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L Andrac-Meyer

Publications and source records attributed to L Andrac-Meyer.

13 recordsLinked to original sources

[Difficult diagnosis of fever of unknown origin related to an infraclinic liposarcoma: "small tumor and fever of unknown origin"].

INTRODUCTION: Palpation of soft tissues constitutes part of the physical examination when faced with a patient with fever of unknown origin. Our case highlights the difficulty of diagnosis when the tumor still remains impalpable ten months after onset of fever and severe biological inflammatory process. EXEGESIS: A 49-year-old woman was admitted for fever of unknown origin associated with important biological inflammatory process. In view of her past medical history of breast carcinoma, a search for a relapse was performed and remained negative. Despite multiple investigations and repeated physical examinations, no diagnosis was obtained. Finally, [18F] fluorodoexyglucose positron emission tomography led to a diagnosis showing a high fixation located in the right thigh, related to a myxoid liposarcoma after surgical resection. CONCLUSION: Dramatic regression of fever and biological inflammatory process after surgical treatment illustrates the concept of "small tumor and fever of unknown origin", an exceptional entity but which physicians should be aware of. The role of new technical imaging with [18F] fluorodoexyglucose positron emission tomography has however to be clarified in the evaluation of fever of unknown origin.

Breast Neoplasms↗

Sarcoidosis preceding chronic myelomonocytic leukemia. Report of two cases.

We report 2 patients who had sarcoidosis with skin involvement associated with bilateral anterior uveitis. During the follow-up, they developed chronic myelomonocytic leukemia. This association is of particular interest as sarcoidosis and chronic myelomonocytic leukemia may be considered as disorders of a common monocyte-macrophage cell lineage.

Antineoplastic Combined Chemotherapy Protocols↗

[Arguments in favor of adipocyte grafts with the S.R. Coleman technique].

The main criticism against fat reinjection procedures is related to whether it is possible to graft adipocytes or not. The ideal solution would be to perform biopsies a few months after the operation to check the evolution of the grafted tissue, but such an approach would be difficult to accept for our patients. To overcome this difficulty the authors have compiled all the arguments that plead in favor of adipocyte grafts when Coleman's technique is used. Peer demonstrated in animal studies that it is possible to graft fatty tissue and that more resorption occurs when the fragments are large in size. The histologic studies have shown that the different stages of Coleman's technique do not alter the viability of the adipocytes. A disorganization of the architecture of the lobules is observed, but this does not compromise the theory of adipocyte grafting. An MRI study, performed on ten patients, demonstrated that the reinjected fat cells persist several months after the procedure. These fat cells presented the same characteristics as the patient's native fat in the surrounding area. This impression was confirmed by histological analysis of the reinjected fatty tissue 18 months after the graft. Finally, the clinical results obtained on over 200 patients treated for various indications in plastic and cosmetic surgery lead us to believe that it is possible to perform grafts of fatty tissue.

Adipocytes↗

[A classical form of actinomycoses involving the mouth, face bones, orbit and base of the cranium in an African patient].

Osteitis due to actinomycosis is now an uncommon clinical entity in industrialized countries. This report describes a classic case of imported actinomycosis involving the buccal cavity, facial bones, orbit and skull base. For two years after the onset, various diagnoses followed by different medical as well as surgical treatments were unsuccessfully attempted first in Senegal then in Italy. Proper diagnosis was finally established in Marseille, France, on the basis of histological findings after extensive surgical biopsy. The patient was treated with high-dose intravenous penicillin G for four weeks followed by daily oral administration of amoxicillin for one year. Surgical reconstruction could not be carried out before the patient's return to Senegal. The pitfalls of diagnosis and treatment of actinomycosis are discussed.

Actinomycosis, Cervicofacial↗

Clinicopathologic growth factors in vestibular schwannomas: a morphological and immunohistochemical study of 69 tumours.

Tumour growth of vestibular schwannomas is still difficult to predict. The aim of our study was to determine whether any defined histopathological feature was correlated with the clinical course. We did a retrospective study with 69 paraffin-embedded tumours to establish whether the number of vessels, blood cells extravasation or degree of inflammation, all semi-quantitatively assessed, could be indicative of potential of growth. An immunohistochemical study was also performed with an endothelial marker CD34, the leukocyte common antigen CD45 and the estrogen and progesterone hormone receptors. All these parameters were correlated with patient's age, duration of symptoms (d), with a clinical growth index (CLI = tumour size/d). No clinical parameters proved to be predictive of tumour growth. Tumour size was significantly (p = 0.01) related to the number of vessels and we found a significant relationship between the clinical growth index (CLI) and total number of vessels, especially when duration of symptoms lasted less than 1 year (p < 0.001). However, we found no relationship between duration of symptoms or CLI and CD34 index. The degree of inflammation was significantly correlated (p = 0.007) with duration of symptoms when it lasted more than 1 year. The CD45 index and the semi-quantitative evaluation of the inflammation were well correlated (p = 0.001). No estrogen receptors antigenic site was detected and only seven tumours expressed progesterone receptor in a few cells without any significant clinical value. These results suggest that vessel density is determinant for sporadic acoustic neuroma growth especially for a short clinical course.

Adult↗

[Infiltrating syringoadenoma of the nipple: a new case].

Infiltrating syringomatous adenoma of the nipple is composed of small sweat ducts and solid strands, surrounded by desmoplastic stroma and preferentially develops in the superficial breast tissue and specially in the nipple. This particular and exceptional lesion deserves to be acknowlegded by pathologists concerned with breast pathology since this tumor mimics grade 1 invasive breast ductal carcinoma.

Breast Neoplasms↗

Early curettage of giant congenital naevi in children.

Early curettage of giant congenital naevi in new-born infants, if performed during the first few weeks after birth, can have a substantial effect on the pigmentation of the lesions, reducing the number of pigmented cells and leaving only moderate scars. We describe our experience in a series of nine congenital naevi treated by curettage between the first and seventh week after birth. Histological changes that occur in the naevus during the first few days after birth mean that early treatment is needed to obtain a cosmetic improvement. Curettage as an early treatment for giant congenital naevi in new-born infants provides cosmetic improvement and might decrease the risk of malignancy; however, the lesions are not cured. Naevus cells persist in the deep dermal layers and may come to the surface, such that close monitoring is needed long after curettage. The cosmetic improvement is likely to benefit the child's psychological development.

Back↗

[Lymphocytic mastitis].

Lymphocytic mastitis is a non infectious inflammatory disease of the breast with lobulocentric lymphocytic infiltrate of variable intensity, collagenous fibrosis and progressive lobular atrophy. The pathogenesis of lymphocytic mastitis is still unknown but some recent reports have suggested an autoimmune origin. We investigated a series of 10 cases by immunohistochemistry and we collected patients' biologic data. The most striking histologic feature was a prominent lobulocentric stromal or intraepithelial lymphocytic infiltrate. Occasionally, the infiltrate was perivascular and nodular along the lobule border. B and T lymphocytes, both demonstrated by immunophenotypic analysis, were shown with a particular pattern of distribution. Pathologists must be aware of this disease in order to recommend immunological investigation.

Adult↗

[Anetoderma during antiphospholipid syndrome. 3 cases].

INTRODUCTION: Anetoderma is a skin disease of unknown etiology sometimes encountered in patients with a lupus syndrome. We report a clinical and pathology analysis of 3 selected cases of anetoderma associated with systemic lupus erythematosus and/or antiphospholipid syndrome. CASE REPORTS: Three patients had skin lesions typical of anetoderma. Antiphospholipid antibodies were present in all three (anticardiolipin in 3, circulating lupus anticoagulants in 3, anti-beta 2GP1 in 2). One patient with systemic lupus erythematosus had signs of antiphospholipid syndrome, the two others had primary antiphospholipid syndrome. DISCUSSION: The analysis of our cases and a review of the literature suggest that anetoderma is a disease which develops in the immunological environment of lupus, and is apparently more related to the presence of antiphospholipids than lupus itself. Thus anetoderma could be another cutaneous sign of the antiphospholipid syndrome.

Adult↗

Desmoid tumour of the breast.

We describe the clinical and pathological features of a case of desmoid tumour of the breast. The lesion was approximately 3.0 cm in greatest dimension. Histologically, it had infiltrating borders and extended to the pectoral muscle. The differential diagnosis is discussed.

Adult↗