Biomedical subjects
Publications and source records attributed to L Andrac.
An inflammatory nodule developed on the glans penis of a 79-year-old man. Histological examination confirmed the diagnosis of metastasis from a carcinoma of the prostate. This case is of interest in view of the rarity of this metastatic localization and the very unusual microscopic pattern of the primary cancer (epidermoid carcinoma).
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In the present study the immunodetection of various markers in a large series of tissue samples have been analysed through the computerized system of image analysis referred to as SAMBA 200. The immunodetection of estrogen and progesterone receptors, Laminin and type IV collagen, Ki 67, keratin, papilloma virus have been performed in frozen sections or in imprints and fine needle aspirates from tumorous and non tumorous disorders of human breast, endometrium, cervix and ovaries. Staining procedures varied with the type of the marker studied (PAP, ABC-P, ABC-GO, APAAP). The results obtained by the multiparametric SAMBA analysis were accurate, reproducible and reliable. Therefore, the SAMBA analysis providing a standardized and automatic analysis of immunodetection performed in tissue sections can be routinely used in pathology laboratories particularly for the prognostic evaluation and for the prediction of hormonotherapy and chemotherapy response of patients with solid malignant disorders.
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Although IgE antibody is able to provoke a late cutaneous allergic response (LCAR), the mechanism of its development is not clear. It seems to involve vasoactive and clotting mediators released from mast cells and basophils. Substances biologically similar to plasma kallikrein (KK), a Hageman factor activator, have been shown to be released by basophils in the course of an IgE-dependent reaction. Because compound 48/80 induces LCAR-like responses in the skin, we compared the ability of tissue KK and compound 48/80 to induce late cutaneous reactions (LCRs). All 40 test subjects showed an immediate wheal and flare reaction (WF) after both KK and 48/80. The WF was followed by an LCR characterized by diffuse edema, pain, and erythema in 36 of 40 subjects with 48/80 and 26 of 40 with KK. The LCRs evoked by the two agents did not differ in their appearance or in their time of development. These reactions increased until the 5 hr mark, began to decrease at the 10 hr mark, and were gone after 24 hr. Histologic study showed edema and a mixed cell infiltration with fibrin deposition. Challenge of the original injection site and a new site after 1 or 2 wk showed a local refractory state lasting 2 wk. Prednisone almost totally suppressed the LCRs induced by both KK and 48/80.
Bilateral medullary carcinoma of the thyroid (MCT) was discovered in a symptomless patient of a high-risk MCT family. Raised serum calcitonin responding abnormally to pentagastrin led to a thyroidectomy. Grossly, the thyroid showed one nodule in the upper third of each lobe. Light microscopy revealed typical MCT with amyloid deposits. Nontumoral thyroid tissue showed C cell parafollicular hyperplasia. Electron microscopy detected intracellular secretory granules (mean diameter, 150 nm) and typical amyloid fibrills. Immunochemistry revealed numerous calcitonin immunoreactive cells in the nodules, in normal para and intrafollicular C-cells and hyperplastic C-cells. Somatostatin and ACTH were detected in certain tumor cells, but not in normal and hyperplastic C-cells. MCT hormonal production potential is discussed.
Twenty-three cases of primary brain lymphomas were morphologically studied. Electron microscopy was done in twelve cases and immunoperoxidase reactions for light chains of immunoglobulins in ten cases. The patients were fourteen males and nine females. Except two children, the mean age was 50 years. Clinical features and pre-operative investigations lacked any specificity. Post-operative radiotherapy could be performed in thirteen patients, eleven of them being still alive with a follow-up varying from 2,5 months to 4,5 years. All the other patients persued fulminating course (max: 4,5 months). Tumors were preferentially located in frontal and temporal lobes. On gross examination, well limited tumors were more frequent than ill-defined or purely infiltrating tumors. Microscopically, all the lymphomas were of the diffuse type. Perivascular clusters of lymphoma cells, meningeal and parenchymal infiltrates and sub-ependymal sprouts were found in the peritumoral areas. The lymphomas were cytologically characterized according to the modified Kiel classification (Lennert et al, 1975) using light and electron microscopic data. So were identified thirteen lymphoblastic lymphomas (with one convoluted-cell type), one centroblastic lymphoma, eight immunoblastic lymphomas (two with plasmacytic differentiation). Light chains of human immunoglobulins were immunocytologically demonstrated in six of twelve tumors tested, all the positive cases corresponding to immunoblastic lymphomas. A unique case of primary meningeal Hodgkin's disease was found. These results were compared with the rare previous reports associating these different morphological investigations.
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The authors report a case of polymorphous liposarcoma situated in the pancreas. Ultrastructural study of proliferation demonstrated two cell contingents which appeared to represent stages of varied differentiation in the elaboration of adipose cells. The marked preponderance in the case studied of clear and little organised cells would appear to justify the histological classification of the polymorphous liposarcoma as a relatively undifferentiated tumour. Furthermore, this study emphasised the value of electron microscopy in the diagnosis of neoplasms which are complex from a morphological standpoint.
One case of herpes zoster keratitis studied after corneal graft is described. Light and electron microscopy investigations show severe pathological changes under the coneal epithelium: Bowman's layer disruption, superficial stromal alterations, sub-epithelial phagocyte proliferation with lipid and mucopolysaccharid vacuolar deposits, abnormal vascularization of the posterior stroma. The authors stress on this interesting ultrastructural study because of very rare cases of the same disease reported in the literature.
The authors report a new case of synovialo sarcoma of the laryngo-pharynx by optic and electron microscopy. Ultrastructural features were similar to those of joint synovialo-sarcoma, i-e, showing glandular like and spindle cell componments. Both of these shared several ultrastructural characteristics, favouring the hypothesis of a common origin. The site and the fine structure of this tumor are discussed according to the literature.
Nevus spilus is clinically defined as a pigmented skin lesion composed of a light brown macule on which darker, circumscribed macular or papular lesions appear at a later stage. Histologically, nevus cells have been found both in pigmented spots and in the background stain. Cases of transformation into melanoma have been reported in the literature and the excision of these lesions is therefore justified. We discuss surgical techniques used in seven patients with nevus spilus and define their indications with respect to the characteristics of the lesion.
Surgical specimens, from 78 patients operated for impalpable breast lesions containing microcalcifications detected on mammographs (breast cancer screening program) were systematically examined by a pathologist during the surgical intervention. The per-operative procedures encompassed (i) X-raying of the unfixed specimens to ascertain that the latter did enclose the screened lesion, (ii) slicing and subsequent X-raying of the specimens slices in order to locate the microcalcifications, (iii) histological evaluation of areas containing the microcalcifications on frozen sections. Thirty-two of the lesions were histologically benign, 55% were malignant and 13% borderline. Forty of the carcinomas were in situ and 60% were invasive. The per-operative histological diagnosis was correct in 65% of the case, erroneous in 10% and uncertain in 25%. Malignancy was never overscored. In 65% of the carcinomas diagnosed during the surgical intervention, the in sano margins excision and axillary lymph node removal could be performed (one stage surgical treatment). These results suggest that X-raying of sliced specimens and histological evaluation during the surgical intervention ascertains that lesions screened by mammographs are effectively and completely removed, and that they are precisely and extensively histologically examined after being identified and located.