[Malignant fibrous histiocytoma. Post-irradiation complication of Hodgkin's disease?].
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Biomedical subjects
Publications and source records attributed to J Simony.
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The double immunohistochemical detection of estrogen receptor (ER) and the estrogen-regulated 52,000-dalton protein (52kDa-P) was performed on 35 fine needle aspirates of primary breast cancers. The nuclear ER, stained brown, was differentiated from the 52kDa-P, stained in red, in the cytoplasm of the same cells. The significant correlation obtained between the percentages of positive aspirated cells and the cytosolic concentrations of these two markers showed the validity of semiquantitative detection in fine needle aspirates, which appeared to be more representative of the content of these markers in tumors than was the detection in a single tissue section. Tumor heterogeneity also was defined by this double immunostaining, since among the tumors positive for both ER and 52kDa-P (18 of 35 cases), a heterogeneous group of 12 tumors contained the markers in two distinct cell populations, whereas a more homogeneous group of 6 tumors contained double-stained cells. The first information provided by this study is that the 52kDa-P is not correlated with the ER. This absence of correlation is in accordance with other studies and indicates that the 52kDa-P is associated with tumor proliferation and possibly invasion, rather than with hormone responsiveness or differentiation. The feasibility and validity of double immunostaining of these two markers in human breast cancer aspirates should stimulate larger studies--with clinical follow-up of the patients--aimed at establishing the clinical usefulness of this presurgical test.
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Malignant fibrohistiocytoma represents one of the most common malignant tumors of soft tissues. Previously difficult to diagnose with precision, it can now be detected pathologically as a result of recent techniques for investigating cellular development. Treatment is by wide exeresis, prognosis remaining reserved and requiring prolonged postoperative surveillance.
The authors report 3 cases of patients having myeloid chronic leukemia presenting skin changes after long-term hydroxyurea therapy. Some of these side effects are already known; such as dryness, pigmentation, spontaneous necrotizing ulceration and chromonychia with longitudinal pigmented bands. Two new signs are described: a band-like erythema on the dorsum of the fingers and toes, as in dermatomyositis and a plantar keratoderma which interpretation is difficult in such a context. The hydroxyurea's imputability is discussed. These lesions altogether are very suggestive of skin changes after hydroxyurea therapy. The occurrence of such phenomena is quite frequent.
One case of chylopericardium associated with chylopneumothorax is reported. Published data make it clear that the pathogenesis of effusions of chyle is imperfectly known and still highly hypothetical. With the exception of tamponade, there are few pathognomonic and dramatic signs. TM and cross-sectional echography is of paramount importance, since it provides a qualitative and quantitative diagnosis of effusion, the nature of which is determined by chemical analysis. Effusions of chyle may be idiopathic or may developed after oesophago-cardio-pulmonary surgery, or even after blockade of lymphatic vessels or as a result of increased lymphatic flow rate or pressure. Although the course of the disease is usually favourable, infectious or haemodynamic complications (e.g. tamponade or constriction) may aggravate the prognosis. Treatment is exclusively surgical and consists of partial pericardectomy, which is unquestioned. There is no consensus of opinion about simultaneous ligature of the thoracic duct.
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The role of echocardiography in the diagnosis and quantitative assessment of pericardial effusion was demonstrated in 57 cases, 10 of which were confirmed by surgery. With this highly sensitive method all effusions equal or superior to 50 ml could be detected and their volume measured with accuracy. There were no false positive results. Two specific signs of tamponade came out very clearly: a decrease in EF slope, which was less than 50 mm/sec, and a notch in the anterior wall of the right ventricle which occurred 0.04 +/- 0.01 sec after QRS.
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Mycosis fungoides was observed in a 71-year-old male with Mediterranean lymphoma, a B-cell malignancy. It is proposed that this association is not incidental since hypergammaglobulinaemia and even monoclonal gammopathies have repeatedly been described in cutaneous T-cell lymphomas. Mediterranean lymphoma might have resulted from (a) helper cell activities of tumor T-lymphocytes, (b) common antigenic stimuli, or (c) deranged T-B cooperation due to concomitant mycosis fungoides.
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