Non-Hodgkin's lymphoma of the upper digestive and respiratory tract: histopathology and implications for treatment.
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Biomedical subjects
Publications and source records attributed to A Ennuyer.
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This statistical study concerned 218 carcinomas of the laryngeal vestibule and margin treated at the Curie Foundation between 1958 and 1967, by primary cobalt therapy followed when necessary by secondary total laryngectomy. It shows that cobalt therapy alone gives excellent results in early forms (T1 and T2) even in the presence of N1 or N2 nodes. By contrast, the proportion of cures is much lower in T3 and T4 forms. Secondary total laryngectomy was used in only 25 cases out of 127 failures. The postoperative course was often difficult (4 fatal complications and 3 pharyngostomies) but 7 of the patients were cured at 5 years. The use of a surgical technique with minimal trauma and in particular respecting the integrity of the carotid gutters has been associated, in a more recent series, with a notable improvement in the results obtained (one cure out of 2 at 3 years).
Aspiration cytology was performed on 2772 breast masses, all of which subsequently had open biopsies. Of the 1745 histologically malignant tumors, 1539 (88%) had a concordant cytologic diagnosis: 54 (0.3%) were diagnosed as probably malignant; 63 (3.6%) were false negatives; and 80 (0.5%) had inadequate smears for diagnosis. Of the histologically benign lesions, 916 (89%) had a concordant cytology: only 3 (0.3%) were false positives; cancer was suggested in 42 (0.4%); and the smears were inadequate in 66 cases (6.4%). Very small or very large sized cancer and a high degree of differentation were major causes of false negative aspirates. Recurrent tumors in those breasts exclusively treated by radiotherapy were documented by cytology in 56 of 69 cases (78%). Aspiration cytology is highly reliable when the diagnosis of cancer is made, but should be ignored if no malignant cells are observed.
This study is based upon 214 cases of laryngeal carcinoma treated at the Foundation Curie, Paris, France, from January, 1958, to 1968. The results in terms of five-year survival have been: (see article). A statistical study of these results was made by Professor Daudel and demonstrated the absence of significant difference for the groups of tumors classed T1 and in Stage I and II treated either by radiocobalt or by surgery, whether followed or not by radiotherapy. By contrast there was a clearly significant difference in favor of surgery for the group of tumors classified as T2, T3, T4, or in Stage III. This significant difference in favor of primary surgery disappeared if we excluded the patients who died of intercurrent illnesses or of a second cancer not involving the larynx, and when we took into account those cures obtained by surgery in the event of failure of radiation and inversely, of those cures having been obtained by radiation therapy in the event of failure of surgery.
The value of cytological diagnosis of solid tumours of the breast where the cells were obtained by suction aspiration through a needle has been analysed in a consecutive series of 2,401 cases, all of which were checked by histological examination. They consisted of 1,745 malignant tumours and 656 benign tumours. The cytological diagnosis of malignancy was confirmed, almost always, error being practically non-existent (4 out of 1,000). This confirms that this simple and rapid test is very valuable in the diagnosis of mammary cancer. On the other hand, when the diagnosis of a benign tumour was made a certain number of cancers were missed (3.6 per cent). This is not therefore as valuable a test when the result is negative as when the result is positive. All the same, in certain cases it can suggest the diagnosis without giving the precise type of lesion, which can only be finally diagnosed histologically.
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