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3 Krasnoyarsk Medical Hospital № 4. Abstract. In the scientific review the action of steroid hormones, hormone receptors localization and angiogenesis in normal endometrium and in the endometrium with atypia is described. The importance of immunohistochemical markers for the prediction of clinical course and outcome of atypical hyperplasia and endometrial adenocarcinoma is discussed. Several studies proved that some markers can be independent prognostic indicators. Listed in the scientific review data allow the rational approach to the treatment of these patients.

Adult onset Still's disease is an inflammatory disorder characterized by daily spiking high fevers, arthritis and an evanescent rash. It is a rare disease of unknown aetiology and can be life-threatening. We present a case of adult onset Still's disease associated with myocarditis requiring the use of invasive ventilation, in which the patient responded well to systemic steroids.

The article presents the results of organ-preserving treatment protocol of atypical endometrial hyperplasia and well-differentiated endometrial carcinoma in young women. This protocol was applied in 24 patients. The period of patients observation was 3—6 years. During 6—9 months the patients were given GnRG analogue with add-back therapy. Intrauterine levonorgestrel-releasing system was inserted with therapeutic purpose for the period of not less than 6 months in atypical endometrial hyperplasia and for 1 year for well differentiated endometrial carcinoma. Combined using of GnRG analogue and intrauterine levonorgestrel-releasing system is effective method for treatment of atypicalendometrial hyperplasia and endometrial carcinoma stage I А in young women, especially in cases of unrealized fertility and can be considered as an alternative way to hysterectomy.

Adult onset Still's disease is an inflammatory disorder characterized by daily spiking high fevers, arthritis and an evanescent rash. It is a rare disease of unknown aetiology and can be life-threatening. We present a case of adult onset Still's disease associated with myocarditis requiring the use of invasive ventilation, in which the patient responded well to systemic steroids.

A 28-year-old girl suffering from lysinuric protein intolerance was referred on account of severe chronic respiratory failure. Since childhood she had failure to thrive with chronic hyperammonaemia and interstitial lung disease but normal respiratory function. At the age of 21, she experienced haemoptysis and worsening of the respiratory disease. CT scan of the chest showed bilateral, symmetrical ground glass opacities and subpleural cysts. At the age of 25, nocturnal non-invasive ventilation was initiated. Lysinuric protein intolerance is an exceptional genetic cause of interstitial lung disease.

Hypercalcaemia occurs in less than 15% of lymphomas but is associated with a poor prognosis. A patient known to have a testicular lymphoma was admitted because of asthenia and weight loss. Hypercalcemia and high serum level of calcitriol were found. A high-grade lymphoma attesting a Richter's syndrome was diagnosed. Palliative treatment consisting in corticosteroids and pamidronate was instituted. Hypercalcaemia in lymphoma has a poor prognosis and is often attributed to an acquired uncontrolled vitamin D 1-alpha-hydroxylase activity by the macrophages close to the lymphomatous cells. Influences of TNFalpha, interleukine 6 and PTHrp are also reported.

Resume Une hypercalcemie est observee dans moins de 15 % des lymphomes mais son apparition est un facteur de mauvais pronostic. Nous rapportons l'observation d'un patient aux antecedents de lymphome testiculaire hospitalise pour une alteration de l'etat general, chez qui existait une hypercalcemie en rapport avec une augmentation de la 1-25-OH-vitamine D. Une transformation en lymphome de haut grade etait diagnostiquee, et un traitement par corticotherapie et pamidronate permettait de normaliser la calcemie avec un recul de trois mois. La survenue d'une hypercalcemie dans le lymphome est de mauvais pronostic. Elle correspond a divers mecanismes, le plus frequent etant le developpement d'une activite 1-α-hydroxylase ectopique autonome des macrophages bordant les cellules lymphomateuses. Les roles du TNFα, de l'interleukine 6 et de la PTHrp sont egalement evoques.