[Lymphocytic gastritis associated with gastric MALT lymphoma].
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Biomedical subjects
Publications and source records attributed to F Maitre.
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The clinical and pathological features of 4 cases of cutaneous neuroendocrine carcinoma are reported. There are unusual malignancies mostly observed in elderly, the prognosis is poor by loco-regional aggressivity and disseminated metastases. They are diagnosed by a pathologist: ultrastructural studies and immunohistochemistry support the diagnosis. A combination of a wild local excision, node dissection and post-operative radiation is recommended.
Placenta praevia percreta, with bladder invasion, was diagnosed at 29 weeks of amenorrhoea with colour Doppler which visualized vascular bundles leaving the placenta and reaching the lower part of the bladder. These bundles were identified as including arterial elements with pulsed Doppler. The criteria for the diagnosis of placenta accreta with ultrasonography and colour Doppler have been presented in the literature. This prenatal diagnosis allowed adapted preoperative management and intensive care, however air embolism could not be avoided and the patient died at the end of the operation.
The authors report a case of metastasis of cancer from the breast in a uterine leiomyoma. The metastases into the body of the uterus from extragenital cancers are rare. If they occur they are usually in the myometrium where they are asymptomatic and where the diagnosis is difficult, or in the endometrium where the diagnosis can be made by biopsy after curettage. A few rare cases of metastases in uterine leiomyoma have been reported in the literature. They can be the cause of very sudden increase in size of fibroids with compression of the pelvic organs.
The authors report a rare case where a pheochromocytoma which was not in the adrenal gland occurred in the broad ligament. A review of the literature resulted in only three published cases being found. When the symptomatology suggests that there may be a pheochromocytoma in the body one has to research where it is sited and one has to think of such a possibility if a tumour in the broad ligament is found during an operation, so that the risks of operating on these tumours can be lessened.
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Hepatic venous catheterisation and transvenous liver biopsy were performed in five patients with hepatic amyloidosis. In three patients, hepatic venous pressures were normal and histological examination of the liver biopsy specimen showed discrete and sparse perisinusoidal amyloid deposits. In the other two, however, the gradient between wedged and free hepatic venous pressures was increased (12 and 16 mmHg; normal 1-4 mmHg) and amyloid deposits were abundant and diffuse in the Disse's space. This study shows that portal hypertension in patients with hepatic amyloidosis is of the sinusoidal type and is related to the reduction of vascular space of hepatic sinusoids by massive perisinusoidal amyloid deposits. Furthermore, portal hypertension is associated with a poor prognosis in patients with hepatic amyloidosis.
Placental villitis, which is defined by the presence of lymphocytic or macrophagic inflammatory cells within the villosities, constitutes a recently-described histopathological entity. This condition is the consequence of an immune response of the feto-placental unit towards a non-specific, multiple aggression and the incidence is very low. The extent of the inflammatory reaction may culminate in placentitis, resulting in miscarriage. Although a large number of infecting agents are known to be responsible for the pathogenesis of villitis, in most cases the etiology remains unknown. The hypothesis of a failure of the mechanisms of immunotolerance during pregnancy is suggested by many authors to explain their origin.
We report the eleventh illustrated case of primary liposarcoma of the heart in a 28-year-old man. The tumor arose from the mitral valve and the left ventricle and was revealed by a solitary brain metastasis 1 year before. The primary tumor and the metastasis were surgically removed. The cardiac and brain neoplasms were myxoid liposarcoma, as confirmed by histochemical, immunohistochemical, and ultrastructural studies. Although review of the literature points out the poor survival of patients with malignant liposarcoma of the heart, no recurrence or metastasis was observed after a 6-month follow-up.
Phyllodes tumors represent a particular class in breast pathology. They are defined as bi-tissue, fibro-epithelial tumors, similar to fibro-adenomas, but their connective tissue component is greatly predominant. They are infrequent as they represent only 3% of breast tumors. They mainly occur during the premenopausal period, since alteration of the hormonal balance may play a role. The authors feel that they represent only a type of the evolution of the fibroadenomas with a relationship, in time, following the sequence: fibroadenomaphyllodes tumor-sarcoma. The diagnosis is exclusively made by histology and there is no pathognomonic sign, whether it is clinical or mammographic. The course is essentially characterized by the possibility of local recurrences, sometimes numerous, and by the occurrence of metastases in case of malignant phyllodes tumor. These two possibilities are correlated with the histological stage of the tumor. The treatment is definitely surgical, possibly mastectomy in case of large or aggressively active tumor.
The graft vs. host reaction (GVHR) induced across a non-H-2 histocompatibility antigen barrier was shown to be a multiorgan disease with a strict time-dependent pattern of functional alterations. The present study was undertaken to examine the effects of the GVHR on corticosterone, aldosterone, corticotropin (ACTH), Na+, and K+ plasma concentrations in mice. GVHR was induced in irradiated (DBA/2 X B10.D2)F1 mice by transplantation of B10.D2 hemopoietic cells. Controls were untreated F1 mice and irradiated syngeneic (F1) cell-grafted F1 mice. Nonimmunological stimuli transiently increased ACTH and corticosterone plasma levels during the first 5 days, although the early ACTH peak was markedly reduced in GVHR mice. Circulating corticosterone levels returned to normal values thereafter in controls. ACTH returned to basal levels in all mice, even in GVHR mice in spite of their persistent high corticosteronism. The enhancing effect of GVHR on plasma aldosterone concentrations was delayed until day 30 after the cell graft. Results suggest 1) a dissociated effect of GVHR on mineralocorticoid and glucocorticoid metabolism and 2) either an alteration of adrenal sensitivity to ACTH in GVHR mice or a possible mimicking of some neuroendocrine activities by the lymphocytes responsible for the onset of the disease.
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