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Biomedical subjects

D Moukassa

Publications and source records attributed to D Moukassa.

At least 19 recordsLinked to original sources

[Massive haemoptysis associated with pulmonary Strongyloides stercoralis hyperinfestation].

INTRODUCTION: Pulmonary infestation with Strongyloides stercoralis is an exceptionally rare cause of haemoptysis, the diagnosis being difficult and often delayed. CASE REPORT: We report the case of a retired coal miner suffering from pneumoconiosis who presented with acute respiratory insufficiency and massive haemoptysis, with a fatal outcome, associated with pulmonary stongyloidosis. The only identified source of infestation with Strongyloides stercoralis was his period in the coal mine and the only risk factors for the hyperinfestation were a short course of systemic corticosteroid therapy and the presence of a peritoneal-auricular valve. CONCLUSION: This observation illustrates the importance of a systematic search for anguillosis in ex coal miners prior to any immunosuppressant treatment in order to avoid the serious and frequently fatal form of hyperinfestation with Strongyloides stercoralis.

Aged↗

[Malignant solitary fibrous tumor of pleura with focal expression of cytokeratin].

Solitary fibrous tumor is a rare circumscribed neoplasm involving usually the pleura and now described in many organs and in the soft tissues with a favorable outcome when completely excised. We report herein a malignant solitary fibrous tumor of the pleura occurring in a 59-year-old woman. The tumor cells strongly expressed vimentin and CD 34. In addition a weak positive staining was obtained using CD 99 and bcl 2. A disconcerting focal immunoreactivity with cytokeratin was observed. Solitary fibrous tumor is composed of loosely arranged spindle cells of variable density and may occasionally mimic malignant mesothelioma, an hemangiopericytoma or synovial sarcoma. Immunohistochemical study is helpful demonstrating a strong positivity for vimentin and CD 34 and absence of staining for epithelial markers and S-100 protein.

12E7 Antigen↗

Enteroviruses can persist with or without active viral replication in cardiac tissue of patients with end-stage ischemic or dilated cardiomyopathy.

To investigate enterovirus replication versus persistence in end-stage cardiac diseases, endomyocardial biopsies from explanted hearts of 70 patients with idiopathic dilated cardiomyopathy (IDCM), 64 patients with chronic coronary disease (CCD), and 45 donors of healthy hearts (controls) were examined by reverse transcriptase-polymerase chain reaction for genomic and antigenomic enterovirus RNA and by VP1 antigen immunohistochemistry. Enterovirus genome was detected in 25 of 70 patients with IDCM and in 21 of 64 patients with CCDs (35.7 vs. 32.8%, respectively; P=.12). Of the 46 patients positive for genomic RNA, only 3 exhibited antigenomic RNA and VP1 antigen that demonstrated active viral replication, whereas 43 had latent infection characterized by the absence of antigenomic RNA associated with or not with VP1 antigen expression. No viral component was detected in control subjects. The findings demonstrate that a small percentage of patients with end-stage chronic cardiac diseases had active enterovirus replication in their myocardium.

Adult↗

Utility of cytokeratin 7 for distinguishing chromophobe renal cell carcinoma from renal oncocytoma.

OBJECTIVE: Chromophobe renal cell carcinoma is a relatively uncommon variant of renal carcinoma described in 1985. The main differential diagnosis is renal oncocytoma. Hale's colloidal iron staining is a powerful adjunct to morphological interpretation but it is not specific and is sometimes difficult to interpret. We studied the immunohistochemical expression of cytokeratin 7 to determine its value in distinguishing chromophobe renal cell carcinoma from renal oncocytoma. METHODS: Immunostaining was performed on paraffin-embedded tumor tissue of 6 chromophobe renal cell carcinomas and 11 oncocytomas with an antibody to cytokeratin 7 (clone OV-TL 12/30, Dako, France) using a streptavidin-biotin method. RESULTS: All chromophobe renal cell carcinomas showed strong cytoplasmic staining with peripheral cell accentuation. In contrast, 8 of 11 oncocytomas were entirely negative and 3 showed only weak and focal staining in less than 5% of the tumor cells. CONCLUSION: Immunohistochemical staining for cytokeratin 7 may be useful for the differential diagnosis of renal oncocytomas and chromophobe renal cell carcinomas when Hale's colloidal iron staining is uncertain.

Adenocarcinoma↗

[Malignant mesenchymoma of mesentery. A controversial entity].

We report a case of malignant mesenchymoma developed in the mesentery in a 62-year-old man with no past history. It was an huge mass in the mesentery of the ileum. The tumor was composed of areas of chondrosarcoma and rhabdomyosarcoma in addition to an undifferentiated fusiform component. Malignant mesenchymoma is a rare sarcoma occurring preferentially in the retroperitoneum or the thigh. The location in the mesentery is exceptional. Malignant mesenchymoma is discussed more particularly with dedifferentiated liposarcoma with heterologous elements. The patient is alive without recurrence three years after surgery.

Abdominal Neoplasms↗

[Early isosexual precocious pseudopuberty revealing a juvenile granulosa cell tumor in a 3-year-old Congolese girl].

We describe a juvenile granulosa cell tumor expressed by an early pseudopuberty occurring in a 3-year-old black child. Clinically, an endocrine syndrome was associated with a pelvic mass and ascites. Hyperoestrogenia and serum alphafetoprotein level were biologically detected. Histological examination showed typical microscopic features of a granulosa cell tumor. The patient is well four years after surgery. Growth and mental development are normal.

Child, Preschool↗

[Primary large cell neuroendocrine carcinoma of the kidney: morphologic and immunohistochemical features of two cases].

Primary neuroendocrine carcinomas of the kidney are infrequent. The large cell neuroendocrine carcinoma is a subtype with an aggressive course and a worse prognosis. We report two cases, a 35-year-old man and a 75-year-old woman who died within 6 and 5-months after surgery despite radical nephrectomy and chemotherapy. Histological and immunohistochemical features are presented.

Adult↗

Cardiac valve papillary fibroelastomas: clinical, histological and immunohistochemical studies and a physiopathogenic hypothesis.

BACKGROUND AND AIM OF THE STUDY: Cardiac papillary fibroelastoma (CPF) is a rare and histologically benign tumor, but may have a malignant propensity for life-threatening complications; thus, surgical removal is justified. Case histories were reviewed of four patients who underwent surgical management after diagnosis of CPF located on aortic (n = 2) or mitral (n = 2) valves. Our aim was to provide explanations for the clinical diversity of the lesions and, using histological and immunohistochemical methods, to hypothesize the genesis of these tumors. METHODS: Among four patients with a diagnosis of valvular CPF, two had previous and recent history of neurological embolic symptoms with small echographically located tumors attached to the ventricular side of aortic cusps. Two other patients (one with paroxysmal atrial fibrillation, one with no neurological or rhythmically related stroke) had CPFs located on the posterior or anterior mitral leaflets. RESULTS: Surgical excision was performed with a conservative valve-sparing approach. Histological and specific immunohistochemical (IHC) studies were conducted on all samples. The postoperative course was uneventful, and histological analysis confirmed the diagnosis of CPF with typical fronds characterized by three successive layers. In the first two patients there was correlation between neurological events and the presence of thrombus aggregated on the injured superficial endothelial layer. In the other patients, no endothelial damage or thrombus was found. IHC studies showed dysfunction of the superficial endothelium, a centrifugal mesenchymal cellular migration arising from the central layer to the superficial layer with differentiation steps, the presence of dendritic cells in the intermediate layer, and remnants of cytomegalovirus (CMV) in the intermediate layer. CONCLUSION: Despite their benign histological aspect, and independent of their size, CPFs justify surgical excision because of their high potential to systemic embolization. In most cases, valve sparing management is possible with no observed recurrence after complete excision. The presence of dendritic cells and CMV strongly suggests the possibility of a virus-induced tumor, therefore evoking the concept of a chronic form of viral endocarditis.

Adult↗

[Esophageal tuberculosis: an unusual localization in an immunocompetent patient].

Oesophageal tuberculosis is a rare localisation for extrapulmonary tuberculosis. This report describes the case of a 30-year-old immunocompetent woman with dysphagia, fever and weight loss. Endoscopic examination revealed an ulcerated lesion in the third part of the oesophagus strongly suggesting oesophageal carcinoma. Histologic samples showed epithelioid cells granuloma in the submucosa. Diagnosis was later confirmed by acid-fast bacilli positive gastric aspirates and a positive Mantoux test using the tuberculin reaction. Barium swallow revealed a narrowing in the third oesophagus. A chest x-ray revealed a infiltrated lesion and a mediastinal lymph node. The patient was put on antitubercular treatment. On follow-up after 3 months, dysphagia, fever, weight loss had disappeared and the ulcerated lesion of oesophagus had improved. The subsequent course of the patient is not known, since she was lost to follow-up.

Adult↗