Biomedical subjects
Publications and source records attributed to E Leteurtre.
Three cases of epignathus teratoma associated with other midline anomalies are reported. The first case involved Pierre Robin sequence and a bifid tongue. The second case was characterized by two teratomas, a meningoencephalocele, and a cleft lip and nose. The third case had Pierre Robin sequence associated with duplication of the pituitary gland and hypoplasia of the corpus callosum.
Human pancreatic cells with a typical ductal phenotype and potential to proliferate can be obtained in vitro, but the differentiation capacity of these putative human pancreatic stem cells remains to be documented. We investigated the protein and mRNA expression of insulin promoter factor 1 (IPF-1) (or pancreas/duodenal homeobox 1), a transcription factor critical for pancreatic development and endocrine cell neogenesis, in human pancreatic ductal cells derived from cultured exocrine tissue. In vitro, exocrine cells rapidly adhered (within 12 h) and were de-/transdifferentiated to ductal cells after 3 days with a dramatic loss of amylase protein (n = 4, 92 +/- 3.3%, P < 0.05 vs. day 1) and a simultaneous increase of ductal cytokeratin 19 protein (n = 4, 3.4-fold on day 3 and 7-fold on day 9, P < 0.05 vs. day 1). IPF-1 protein and mRNA levels were low to undetectable in exocrine preparations before culture. After 2 days of culture, a 3.2-fold increase in IPF-1 protein was observed, corresponding to the characteristic 46-kDa protein in Western blots. Reverse transcriptase-polymerase chain reaction confirmed a 10.5-fold increase in IPF-1 mRNA levels after 3 days of culture (n = 5, P < 0.001 vs. day 1). Double immunocytochemistry showed direct evidence that IPF-1 appeared during culture in these exocrine-derived ductal cells (cytokeratin 7-positive) and was not merely in contaminating endocrine cells (chromogranin A-positive). In conclusion, we describe herein the first converging evidence on both the molecular and protein level that human cells with a typical ductal phenotype derived ex vivo from pancreatic exocrine tissue (obtained from healthy donors) can reexpress IPF-1 in culture, suggesting their pancreatic precursor/stem cell potential.
We describe herein a case of a mixed ductal-endocrine pancreatic carcinoma. Rare cases of mixed pancreatic tumors have been described, with endocrine and exocrine components each making up a significant proportion of the neoplasm; to our knowledge, only one case has been reported with a mixed liver metastasis. In our case, ductal and endocrine cells were intimately admixed in the primary tumor and in a peripancreatic lymph node metastasis, diagnosed by standard light microscopy and double immunostaining for cytokeratin 19 and synaptophysin. The endocrine component was immunoreactive for somatostatin. Tumors with admixed endocrine and exocrine components support the hypothesis of a common endodermal histogenesis for the ductal and endocrine cells in the human pancreas.
Castleman's disease (or angiofollicular lymph node hyperplasia) is a rare pathologic process of unknown etiology. Commonly, it is an unique tumor localized in the mediastinum (unicentric disease). Extrathoracic localizations are however reported with an increasing frequency. We describe two cases of mesenteric Castleman's disease. Diagnosis can be suggested by preoperative morphologic explorations (ultrasonography with Doppler, computed tomography scan, magnetic resonance imaging and angiography) and confrontation with clinical and biological data (young age, biological signs of inflammation). In the classical unique tumor of hyalin-vascular type, surgical removal allows definitive cure. Prognosis is poor in the plasma cell type, mostly in multicentric disease due to a high incidence of malignancy.
Woringer-Kolopp disease is a localized epidermotropic T cell lymphoma with good prognosis. We describe a 79-year-old man with an erythematous scaly plaque of the foot. Clinical diagnosis of psoriasis, parapsoriasis and fungal infection were proposed. Histopathological and immunohistochemical findings were characteristic of Woringer-Kolopp disease. We observed an immunohistochemical positivity of tumour cells for the anti-CD103 antibody (alphaEB7 integrin) according to the epidermotropism of this localized cutaneous T cell lymphoma.
At birth, virtually all peripheral CD8(+) T cells express the CD28 co-stimulatory molecule, but healthy human adults accumulate CD28(-)CD8(+) T cells that often express the CD57 marker. While these CD28(-) subpopulations are known to exert effector-type functions, the generation, maintenance and regulation of CD28(-) (CD57(+) or CD57(-)) subpopulations remain unresolved. Here, we compared the differentiation of CD8(+)CD28(bright)CD57(-) T cells purified from healthy adults or neonates and propagated in IL-2, alone or with IL-4. With IL-2 alone, CD8(+)CD28(bright)CD57(-) T cell cultures yielded a prevailing CD28(-) subpopulation. The few persisting CD28(dim) and the major CD28(-) cells were characterized by similar telomere shortening at the plateau phase of cell growth. Cultures from adults donors generated four final CD8(+) phenotypes: a major CD28(-)CD57(+), and three minor CD28(-)CD57(-), CD28(dim)CD57(-) and CD28(dim)CD57(dim). These four end-stage CD8(+) subpopulations displayed a fairly similar representation of TCR V(beta) genes. In cultures initiated with umbilical cord blood, virtually all the original CD8(+)CD28(bright) T cells lost expression of CD28, but none acquired CD57 with IL-2 alone. IL-4 impacted on the differentiation pathways of the CD8(+)CD28(bright)CD57(-) T cells: the addition of IL-4 led both the neonatal and the adult lymphocytes to keep their expression of CD28. Thus, CD8(+)CD28(bright)CD57(-) T cells can give rise to four end-stage subpopulations, the balance of which is controlled by both the cytokine environment, IL-4 in particular, and the proportions of naive and memory CD8(+)CD28(+) T cells.
Biotin-rich pseudoherpetic nuclear inclusions may be observed in endometrial epithelial cells during pregnancy, post-partum or in association with choriocarcinoma. They may be observed in tumor cells in a few papillary carcinomas of the thyroid gland in young women. These inclusions may be responsible for false diagnoses of herpesvirus infection at morphological and immunocytochemical examination. They may be responsible for false positives in immunocytochemistry and in situ hybridization.
We present a case of a severe hepatitis associated with acute renal failure and anuria consequently to the ingestion of 112 mg of buprenorphine, 48 hours before. The normalisation of hepatic and renal functions is associated with discontinuation of buprenorphine administration and hemodialysis treatment. Buprenorphine seems to be directly responsible for this hepatonephritis as indicated by the high plasmatic levels of buprenorphine (224 ng/ml) and norbuprenorphine (30 ng/ml) never described until now. Buprenorphine toxicity could be due to the inappropriate ingestion mode (oral instead of sublingual) and could be increased by previous acetaminophen intake.
A primary serous papillary cystadenocarcinoma of the rectovaginal septum was diagnosed in a 35-year-old woman. There were invasive microfoci in peritoneum and lymph node micrometastasis as well as a small superficial non invasive tumor focus in the left ovary. Diagnosis was based on morphological, immunohistochemical and ultrastructural features of tumor tissue. The patient had surgery and post-operative chemotherapy. Progression of peritoneal disease was found six months after surgery. In this very rare location of serous carcinoma, tumor might have developed from peritoneal inclusions in the rectovaginal septum.
OBJECTIVES: An excluded rectum may be at risk of carcinoma in the course of Crohn's disease. Surveillance of patients requires detection of dysplasia. The aim of our study was to determine the frequency of dysplasia from secondary proctectomy specimens in active rectal Crohn's disease. METHODS: Twenty three patients (13 women and 10 men, median age 38 years) were studied. The median duration of rectal exclusion was four years. Detection of dysplasia relied upon histopathology. Immunohistochemistry with MIB-1 (Ki-67) and anti-p53 (clone DO7) antibodies was performed as well. RESULTS: Frequency of dysplasia was 30%. This was low grade dysplasia, focally observed in proctectomy specimens. MIB-1 was positive on 46% of dysplastic cells. There was no expression of p53 protein. CONCLUSIONS: These results must be taken into account for decision of secondary proctectomy, in patients having an excluded rectum for Crohn's disease, when ileorectal anastomosis is not possible. Rectal endoscopic surveillance is advisable with multiple biopsies according to focal distribution of dysplasia.
The morphological criteria for the diagnosis of endocervical atypia and dysplasia are variably defined. Diagnosis is difficult. MIB-1 (Ki-67) cell proliferation-associated antigen was detected retrospectively by immunohistochemistry in 230 cervical cone specimens. The percentage of MIB-1 positive cells was 1 to 25% (median 2%) and limited to small hot spots in normal and subnormal glands (140 cases). It was 1 to 30% (median 4%) in endometrioid metaplasia and microglandular hyperplasia (55 cases); 30 to 60 (median 40%) and limited to 1-3 glands in atypia (24 cases); 45 to 60% (median 50%) and diffusely distributed in dysplasia (5 cases). In situ (3 cases) and invasive (3 cases) adenocarcinomas were characterized by a high% (> 60) of MIB-1 positive cells.
A case of alveolar rhabdomyosarcoma of the hand in a 21-year-old patient is reported. In the light of this case, the authors review the literature and analyse the therapeutic implications.
We report MRI and CT findings of an intrapancreatic accessory spleen. The lesion was hypervascular on CT and isointense to the spleen on MRI. This uncommon localisation may simulate a pancreatic mass. If the diagnosis is suspected, it can be confirmed by scintigraphy.
Polymyositis is characterized by a T-cell-mediated and MHC-I-restricted cytotoxic process, whereas dermatomyositis is a primitively vascular disease with microangiopathy mediated by the complement C5b-9 membranolytic attack complex. We have tried to estimate the frequency of vascular abnormalities in polymyositis as defined by Bohan and Peter. We have retrospectively studied 17 patients with dermatomyositis and 15 patients with polymyositis. Vascular abnormalities have been defined by clinical, capillaroscopic and histologic (muscle biopsy and minor salivary glands biopsy) features. After clinical features, 5/17 dermatomyositis had a Raynaud's phenomenon, against 6/15 polymyositis. Digital necrosis has been observed for 2/17 dermatomyositis and 2/15 polymyositis. In capillaroscopy, 14/17 dermatomyositis had a microangiopathy with or no enlarged capillary loops, against 7/15 polymyositis. None of these polymyositis had enlarged capillary loops. The muscle biopsy showed a predominantly perivascular or perimysial inflammatory infiltrate (vascular process) for 10/16 dermatomyositis against 4/13 polymyositis; a perifascicular atrophy for 3/16 dermatomyositis against 2/13 polymyositis. The histological study of minor salivary glands, showed vascular lesions for 2/11 dermatomyositis and for 1/8 polymyositis. Finally, Bohan and Peter's classification is now inadequate to distinguish between dermatomyositis and polymyositis. Indeed, some dermatomyositis sine dermatitis, may exist and be recognized by their vascular features. To distinguish between dermatomyositis and polymyositis is important, to evaluate the risk of cancer which is more frequent in dermatomyositis.
Infectious mononucleosis is a common and benign disease. Although hepatic cytolysis is common during infectious mononucleosis, fulminant hepatitis is rare. We report an observation of a fatal fulminant hepatitis complicating a primary EBV infection in a 15 year-old male.