Folliculosebaceous cystic hamartoma. Reported case with a neural component

The clinical and histological features of a recently recognized entity, folliculosebaceous cystic hamartoma, are reported. The peculiarity of our case is a previously unreported neural proliferation in the stroma.

Cavernous angioma of the pineal region

The pineal region is one of the most rare localizations of intracranial cavernous angiomas, with only 8 cases reported up today. The Authors report a case of cavernous angioma of such localization and review the pertinent literature. Magnetic resonance allows the correct diagnosis of cavernous malformations on the basis of their typical aspect, even in the absence of histological verification. We suggest that this imaging technique will allow to identify more frequently pineal cavernomas preoperatively, thus avoiding useless irradiation.

[Congenital smooth muscle hamartoma. Clinical-histological considerations (3 cases)]

The Authors report 3 cases of "Congenital Smooth Muscle Hamartoma" (CSMH). CSMH presents as congenital patches or slightly indurated plaques with prominent overlying hair, often hyperpigmented. Histopathologic examination showed increased numbers of well-defined smooth muscle bundles in the superficial and deep dermis. CSMH and Becker's nevus should be considered in the differential diagnosis of any congenital hairy hamartoma.

Familial cerebral cavernous angiomas

Three families with two or more members affected by cavernous angiomas of the brain are described and the other 17 reported in the literature are reviewed. The familial occurrence of cerebral cavernous angiomas has been considered a rare event; nevertheless, the experience of the authors (positive familiarity in three patients where two or more relatives have been explored radiologically) suggests that cavernous angiomas of the brain might be, at least in most cases, a familial disease. Therefore, when a patient with cerebral cavernous angioma is observed, a careful familial history and the exploration of the familial members by computerized tomography or better still by magnetic resonance must be performed. The high frequency of multiple lesions in familial cases, the surgical indications and the role of the ultrasonic prenatal diagnosis are also discussed.

[Perforating pilomatrixoma in adults]

Two rare cases of perforating pilomatrixoma similar to those reported in the literature are described. Clinical examination showed in two old-women a reddish inflammatory exophytic tumor, 1 cm in diameter, with central erosive surface, with a rapid growth (3-5 months). Histologic examination showed: multiple masses of basophilic cells situated in the upper dermis making contact with the epidermis in a "follicle-like" opening; occurrence of transepithelial elimination phenomena.

Eccrine angiomatous hamartoma: a lipomatous variant

The eccrine angiomatous hamartoma is a rare cutaneous lesion histologically characterized by the presence in the intradermal lobules of mature eccrine sweat glands and angiomatous capillary channels. We report a case of eccrine angiomatous hamartoma with unusual lipomatous involvement.

Intracranial plasma cell granuloma

An exceptional case of intracranial plasma cell granuloma, located in the right frontoparietal convexity in a 16-year-old boy is reported. Reports of these rare inflammatory lesions locate them primarily in the lungs and in other regions of the body, and only exceptionally in the nervous system; indeed, only three intracranial cases and one other arising from the spinal meninges have been reported. The computed tomographic and surgical aspects suggested a falx meningioma in our case. The pathological diagnosis differentiating these from other intracranial lesions with a plasma cell component, including meningioma with plasma cell infiltration and plasmacytoma, is discussed.

[Verruciform xanthoma of the penis]

Verruciform xanthoma is a solitary verrucous lesion, usually occurring on the oral mucosa. It is characterized histologically by the presence of foam cells within elongated dermal papillae. Only few extra-oral case of V.X. have been reported. An unusual location of verruciform xanthoma of the penis is described.

Multiple minute digitate hyperkeratosis

We report a case of multiple minute digitate hyperkeratosis. The patient had hundreds of keratotic lesions--some tiny and spiked, others larger, flat papules--localized on the trunk and arms. Histologic sections showed focal areas of compact hyperorthokeratosis with few dermal changes. Ultrastructurally, keratohyalin granules were smaller than normal. The keratin pattern was one of a normal variant. Odland bodies present. Various family members of the patient, in different generations, were affected.

Postoperative cervical pseudomeningocele

A case of postoperative cervical pseudomeningocele in a woman submitted to laminectomy for protruded disc is reported. The patient was investigated by myelography and metrizamide computed tomography and surgically treated with a good neurological result. The other eight reported cases of postoperative cervical pseudomeningocele are reviewed and the role of metrizamide CT scan in diagnosing this unusual complication of cervical laminectomies is emphasized.

The blood leukocyte count and its prognostic significance in subarachnoid hemorrhage

This study reviews the white blood cell count in 75 patients with subarachnoid hemorrhage and correlates it with the clinical grade at admission, the outcome, the presence of angiographic spasm and blood clots in the cisternal spaces. Patients with subarachnoid hemorrhage with normal angiograms usually have slow white cell count and favourable outcome. In patients with subarachnoid hemorrhage due to ruptured aneurysms, their'is a clear correlation between the cell count and the entity of the cisternal hemorrhage and arterial spasm. Whereas the cell count is fairly correlated with the clinical grade at admission, a cell count exceeding 20,000 in associated with a 90% rate of poor outcome, even in patients with low clinical grade at admission. Therefore the count of the white blood cells seems to have high prognostic value in predicting the neurological deterioration due to arterial spasm.

Late neurological dysfunction in adult lumbosacral lipoma

The case of a 53-year-old woman with adult-onset neurological dysfunction secondary to spinal dysraphia and lumbosacral lipoma is presented. This condition not only affects children, but may produce neurological troubles also in adult age. This observation confirms that lumbosacral lipomas do not represent a static condition but carry the potential for late neurological dysfunction and therefore they should be treated in early life to prevent late complications. Besides the adult-onset urinary dysfunction and lumbosacral and sciatic pain should suggest the possibility of spinal dysraphia and lumbosacral lipoma.

Elaboration of a standard procedure for the measurement of vibration emitted by percussive tools--application to breakers

The Association Française de Normalisation (AFNOR) is preparing a standard on the exposure assessment of vibration from percussive tools. Therefore, a test code was developed for the measurement of vibration from percussive tools under laboratory conditions. The handle vibration from six different breakers, among which three tools were of "antivibration design," was measured with the following energy absorption methods: hydraulic base, steel shot, actual breaking of concrete, AFNOR concrete block, pointed chisel embedded in concrete. The last four methods were applied with breakers held by three successive operators. In addition, the first two were used with tools mounted in a rig which held them vertically and loaded them with a vertical downforce. The results indicated that the steel shot method was preferable although it gave 20% lower vibration results than those recorded for the actual breaking of concrete. It has the advantages of yielding consistent results with low scatter and being simple and cheap. Since difficulties have been experienced during the use of a pneumatic rig with breakers of antivibration design conception, the shot method should be applied with human operators.