Biomedical subjects
Publications and source records attributed to J Testard.
Inflammatory pseudotumors of the lung are uncommon benign lung tumors. Their tendency for local extension requires an exact histopathological diagnosis to rule out neoplastic proliferation. The case presented here highlights the clinical findings as well as the difficulties in making the diagnosis and the therapeutic uncertainties.
The authors describe a case of mediastinal fibrosis in a 53 year old woman which presented with a superior venacaval syndrome ten years after the diagnosis of a Riedel's thyroiditis. The clinical and laboratory evidence did not reveal anything to suggest other fibrosing disorders (such as retroperitoneal fibrosis, extra-hepatic biliary fibrosis or orbital fibrosis) which could be associated either simultaneously or successively with this multi-focal fibrosis. The physiology of this disorder currently remains imprecise. A current hypothesis is that there is an immunological reaction in the periarterial area leading to lipid components make atheromatous plaques. The therapeutic means are limited and depend on the localisation of the fibrous tissue and of their functional repercussions. Currently, the benefit of corticosteroids on the mediastinal fibrotic lesions has not been demonstrated.
The authors record the case of a patient who was under review for pulmonary tuberculosis in whom an Abrikossof granular cell tumour and a cyst were found which had developed from an intrapulmonary lymph node. These two entities are rare and their association extremely unusual and have never been described until now. We review their histogenesis.
A geneological study made it possible to establish a link between two medullary thyroid carcinoma families from Normandy totalling 9 sick subjects, and a probable link with a third family. The study contributed to the diagnosis of multiple endocrine neoplasia type IIa, whereas the condition had been diagnosed for 6 years as familial medullary thyroid carcinoma, without phaechromocytoma. Group in these two families together increased the number of subjects tested, thereby facilitating genetic link analysis and enabling the link with markers of the disease on chromosome 10 to be asserted. The genetic study can now be used to detect individuals at risk, and with regular laboratory tests the diagnosis will be made at the "precancerous" stage. A genealogical study going back to the family-founding couple will increase the population which will benefit from screening in this region north of Rouen.
We report seven cases of dissection of the abdominal aorta. Three patients had acute back pain, whereas four patients had more chronic courses. In six cases, as a result of the palpation of a pulsatile abdominal mass, clinical diagnosis was an atheromatous aneurysm. Angiography and CT scanning demonstrated a dissected abdominal aorta and a normal thoracic aorta. Six patients with an infrarenal dissection were treated by replacement of the aorta with a Dacron prothesis, and one patient with an suprarenal dissection was treated conservatively. With a mean follow-up of 3 years, all patients were alive and free of symptoms. These results favor graft replacement in case of infrarenal aortic dissection and more selective surgical indications in suprarenal aortic dissection.
Explore the source record for details and available documents.
The case of a woman with congenital antithrombin III (AT III) deficiency undergoing elective hysterectomy is reported. AT III deficient patients have high risks of thromboembolic disease, especially developing during and after surgery. It is usual practice to discontinue oral anticoagulants with antivitamin K activity and to obtain effective AT III activity by the transfusion of freeze-dried concentrates of AT III and/or fresh frozen plasma (FFP). Heparin is prescribed as soon as AT III activity reaches 70%. The oral anticoagulant regimen is reinstituted in the late postoperative period. In our case, transfusion of FFP, in the pre- and postoperative periods, results in an AT III activity of 63%. Heparin was not used because oral anticoagulants were readministered early, 12 h after operation. No clinical thrombo-embolic complication was observed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.