Seventeen paediatric patients with immunodeficiency syndromes (10 with selective IgA deficiency, four with panhypogammaglobulinaemia, and three with selective T cell deficiency) were investigated for bacterial overgrowth of the small intestine and gut permeability to macromolecules. Five of 12 patients showed viable bacterial counts of more than 2 x 105/ml in jejunal fluid. Bacterial overgrowth was also confirmed indirectly by breath hydrogen determination, which was higher than 10 ppm in four of the five patients with positive jejunal culture. Gut permeability to lactulose and L-rhamnose was abnormal in 16 of the 17 immunodeficient patients, who also had higher mean urinary excretion ratios than control subjects -mean (SD) values were 0216 (0.160) and 0-029 (0.002), respectively. These studies indicate that bacterial overgrowth of the small intestine is a common feature in immunodeficient patients, regardless of the immunological abnormality. Moreover, these patients have an increased gut permeability to macromolecules.

Neuroendocrine tumors (NETs) are rare, with an incidence of about 5 per 100,000 inhabitants. As no study on NETs has ever been specifically conducted on the population of Campania, we performed a retrospective analysis of all newly diagnosed NETs at the Antonio Cardarelli hospital between 2006-2009. A search of the registry of the Pathology Department of the Antonio Cardarelli hospital was carried out to retrieve available data on all newly diagnosed NET cases. Two hundred and ninety-nine NET tumors were diagnosed at our Institution from January, 2006 to December, 2009. Globally, 121 patients (40% of the population) had a lung NET, while 92 patients (30% of the population) presented a GEP-NET. The most common primary tumor site varied by sex, with female patients being more likely to have a primary NET in the lung, breast or colon, and male patients being more likely to have a primary tumor in the lung. Also, twenty-three cases of breast NETs were identified, and clinical information regarding therapy and response was available for 22 patients. Our study represents a pioneering effort to provide the medical community in Campania with basic information on a large number of patients with different types of NETs. The Antonio Cardarelli hospital could greatly benefit from cooperation with other hospitals in order to become a highly specialized center for NETs in the region and Southern Italy.

IntroductionCoronary artery aneurism (CAA) is a rare condition, characterized by a dilatation of 1.5 times the diameter of an adjacent normal coronary vessel. Finding of a giant CAA is a very uncommon event. We present a case of incidental finding of an asymptomatic giant aneurism affecting the circumflex coronary artery; then we discuss epidemiology, etiology and clinical approach, referring to published literature data. Case ReportA 74-year-old woman presented at hospital with fever and uncontrolled hypertension. Over the past years, she had suffered from chronic obstructive pulmonary disease (COPD) and hypertension that had not been further investigated. While blood specimens showed no significant findings (mild inflammation), chest radiograms revealed the presence of a pulmonary mass and a transthoracic echocardiography revealed an anechogenic interatrial lesion, that measured 56 mm, with apparent internal flow (Figure 1). Chest computed tomography (CT) with radiopaque contrast showed a solid lesion in the superior left pulmonary lobe, while the cardiac angiographic multi-slice CT showed a markedly ectatic and winding circumflex artery (maximum diameter: 8 mm), with a saccular aneurysm placed between the medium and the distal third of the vessel, just after a marginal branch emergence. The aneurysm measured 6.4×5.5 cm and presented nor endoluminal thrombosis neither parietal calcifications. The distal branch of circumflex artery overflowed into the extremely dilated and winding Giant aneurysm of circumflex coronary artery in asymptomatic patient ABSTRACTWe report a case of a 74-year-old woman who presented to the hospital for fever and uncontrolled hypertension. We found, incidentally, a giant aneurysm of the circumflex coronary artery measuring 6.4×5.5 cm. We show suggestive computed tomographic scan images, multi-slice reconstructions and a review of the epidemiology, diagnosis and treatment of this condition. Contributions: AB was involved with review of the literature, diagnostic process and drafting of the manuscript; OP, CDF, GF, GB and GPV were involved with radiological and ultrasound analysis and drafting; GM, PF and CP were involved in the diagnostic process and drafting.Conflict of interest: the authors declare no conflict of interest.

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