[Amyloid goiter. Apropos of a case].
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Biomedical subjects
Publications and source records attributed to F Piard.
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The population based registry of digestive cancers in the french county of Côte-d'Or enables a study of the treatment and prognosis of colorectal cancers. During 1976-1981, 587 rectal cancers and 717 colon cancers were diagnosed. Curative resection was performed in 61 p. 100 of rectal and colon cancers. Operative mortality after curative resection was 9.7 p. 100 for rectal cancers and 13.1 p. 100 for colon cancers. The overall 5 year observed survival rate was 26.5 p. 100 for rectal cancers and 29.8 p. 100 for colon cancers. After curative surgery, 5 year corrected survival rates was 57.2 p. 100 for rectal cancers and 66.9 p. 100 for colon cancers. Five year survival rate was related to the topography of the cancer (it was lower for caecal cancers), to the macroscopic type of growth (it was higher for exophytic carcinomas than for infiltrative carcinomas) and to the size (it was higher for tumors less than 3 cm than for larger tumors). The major determinant of the survival was the pathological stage of the tumor. Patients with Dukes' A lesions at the time of curative surgery had almost the same life expectancy as persons without rectum or colon cancer. These data suggest that a substantial improvement in prognosis might result from earlier diagnosis of the disease. This commands modifications in the policy of detection of colorectal cancers.
Transrectal fine needle aspiration of the prostate is an excellent method of diagnostic approach. The simplicity of its application and its reliability in the positive cases make it particularly valuable. Therefore, this method should be used more currently as diagnostic tool in prostatic carcinoma.
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The benign clear cell tumor of the lung is an uncommon neoplasm. It is often confused, before histological analysis, with metastases. The data of one personal observation are similar to those of 19 other cases of the literature. This tumor which occurs with an equal frequency in adults of the two sexes is often asymptomatic. It is discovered after a systematic x-ray control of the lungs. It is located in the peripheral parenchyma and looks like a round, homogeneous, well delimited opacity. Its evolution is always favourable after surgical excision. The benign clear cell tumour is never identified before pathological study. This neoplasm 1 to 6 cm in diameter consists of a uniform proliferation of clear cells filled up with free of intra-vesicular glycogen. Its cytological and structural features are not the same as those of the other primitive bronchopulmonary tumours having an important clear cell contingent. The histochemical and ultra-structural studies are at the origin of three hypotheses; is the benign clear cell tumor an apudoma, a smooth muscular neoplasm or an adenoma of the terminal bronchioles?
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We report a case of peliosis hepatis in a 47-year old male patient with dermatomyositis treated with azathioprine and corticosteroids. Three months after the combined treatment was initiated, the patient developed right thoracic herpes zoster, agranulocytosis and liver enlargement with signs of portal hypertension. Needle biopsy of the liver revealed peliosis. Azathioprine was withdrawn. The clinical and laboratory abnormalities disappeared progressively. The main causes of peliosis hepatis are considered. Up to now, azathioprine had been held responsible for peliosis hepatis only in renal transplant recipients.
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The authors report a new case of myoid tumour of the stomach, a chance discovery in an asymptomatic patient. The diagnosis of a heterogeneous tumour of gastric origin was made possible by echography and tomodensitometry. The myoid nature of the tumour was confirmed histologically. With the recognition of this new case the literature on the subject was reviewed. The features special to these tumours are studied with emphasis on the usefulness of echography and tomodensitometry in diagnosis, also the therapeutic approach to be adopted with regard to these tumours.
The authors report a case of polypoid heterotopic gastric mucosa in the ileum presenting as intussusception with hypochromic anemia in a 6 year-old boy. Tumorous heterotopic gastric mucosa in the small bowel is very uncommon. So far 22 similar cases have been published in the literature. This congenital intestinal anomaly is discovered in one third of the cases during the first decade. In 9 of 23 cases gastric heterotopia was diagnosed after an ileal resection for intussusception induced by the heterotopia presenting as a pedunculated or sessile polyp. In our case the great number of the polypoid formations is exceptional and has not been previously described.
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