of the extensor tendons in the metacarpal fossae. When the thumb is affected, a Z-deformity is observed. The present analysis was based on 21 patients (30 hands, 24 of which were operated on over the period 1989 to 1996). A distinction should be made between Jaccoud's disease following a known inflammatory arthropathy (15 hands; average patient age 55 years) and the idiopathic form of the disease (9 hands; average patient age 70 years). From a clinical point of view, a classification of the deformities is needed so that appropriate surgical treatment can be determined. In the present study, four groups were therefore proposed: in groups I and II, the realignment to centre of the extensor tendons over the metacarpophalangeal joint and joint stabilization yielded 87% positive results. In groups III and IV, the results were not as satisfactory either for the Swanson implant or for metacarpal shortening osteotomy. The pathogenesis of Jaccoud's disease has not yet been determined, but now that more information has become available and a better analysis can be made of its various clinical and anatomopathological characteristics, these should assist in defining precise surgical indications.

Bladder Endometriosis: Deep Infiltrating Endometriosis or Adenomyosis?

Objective: To describe the anatomopathologic characteristics of endometriosis infiltrating the bladder detrusor. Design: Descriptive anatomopathologic study. Setting: Tertiary care center for endometriosis. Patient(s): Four patients, aged 22–38 years, who underwent laparotomy for bladder endometriosis. Intervention(s): Surgical excision and pathologic analysis of bladder endometriotic nodules in four patients. Main Outcome Measure(s): Gross and microscopic characteristics of endometriotic nodules. Result(s): A nodule of adenomyosis on the anterior wall of the uterus, in continuity with the detrusor lesion, was excised in three patients. In the other patient, bladder endometriosis was continuous with a nodule that infiltrated the left parametrium and extended as far as the posterior leaf of the ipsilateral broad ligament. Microscopically, all of the lesions had a similar histologic pattern: foci of endometriosis scattered in the bladder wall. The main feature was the paucity of endometrial-type stroma, particularly in the bladder submucosa, where glands were almost always dilated and cystlike and were lined by flattened cells. Conclusion(s): Analysis of our patients, although it does not pinpoint the pathogenesis of the disease, seems to exclude the hypothesized intraperitoneal origin of endometriotic lesions of the bladder detrusor.

La pielonefrite xantogranulomatosa: Presentazione di un caso e revisione della Letteratura

The authors report a case of xanthogranulomatous pyelonephritis discovered casually following diagnostic tests for an episode of hematuria. The anatomo-pathological characteristics are described followed by possible symptoms and indicated therapy. The latter generally consists of radical and rarely conservative surgery in localised forms.