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Biomedical subjects

H Sevestre

Publications and source records attributed to H Sevestre.

At least 19 recordsLinked to original sources

[ASCUS: an update].

A report of ASCUS is always confusing or painful to the clinician, as histological correlate of this diagnosis is wide, ranging from a totally normal cervix mucosa to infiltrating carcinoma; most of the time it is the result of benign inflammatory or reactive changes. This is the reason why this category has evolved since its introduction in the Bethesda system for reporting cervical cytology in 1988, to achieve a closer link to the lesional diagnosis. The most recent modification took place in 2001, to subcategorize the ASC into ASC-US and ASC-H. The present review provides guidelines to manage these diagnoses.

Cytodiagnosis↗

[Epidemiology of HPV infection].

HPV DNA testing using Hybrid Capture 2 (Digene) was added to a program of liquid based (Thinprep, Cytyc) cervical cancer screening in a population of sexually active women aged from 20 to 62 years, without the history of uterine cervix pathology. 14.32% of 3832 women in this population were HPV positive. Positivity peaked in women aged 25-29 (19.4%) and gradually decreased, with 8% of positivity after 60 years. Positivity was independently related to parity, tobacco use and was correlated to cervical pathology. The rate of positivity in this population seems to preclude the use of HPV testing as a primary screening tool.

Adult↗

Comparative histological and biometric study of the coronary, radial and left internal thoracic arteries.

In an attempt to elucidate the causes of occlusion of radial arteries used for coronary artery bypass grafts and to improve the results of these procedures, we studied the biometry and histology of the coronary, radial and left internal thoracic arteries. These arteries were harvested from 20 cadavers (13 males, 7 females). The specimens were calibrated to the various bypass graft sites using coronary calibrators, and were then submitted to histological examination to determine the structure and innervation of the vessel wall. No correlation was observed between the internal calibers of these various arteries, with the exception of the anterior interventricular and right coronary arteries. Intimal changes and the presence of atheromatous plaque were observed in coronary and radial arteries, but never in the internal thoracic artery. Like the coronary arteries and their branches, the radial artery is a muscular artery. Aging of muscular arteries results in thickening of the intima, which becomes fibrotic due to migration of myocytes from the media and duplication of the internal elastic lamina. The media becomes fibrous, hypertrophic or atrophic. The walls of the radial and coronary arteries contain several adventitial nerves (sympathetic and parasympathetic nerve fibers), but these nerve fibers were not observed in the wall of the left internal thoracic artery. In contrast, the internal thoracic artery, like the aorta, is an elastic artery. Aging of elastic arteries is first observed between the ages of 20 and 29 years and is characterized by loss of one or several elastic laminae of the media and more marked intimal thickening, over a variable length. Even if a radial artery's caliber is similar to that of the coronary artery, histological evolution and graft patency depend on its muscular identity.

Aged↗

[Biometry and structure of the left internal thoracic and radial coronary arteries].

In an attempt to elucidate the causes of occlusion of radial arteries for coronary artery bypass grafts, we studied the biometry and histology of the coronary, radial and left internal thoracic arteries of 20 anatomical subjects (13 males and 7 females). These specimens were calibrated to the various bypass graft sites using coronary calibrators, and were then submitted to histological examination to determine the structure of the vessel wall. Our preliminary results show no correlation between the internal calibres of these various arteries. Like the coronary arteries and their branches, the radial artery is a muscular artery. In contrast, the left internal thoracic artery like the aorta, is an elastic artery.

Aged↗

[Difficulties in diagnosis of human dirofilariasis outside known enzootic areas].

INTRODUCTION: Human non-visceral dirofilariasis, a mosquito-borne disease of carnivores (dogs), is chiefly due to Dirofilaria repens in France and is well known in the Mediterranean basin. This zoonosis can be misdiagnosed in northern areas of France. We present and discuss two human cases diagnosed in Abbeville and Amiens (Picardy) by histological examination. EXEGESIS: The former case appeared as an axillary tumefaction occurring in a 41-year-old women 6 months after holidays in Montauban (southwestern France), the other as an intraorbital 'tumor' in a 53-year-old man who travelled for professional purposes in Central Europe and North America. Morphological, clinical, and epidemiological data of these human infections are discussed and the diagnostic features in tissue sections for species identification are reviewed. CONCLUSION: Increasing travel customs during the last decades favour the emergence of zoonotic parasites unusually in human hosts. Outside known enzootic areas, diagnosis is often delayed until pathological examination. In France, the incidence of human dirofilariasis has steadily increased and must be considered in the workup of cutaneous or intraorbital nodules.

Adult↗

Cerebro-costo-mandibular syndrome in a father and a female fetus: early prenatal ultrasonographic diagnosis and autosomal dominant transmission.

Ultrasonography in a female fetus revealed cystic cervical hygroma, severe micrognathia, and vertebral and upper limb anomalies suggestive of cerebro-costo-mandibular syndrome (CCMS) which was diagnosed ultrasonographically at 16 weeks' gestation. The father is affected and presents with a Pierre Robin sequence, short stature and typical costovertebral anomalies. CCMS is a rare and severe disorder. The high frequency of sporadic cases, vertical transmission, and the excess of sibs affected via horizontal transmission suggest dominant autosomal mutation with possible germinal mosaicism. The vertical familial case detailed in the present report is a reminder of the high risk when one parent or one sibling is affected and the extreme variability of phenotype and costal ossification. Early prenatal ultrasound diagnosis is possible in a severely affected fetus.

Abortion, Therapeutic↗

[Epithelioid leiomyosarcoma of the uterine cervix. Report of a case].

We report a case of an epithelioid leiomyosarcoma of the uterine cervix in a 42 year-old woman. This is a very rare tumor. Usually, the presenting symptoms are vaginal bleeding and abdominal pain. Two problems have to be solved by the microscopy: to prove the smooth muscle differentiation of the tumor and to assert the malignancy. Surgery remains the basis of therapy. Prognosis is poor.

Adult↗

[Cellular angiofibroma. A rare vulvar tumor. Report of a case].

Cellular angiofibroma is a rare tumor. We report a vulvar case in a 37 year old woman. This nodular, well circonscribed tumor consists of bland spindle cells, numerous thin or thick often hyalinized vessels and adipocytes. The stromal cells are positive for vimentin and negative for CD34, protein S100, smooth muscle actin, desmin, epithelial membrane antigen and cytokeratin. Cellular angiofibroma is a benign tumor that has to be differentiated from aggressive angiomyxoma, angiomyofibroblastoma, glomangiopericytoma, spindle cell lipoma, solitary fibrous tumor and perineurioma.

Actins↗

[Cellular neurothekeoma, a rare cutaneous tumor. Anatomo-clinical and immunohistochemical study of 2 cases].

Cellular neurothekeoma is an unusual cutaneous tumor described in 1986. We report two new cases in 14-year-old girls. Both tumors measured less than one centimeter and were located on the forearm and the shoulder. They had a plexiform architecture and were developed in the dermis and the dermo-hypodermic junction. Spindle and epithelioid tumor cells were immunoreactive for vimentin, NKI-C3, NSE, CD68 and smooth muscle actin. There was no recurrence 2 and 7 months after the operation. Cellular neurothekeoma is a benign tumor. Its histogenesis is still unknown. Histological and immunohistochemical features, with positivity of the tumor cells for NKI-C3, a non specific melanocytic marker, and negativity for S-100 protein and HMB-45, allow to differentiate cellular neurothekeoma from myxoid neurothekeoma and melanocytic tumors.

Actins↗

[Mesothelial cyst of the adrenal gland].

We report a case of a mesothelial adrenal cyst which was incidentally discovered in a 38-year old woman. The diagnosis was confirmed by an immunohistochemistry study. Adrenal cysts are rare. They occur more commonly in female patients during the 4th and 5th decades and are usually asymptomatic. Adrenal cysts are divided into four groups : parasitic, epithelial, endothelial cysts and pseudocysts. The management is still discussed : follow-up, surgical resection or fine-needle aspiration.

Adrenal Gland Diseases↗