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Biomedical subjects

G Lagneaux

Publications and source records attributed to G Lagneaux.

8 recordsLinked to original sources
PubMed1996

Preoperative lymph node staging in rectal cancer: a difficult challenge.

The specimens of 59 rectal cancers that had been scanned by preoperative endorectal ultrasound (EUS) were analysed by the pathologist in order to draw a map of the pararectal lymph nodes that should be detected by preoperative staging. 389 lymph nodes (LNs) were detected in the mesorectum, close to the tumour. Malignant LNs were larger than the non invaded: 17% of the LNs less than 6 mm in diameter were invaded whereas 23% of the LNs 6 mm or more in diameter were free of metastatic invasion. The non invaded LNs displayed three main patterns: follicle, sinusoidal and mixed types. Metastatic LNs were partially (n = 25) or totally (n = 76) invaded by tumoural cells. Diffuse involvement includes 4 different patterns: cellular proliferation, fibrosis, necrosis and cyst formation. Accuracy of EUS evaluated by a "patient by patient" comparison was 61%, with a sensitivity of 84% and a specificity of 39%. However, a comparison "lymph node by lymph node" showed a detection rate of 21% of the lymph nodes of 3 mm and more. It is concluded that a low percentage of LNs are detected by EUS in our experience. Metastatic and non metastatic LNs exhibit a great variety of morphological features and it seems difficult to reliably correlate metastatic invasion with a specific endosonic appearance. LN size remains the most reliable parameter.

Humans↗
PubMed1995

Long-term favourable outcome of portal hypertension complicating primary systemic amyloidosis.

An unusual case of systemic amyloidosis complicated by portal hypertension is reported. In this condition, portal hypertension is a rare event associated with poor prognosis. In our patient, severe presymptomatic sinusoidal portal hypertension was demonstrated by hepatic vein catheterization and coincided with abundant perisinusoidal amyloid infiltration. Despite these features and the absence of objective response to 20 courses of melphalan and prednisone, the patient was still in good clinical condition 4 years after initial diagnosis. This observation suggests that in primary amyloidosis, the incidence of sinusoidal portal hypertension might be underestimated and also that it may be associated with a relatively good prognosis.

Amyloidosis↗
PubMed1994

[An unusual cause of chronic diarrhea: lymphocytic colitis].

We report a case of lymphocytic colitis in a 74-year-old woman presenting with watery diarrhea since 1 year and in whom previous extensive investigations were normal. The diagnosis could be made on the basis of typical pathological pattern in colonic biopsies. The outcome was favourable with salazopyrine therapy. The clinical, histological and pathophysiological aspects of lymphocytic colitis are discussed.

Aged↗
PubMed1992

Muscle regeneration after endoureteropyelotomy?

Three specimens of ureteropelvic junction, obtained at dismembered pyeloplasty after successful endoureteropyelotomy, were studied. In the regenerative tissue, numerous cells were found with morphological, immunohistochemical and ultrastructural characteristics of mature smooth muscle cells; no regeneration of bundle arrangement was observed.

Desmin↗
PubMedDate not supplied

Colorectal villous tumors accuracy of the preoperative biopsies.

This study was undertaken to assess the reliability of the endoscopic biopsies in the evaluation of colorectal villous tumors (CRVT). In 163 consecutive patients referred for surgical treatment of CRVT, preoperative evaluation had been routinely done by colonoscopy and multiple biopsies. Tumors were classified in 3 groups: low grade tumors, high grade tumors and adenocarcinomas. Infiltration in depth was staged on the postoperative specimens according to the Dukes-Aster-Coller's classification. All the tumors were completely resected by surgery and definitive pathological diagnosis was established. An exact correlation between the pre- and postoperative staging was observed in 48% of the cases. Accuracy averaged 54% in the group-by-group comparison, with an overstaging rate of 6.7%, and an understaging rate of 39%. The incidence of adenocarcinomas was 22% in the group with clearly benign preoperative biopsies and 50% in the other cases. There were significantly more B2 and C tumors among the patients referred after 3 or more endoscopic attempts (33%) than after one or two sessions (10%) (p < 0.0003). We confirm that in spite of multiple endoscopic biopsies, only a complete resection permits an exact staging and an appropriate therapeutic choice.

Adenocarcinoma↗
PubMedDate not supplied

[Place of endorectal echography in the diagnosis and treatment of sessile villous tumors of the rectum].

Appropriate treatment of villous adenomas of the rectum remains a challenge, since accurate diagnosis can only be established after total removal of the lesion. The aim of the study was to assess the contribution of endorectal ultrasound (EUS) to diagnosis and treatment of these tumours. From 1989 to 1992, 22 patients with 24 villous adenomas of the rectum had preoperative EUS. Sixteen tumours were C1 (< 1/3 of the rectal circumference), 6 were C2 (between 1/3 and 2/3), and 2 were C3 (> 2/3). Multiple biopsies showed slight or moderate dysplasia in 12 cases, severe dysplasia or islets of invasive cancer in 12 cases. Depth of tumoural invasion could not be established. Tumours were staged by EUS as uT1 (no malignant infiltration) in 17 cases, uT2 and uT3 (invasive cancers) in 5 and 2 cases respectively. Patients had local excision of the tumours in 21 cases, and a radical rectal resection in 3. Accuracy of pathological sampling and EUS for diagnosis were evaluated, as well as the contribution of EUS to the treatment. Multiple biopsies achieved a 62% accuracy rate of diagnosis. Sensitivity in detecting invasive cancer was 71.5%. EUS reached a 92% accuracy rate; sensitivity and specificity in detecting invasive cancers were 85% and 94% respectively. The initial therapeutic option was modified in 6 patients as result of EUS stadification: undelayed surgery instead of iterative coagulations (n = 1), radical instead of local resection (n = 2) and local instead of rectal resection (n = 3).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma, Villous↗
PubMedDate not supplied

Cytologic patterns of reparative processes, true dysplasia and carcinoma of the gastric mucosa.

The cytologic features of dysplasia and carcinoma of the stomach are still poorly defined. In a series of 90 cases, a precise correlation could be made between smears and histologic data. Cytology was sensitive enough to allow characterization of: (1) active repair/regeneration, associated, in a number of cases, with intestinal metaplasia (slight dysplasia); the cellular atypia is minimal; (2) true dysplasia (formerly moderate and severe); this preneoplastic state is characterized by cellular atypia within clusters; and (3) true carcinomas (intestinal or diffuse type); classic criteria for malignancy are present, with a prominent lack of cell cohesiveness, though distinction from dysplasia may be very difficult. The advantages of cytology are the survey of large mucosal areas, investigation of the cardial region, not always accessible to endoscopic biopsy, and exploration of large ulcers. With the adjunct of cytology, the specificity and sensitivity of endoscopy plus histology clearly increase.

Biopsy↗