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Unilateral exophthalmos was caused by a cholesterol granuloma in a 42-year-old patient. The clinical picture, roentgenographic and NMR tomographic changes, surgical therapy and histopathological results are described and discussed with regard to the etiology and differential diagnosis of this disease.

Rare plasmocytomas without paraprotein (frequency less than 1%) can present a diagnostic trap. Three observations give grounds for drawing attention to misinterpretation of symptoms and the problematic nature of the diagnosis. In one patient, a monoclonal immunoglobulin (kappa light-chains) was detectable in the bone-marrow myeloma cells (non-excretory plasmacytoma). In a further patient no paraprotein could be found in the myeloma cells (non-secretory plasmacytoma) despite repeated investigations. An additional unusual feature in a third patient was the simultaneous presence of chronic lymphocytic leukaemia; his plasmocytoma was first detected at autopsy.

Multiple sclerosis (MS) is one of the most common diseases of the central nervous system. Up to now, there is no pathognomonic test to ascertain the diagnosis and in 10 to 15% of MS cases there are problems in differential diagnosis. We report 15 bioptically diagnosed MS cases with atypical clinical, C.S.F. and neuroradiological findings. In each case the diagnosis of MS was made by CT/MRI-stereotactic brain biopsy. Neoplastic and other non-tumorous lesions could be excluded. Indications for and significance of stereotactic brain biopsy in atypical cases of MS are discussed.

The case-history of a child with von Recklinghausen disease is described: The patient suffered the following tumors: Olfactory nerv meningeoma, optic nerv glioma, acoustic nerv neurinoma, intraventricular meningeomas, intraspinal ependymoma and peripheral neurinomas. The pathogenesis (neurocristopathy) and aetiology are discussed.