Showing papers in "Annales De Pathologie in 1998"

Cutaneous Alternaria infectoria infection after liver transplantation

Abstract: Les auteurs rapportent un cas d'alternariose cutanee apres greffe hepatique. Cette phaeohyphomycose rare est surtout observee chez les sujets sous corticotherapie. Le cas present se singularise par l'espece isolee : Alternaria infectoria. Les aspects cliniques et histopathologiques, les problemes diagnostiques poses sont successivement abordes.

Immunohistochemistry in the differential diagnosis of mesothelioma and adenocarcinoma. Evaluation of 5 new antibodies and 6 traditional antibodies

Abstract: Sur une serie de 28 mesotheliomes et 30 adenocarcinomes. les auteurs ont evalue cinq anticorps recents utilisables sur coupes en paraffine : la calretinine. HBME-1 et la thrombomoduline annonces comme « specifiques du mesotheliome », ainsi que AUA1 et MOC31 dits « specifiques des adenocarcinomes ». Ils les ont compares aux anticorps traditionnels anti-ACE, BerEP4, CA125, CA19.9, LeuM1 et vimentine, Les anticorps anti-calretinine, HBME-1 et thrombomoduline, avec une sensibilite respective de 100 %, 89 % et 43 % et une specificite de 50 %. 70 % et 87 %, ont ete moins performants dans le diagnostic positif de mesotheliome que l'anticorps antivimentine (sensibilite: 100 %, specificite: 67 % ). AUA1. BerEP4 et MOC31 ont une sensibilite de 100 % pour l'adenocarcinome, mais BerEP4 et MOC31 sont plus specifiques (86 % chacun ). Le phenotype « vimentine positif, ACE negatif, CA19.9 negatif » a une sensibilite de 100 % et une specificite de 97 % pour le mesotheliome. Dans l'attente de marqueurs plus specifiques, les auteurs preconisent l'utilisation conjointe des anticorps anti-ACE, CA19.9. MOC31 (ou BerEP4) et vimentine dans le diagnostic differentiel entre mesotheliome et adenocarcinome.

Métastase mammaire d'un carcinome papillaire à cellules hautes de la thyroïde

Abstract: The authors report a case of breast metastasis from a "tall cell" variant of papillary thyroid carcinoma in a 59-year-old woman. This metastasis was discovered two months after the diagnosis of an inextirpable thyroid tumor. Tall cell variant of papillary thyroid carcinoma is a sub-type of papillary carcinoma with an aggressive course and frequent metastases (in patients over 50 years of age). No mammary metastasis of this tumor type has been reported so far.

[Recommendations for anatamo-pathologic management of soft tissue sarcomas in the adult. Pathologists of the FNCLCC Sarcoma Group (Fédération Nationale des Centres de Lutte Contre le Cancer)].

Abstract: Adult soft tissue sarcomas comprise a heterogeneous group of rare tumors having a wide range of clinical, gross and histological presentations. Outcome is variable. The pathologist's task is difficult but must be based on a rigorous method. The aim of these recommendations is to describe the main steps of management: collection of clinical information, performing biopsy, handling the fresh specimen, gross examination, histological examination, use of special techniques, definition of the main prognostic factors and key features of the pathology report.

[Endometrial stromal tumor associated with rhabdoid phenotype and and zones of "sex cord-like" differentiation].

Abstract: An unusual endometrial stromal sarcoma is described in a 50-year-old patient. The distinctive feature of this case is the focal occurrence of sex cord-like pattern and rhabdoid appearance of tumor cells. Rhabdoid cells have an eosinophilic cytoplasm and a vesicular nucleus with a prominent nucleolus. Immunohistochemistry showed positive cytoplasmic staining for both cytokeratin and vimentin, and ultrastructural examination identified tumor cells with abundant cytoplasmic intermediate filaments. To our knowledge, only one case of endometrial stromal sarcoma with this unusual morphological association has been reported in the literature.

Arrhythmogenic right ventricular dysplasia and Uhl disease. Anatomic study of 100 cases after sudden death

Abstract: Assessing 100 cases of arrhythmogenic right ventricular dysplasia causing unexpected sudden death, we stress two aspects of the disease, specially concerning pathologists: diagnosis value and limitations of endomyocardial biopsy and high frequency of the disease among unexpected sudden death in young adults When the disease is identified genetic screening should be performed among patient's family members The anterior right ventricular wall is very thin (partly or completely) and microscopic examination shows absence of muscle cells, replaced by normal fatty tissue Associated lesions are often present: slight abnormalities of left ventricle, mucoid degeneration of auriculo-ventricular valves and recently described lesions of His conductive tissue Apoptotic anomalies are now incriminated for agenesy or disappearing right ventricular muscle

Hyperplastic polyp in heterotopic gastric mucosa. A rare lesion of the cervical esophagus

Abstract: Des plages de muqueuse gastrique heterotopique du tiers superieur de l'oesophage sont frequemment observees lors d'examens endoscopiques. La survenue d'un polype hyperplasique, developpe sur l'un de ces ilots muqueux antro-fundiques heterotopiques, est un evenement rare. Nous en rapportons un cas chez un homme de 60 ans, revele par un pyrosis. Le risque theorique de transformation maligne d'une telle lesion existe, mais aucun cas n'a jusqu'alors ete rapporte dans l'œsophage.

Reproducibility of histoprognostic grades of invasive breast cancer

Abstract: In the framework of the quality assurance of the pathologists involved in the screening campaign it was proposed to test the reproducibility of the classical SCARFF, BLOOM and RICHARDSON (SBR) grade and the ELSTON-ELLIS grade (E-E) mentioned in the recent European recommendations. Twenty-four cases of invasive carcinoma were analyzed by 21 pathologists. Sixty-eight per cent agreement was obtained for the SBR grade and 69% for the E-E grade in the first round and vice versa in the second round. The mean value of the kappa test was 0.54 with SBR and 0.53 with E-E. The differentiation of the carcinoma was found to be the most reliable index (kappa score greater than 0.5), followed by the mitotic index (kappa score = 0.39 for SBR and 0.36 for E-E), and the nuclear polymorphism obtained the lowest score (kappa score ranging from 0.33 to 0.38). In our hands, the use of the E-E grade did not improve the reproducibility particularly for the mitotic index. Our results suggest however that the reproducibility may be improved by training.

Pancreatic metastasis of a renal adenocarcinoma. Apropos of 2 cases

Abstract: The pancreas is an uncommon site of metastasis for renal cell carcinoma. We report 2 cases of patients who underwent total and subtotal pancreatectomy 13 and 10 years after resection of the primary tumor. One of the patients already had liver and cerebellum metastasis, the second one had a solitary metastasis to the pancreas. In both cases, tumoral proliferation invaded the lumen of the Wirsung, and in one case was prominent through the papillae.

[Littoral cell angioma: a rare vascular splenic tumor].

Abstract: L'angiome a cellules littorales est une tumeur primitive vasculaire rare de la rate dont l'evolution est a priori benigne. Sa presentation clinique est peu specifique. Le diagnostic est histologique et immunohistochimique. Il repose sur la mise en evidence de lacs sanguins anastomotiques avec projections papillaires bordes de cellules tumorales presentant une double differentiation vasculaire et macrophagique soulignee par l'etude immunohistochimique. Notre observation rapporte un cas d'angiome a cellules littorales et permet de discuter les eriteres diagnostiques et l'histogenese de cette lesion.

A case of hyalinizing spindle cell tumor with giant rosettes in the presacral region. Immunohistochemical and ultrastructural study

Abstract: Hyalinizing spindle cell tumor with giant rosettes is a slowly growing tumor with a risk of local recurrence in case of incomplete surgical excision that could be regarded as a distinctive type of low-grade fibroblastic tumor. We report a case involving the presacral area. This tumor was composed of areas of bland spindle cell proliferation with a fascicular pattern in a fibrous or myxoid stroma, intermixed with giant rosettes consisting of rounded cells surrounding a central collagen core. The tumor expressed vimentin, and, for cells comprising the rosettes, S-100 protein, NSE and CD-57. These latter cells exhibited ultrastructural features of Schwann cells, the tumoral cells of fascicular area exhibiting features of fibroblastic cells. Flow cytometry showed DNA-aneuploidy and a very low S-phase fraction. This tumor appeared to be composed of two cellular components, fibroblastic and Schwann cells, located, at the opposite of neurofibroma, in two distinct areas.

Large cell variant of small cell carcinoma of the ovary with hypercalcemia

Abstract: Nous rapportons une forme rare de carcinome a petites cellules de l'ovaire dans sa variante dite a grandes cellules. Le diagnostic histologique reposait sur la presence de cellules tumorales de grande taille au noyau fortement nucleole et au cytoplasme abondant eosinophile. L'immunohistochimie montrait une positivite forte pour les marqueurs mesenchymateux, vimentine et actine muscle lisse et faible pour les marqueurs epitheliaux. La microscopie electronique montrait la presence de filaments intermediaires et de jonctions intercellulaires sans granule neuro-secretoire. Cette tumeur est associee dans 2/3 des cas a une hypercalcemie. Recemment, a ete mis en avant le role du parathormone-related peptide produit par les cellules tumorales pour expliquer cette hypercalcemie : il etait focalement present dans notre tumeur. Cette tumeur, d'histogenese encore inconnue, est hautement maligne et survient preferentiellement chez des femmes jeunes.

[Primary angiosarcoma of the central nervous system: report of a case].

Abstract: Nous rapportons un cas d'angiosarcome cerebral primitif du lobe parieto-temporal droit, chez un homme de 44 ans avec etude immunohistochimique. Ce cas avait un aspect macroscopique particulier avec une kystisation importante. Son evolution fut tres defavorable, avec une survie de 9 mois. Cette observation est comparee aux 27 cas publies a ce jour.

[Kikuchi-Fujimoto subacute necrotizing lymphadenitis: two histologic forms observed in the same patient].

Abstract: La lymphadenite necrosante subaigue de Kikuchi-Fujimoto est une entite anatomo-clinique d'evolution benigne de l'adulte jeune. Sa pathogenie est mal connue. Elle se manifeste sous deux formes histopathologiques : la forme proliferative et la forme necrosante. Nous rapportons le cas d'une jeune fille de 17 ans qui presentait des adenopathies cervicales et chez qui les deux formes histologiques ont ete observees sur deux biopsies ganglionnaires successives. Cette observation permet de souligner la difficulte diagnostique que pose la forme proliferative simulant un lymphome non Hodgkinien. De plus, elle illustre l'evolution en deux phases de cette maladie.

[Importance of the study of the expression of MIB-1 (Ki-67) for the diagnosis of endocervical glandular lesions].

Abstract: La definition des atypies et dysplasies glandulaires endocervicales est diverse selon les auteurs et leur diagnostic est difficile. Le but de ce travail etait d'evaluer retrospectivement en immunohistochimie l'expression du marqueur (le proliferation MIB-1 (Ki-67) par les cellules glandulaires endocervicales. Le materiel correspondait a 230 pieces de conisation. Le pourcentage de cellules MIB-1 positives etait de I a 25 % (mediane 2 %) dans les glandes normales et subnormales (140 cas) ; 1 a 30% (mediane 4 %) dans les lesions de metaplasie tubo-endometroide et d'hyperplasie microglandulaire (55 cas) ; 30 a 60% (mediane 40 %) dans les glandes atypiques (24 cas) pour des foyers limites a 2 ou 3 glandes, 45 a 60 % (mediane 50%) dans les glandes dysplasiques (5 cas) pour des territoires etendus a plus de 3 glandes. Les adenocarcinomes in situ (3 cas) et invasifs (3 cas) etaient caracterises par un pourcentage eleve (60 %) de cellules MIB-1 positives.

Grossesse ectopique rétropéritonéale : à propos d'un cas

Abstract: Retroperitoneal space is an exceptional location of extrauterine pregnancy (four cases have been previously reported). The authors report a case of retroperitoneal ectopic pregnancy. Pathogenesis is discussed.

[Polycystic disease of the salivary glands: report of an attack of the submaxillary glands].

Abstract: La maladie polykystique dysgenetique des glandes parotides est une affection rare qui se caracterise par le remplacement partiel du parenchyme salivaire par de multiples kystes epitheliaux developpes aux depens des canaux intercalaires. La revue des quatorze cas de cette affection publies dans la litterature montre qu'elle interesse essentiellement les femmes et se presente sous la forme d'une augmentation asymptomatique et souvent bilaterale de la taille des parotides. Nous rapportons, a notre connaissance, le premier cas de maladie polykystique interessant les glandes sous-maxillaires et survenant chez un homme.

Pseudomyxoma extraperitonei. Report of 3 cases

Abstract: The authors report three additional cases of pseudomyxoma extraperitonei and describe the modalities of occurrence and evolution. Pseudomyxoma extraperitonei arises from spontaneous or accidental implantation of mucosal cells of the primary site. This inoculation is accompanied by the modification of glandular cells which survive by adapting themselves to the interstitial connective tissue environment, raising thus the ability of extensive involvement and tumor-like invasive behavior.

[Ovarian mucinous tumor of gastric and intestinal type associated with Peutz-Jeghers syndrome: in situ hybridization study of apomucin gene transcripts].

Abstract: Occurrence of mucinous tumors is favored by Peutz-Jeghers syndrome (PJS). A case of bilateral ovarian mucinous tumor associated with ovarian mature teratoma occurring in a 22-year-old woman with PJS was reported. Tumor cells included 5 cell types: tall columnar mucinous pale cells with neutral mucins; goblet cells with acidic nonsulfated mucins; non mucinous columnar cells; mucinous cuboidal cells lining small glands; endocrine cells. Expression of the MUC2, MUC3, MUC5AC and MUC6 genes was demonstrated by in situ hybridization according to cell type. Some atypia and numerous mitotic figures were observed in basal glands. Diagnosis was ovarian borderline mucinous tumor with gastric and intestinal phenotype associated with PJS.

[Castleman's disease and chromophobe carcinoma of the kidney. An incidental association?].

Abstract: We report a case of Castleman's disease in a 65-year-old female, revealed by a renal tumor associated with inter-aortico-cava adenopathies and renal chromophobe cell carcinoma. This observation points to the difficulties in differentiating local Castleman's disease, which may be cured by surgical excision, from multicentric disease associated with a dysimmune syndrome of uncertain prognosis. The association of multicentric Castleman's disease with a carcinoma has rarely been described. It could be the emergence of a neoplasia in a context of dysimmunity or Castleman's disease might be related to the production of interleukin 6 by a renal carcinoma.

Lipoma of the internal auditory canal. Report of two cases simulating acoustic neuroma

Abstract: Nous rapportons deux observations de lipomes du conduit auditif interne chez des patients âges de 45 et 53 ans, se presentant initialement comme des neurinomes de l'acoustique. Le lipome de l'angle pontocerebelleux est une lesion rare, plus exceptionnelle que les autres lipomes intra crâniens. La connaissance de cette lesion et de l'etroite relation qu'elle entretient avec les nerfs crâniens avoisinants incite a realiser un examen extemporane lorsque l'imagerie est evocatrice, afin de limiter les sequelles fonctionnelles postoperatoires.

[T-cell lymphomas and "natural killer". Histopathologic, immunologic and molecular aspects].

Abstract: Plan LYMPHOMES LYMPHOBLASTIOUES T ASPECTS GENERAUX DES LYMPHOMES T PERIPHERIQUES Aspects morphologiques generaux Aspects immunohistochimiques et genomiques Aspects cytogenetiques DESCRIPTION DES ENTITES DE LYMPHOMES T PERIPHERIQUES ET NK Presentation essentiellement leucemique Presentation essentiellement ganglionnaire Presentation essentiellement extra-ganglionnaire PHYSIOPATHOLOGIE Virus d'Epstein-Barr Cytokines Molecules d'adhesion CONCLUSION

Apparently isolated case of African Burkitt lymphoma localized in the breast

Abstract: We report a case of unilateral primary Burkitt lymphoma of the breast. It occurred in a young woman with a history of recent abortion, as a painful mass confused with an abscess. The diagnostic was suggested after fine needle aspiration. Biopsy allowed confirmation, by revealing a B-phenotype lymphoma with intranuclear Epstein-virus small RNA (EBER) in all cells. Additional investigations (clinical and radiographic) were negative (no lymphadenopathy). Chemotherapy induced rapid and complete remission. Patient is in good health (no local recurrence) 5 years later.