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Biomedical subjects

L Guillou

Publications and source records attributed to L Guillou.

At least 19 recordsLinked to original sources
PubMed1995

Acquired deficiency in C1-inhibitor associated with signet ring cell gastric adenocarcinoma: a probable connection of antitumor-associated antibodies, hemolytic anemia, and complement turnover.

BACKGROUND: Acquired deficiency in C1-inhibitor (C1-INH) associated with malignancy is often asymptomatic because clinical manifestations are not dependent on a critical complement threshold (in contrast to hereditary C1-INH deficiency). Increased complement consumption involving different kinds of antibodies is the postulated mechanism for this disease, but other factors must play an important role. CASE REPORT: A 76-year-old woman with unremarkable medical history experienced three episodes of angioedema over 6 months. Investigations revealed a complement profile characteristic of acquired deficiency in C1-INH, a hemolytic anemia, and a signet ring cell adenocarcinoma (linitis plastica). A gastrectomy and a splenectomy were performed. The postoperative course was characterized by a complete disappearance of the symptoms of angioedema and hemolytic anemia. A local recurrence of the tumor 5 months later could not be resected. The patient died 17 months after the initial surgery was performed. RESULTS: Quantitative and functional analyses of the complement factors showed persistent excessive complement consumption. Markers of hemolytic anemia disappeared after tumor removal but recurred in the second part of the disease evolution. Immunohistochemical findings in tumor tissue showed loss of normal blood group antigens but expression of Lea antigen, as well as C1q deposition. CONCLUSION: To explain the whole clinical and laboratory picture, we hypothesize a connection between tumor immunohistochemical profile, complement consumption, and hemolytic anemia. Tumor cell surface antigens might lead to a permanent but asymptomatic complement consumption that is worsened and becomes clinically manifest by superimposed hemolytic anemia caused by cross-reactive antibodies to newly expressed blood group antigens on tumor cells. This hypothesis should be confirmed by other observations.

Aged↗
PubMed1995

Gynecomastia with unusual intraductal "clear cell" changes mimicking pagetoid ductal spread of lobular neoplasia.

This report describes a case of unusual intraductal "clear cell" changes of male breast that mimicked pagetoid ductal spread of lobular neoplasia. The lesion developed inside a nodule of gynecomastia of the left breast in a 56 year-old man. Immunohistochemically, the enlarged clear cells reacted positively with epithelial membrane antigen, low molecular weight cytokeratin and three breast markers (i.e.: gross cystic disease fluid protein-15 and -44 and estrogen receptors). They were negative for high molecular weight cytokeratin, muscle-specific actin, desmin and vimentin. Differential diagnoses included pagetoid ductal involvement by lobular neoplasia (i.e.: lobular carcinoma in situ and/or atypical lobular hyperplasia), pagetoid growth of intraductal carcinoma, atypical intraductal hyperplasia, and unusual intraductal myoepithelial proliferative lesion.

Diagnosis, Differential↗
PubMed1994

Primary malignant mixed Müllerian tumor (metaplastic carcinoma) of the female peritoneum. A clinical, pathologic, and immunohistochemical study of three cases and a review of the literature.

BACKGROUND: Malignant mixed mesodermal tumors (malignant mixed Müllerian tumors [MMMT]) occur rarely in extragenital sites. METHODS: The authors analyzed the clinical, pathologic, and immunohistochemical features of three cases of primary MMMT of the female peritoneum. RESULTS: The neoplasms occurred in 60-, 64- and 84-year-old women and arose from pelvic peritoneum. Two patients died with disseminated disease 8 and 24 months postoperatively. The third died of cardiac failure 12 months postoperatively with questionable metastatic disease. Microscopically, two tumors were of the heterologous type, containing foci of rhabdomyosarcomatous (case 1) and chondrosarcomatous (case 3) differentiation. Immunohistochemically, coexpression of keratin and vimentin was observed focally in both carcinomatous and sarcomatous components in all three neoplasms, whereas coexpression of low molecular weight cytokeratin, vimentin and actin was observed focally in case 2. Rhabdomyosarcomatous areas were positive with desmin and actin, and chondrosarcomatous areas for S-100 protein. Both epithelial and mesenchymal components were positive for alpha-1 antichymotrypsin in all cases. CONCLUSIONS: On the basis of the present cases and a review of 15 reports from the literature, primary MMMT of the female peritoneum proved to be a rare but highly malignant neoplasm occurring in elderly postmenopausal women. Of 15 patients with available follow-up, 12 died with disease, mostly within 1 year, regardless of the initial tumor stage, histology (homologous versus heterologous MMMT) or treatments attempted. The tumor developed within pelvic peritoneum in half the cases. Histogenetically, peritoneal MMMT are thought to represent "metaplastic" carcinomas originating from the secondary Müllerian system.

Actins↗
PubMed1994

Papillary variant of low-grade mucoepidermoid carcinoma--an unusual bronchial neoplasm. A light microscopic, ultrastructural, and immunohistochemical study.

The authors report an unusual bronchial papillary tumor found in the right lower lobe of a 89-year-old woman at the time of postmortem examination. The lesion was difficult to classify and did not fit well into any lung neoplasm category. Light and electron microscopic features were consistent with a papillary variant of low-grade mucoepidermoid carcinoma. Differential diagnoses mainly included the papillary bronchial mucous gland adenoma and the mixed epithelial-cell-type papilloma. Histogenetically, the tumor appeared to originate from the surface epithelium. Because the lesion showed features of low malignant potential, lobectomy would constitute an appropriate therapy whenever possible.

Aged↗
PubMed1994

Ductal adenocarcinoma arising in a heterotopic pancreas situated in a hiatal hernia.

We present a case of ductal adenocarcinoma originating in a heterotopic pancreas in a 60-year-old patient. The tumor developed at the esophagogastric junction in a hiatal hernia. The nontumoral pancreatic tissue showed ductal cystic dystrophy with enclosed stones, as well as lesions of chronic pancreatitis with metaplastic changes. The perigastric lymph nodes and the liver contained metastatic deposits. Malignant transformation in an ectopic pancreas is exceptional. To our knowledge, this would be the first case occurring in such a location. We review the literature on the subject and discuss the theory of the tumors arising in an aberrant pancreas.

Carcinoma, Ductal, Breast↗
PubMed1993

Malakoplakia and adenocarcinoma of the caecum: a rare association.

Colonic malakoplakia can occur either as a part of systemic disease with multiple colonic and extracolonic deposits or as an incidental finding associated with a rectal or sigmoidal adenocarcinoma. A case is reported which shows an association between malakoplakia and adenocarcinoma of the caecum.

Adenocarcinoma↗
PubMed1992

[Decrease in general health status, febrile state and sinusitis in renal insufficiency].

UNLABELLED: A 59-year old man, dialysed for 9 years because of chronic renal failure of unknown etiology, was also suffering from a hypertensive cardiopathy and anemia. He has received more than 70 units of blood over the past few years. An elevated blood aluminium level prompted treatment with desferrioxamine for 3 years. Following episodes of melena, an intestinal-wall lesion, located 8 cm above the ileo-caecal valve was discovered. Blood serotonin levels were elevated; biopsy of the liver revealed tumor cells with round-shaped nuclei which stained positive for synaptophysin, findings compatible with a carcinoid tumor or a pancreatic islet-cells tumor. Considering the whole clinical situation, aggressive diagnostic of therapeutic measures were not pursued any further. The patient lost 8 kg over the next few months and was finally hospitalised with fever. Physical examination revealed ascites, edema and a gingival abscess which was drained. Blood cultures grew Klebsiella pneumoniae. Antibiotics were prescribed. A month later the patient complained again of fever accompanied by myalgias, edema and pain of the eyelids, mainly on the right side, pain in the maxillary area and on right eye motion. ENT examination revealed a necrotic lesion of the right middle turbinate which on histology was diagnosed as acute purulent rhinitis without granuloma or vasculitis. A CT-scan demonstrated mucosal thickening of the left sphenoidal, ethmoidal, frontal and maxillary sinuses without any osteolytic lesions. The patient suffered a sudden right eye blindness with signs of retinal ischemia accompanied by an elevated sedimentation rate of 130 mm. Steroid treatment for suspicion of a temporal arteritis was introduced. 2 days later the patient was rehospitalized in a semi-comatose condition. No new information was gained from the usual laboratory investigations and the physical examination was comparable to the previous hospital stay. Blood cultures remained sterile. He died a few hours later. DISCUSSION: The discussant, A. de Torrenté MD, accepts the diagnosis of a hypertensive cardiopathy, renal failure of unknown origin and a carcinoid of the terminal ileum with hepatic metastases. The role of iron overload as a contributory factor for the cardiac disease is discussed. More problematic are the manifestations of the terminal disease with involvement of the sinuses, the eyes and the mouth. The "lethal midline granuloma" (a syndrome and not a disease entity) covers many different diseases which can be considered in this case: Wegener's granuloma, various lymphomas, parasitic, bacteria- and fungus-induced diseases.(ABSTRACT TRUNCATED AT 400 WORDS)

Carcinoid Tumor↗
PubMed1991

Alveolar soft-part sarcoma of the uterine corpus: histological, immunocytochemical and ultrastructural study of a case.

A case of alveolar soft-part sarcoma located in the uterine corpus is reported. It was an incidental finding in the hysterectomy specimen of a 40-year-old woman. Light and electron microscopic examination revealed periodic-acid-Schiff-positive, diastase-resistant, membrane-bound cytoplasmic granules and crystalloids. Tumour cells expressed immunoreactivity with vimentin, desmin, cytokeratins, NK1/C3 and HMB-45 antibodies. Four years postoperatively, the patient is still alive without evidence of disease. Differential diagnoses, immunocytochemistry and clinical management of uterine alveolar soft-part sarcoma are discussed and the literature reviewed.

Adult↗
PubMed1991

Squamous cell carcinoma of the lung in a nonsmoking, nonirradiated patient with juvenile laryngotracheal papillomatosis. Evidence of human papillomavirus-11 DNA in both carcinoma and papillomas.

Malignant transformation of laryngeal juvenile papillomatosis most often occurs in patients with previous radiation therapy or smoking histories. We report the case of a 35-year-old, nonsmoking, nonirradiated man who developed squamous cell carcinoma of the lung with a 33-year history of laryngotracheal juvenile papillomatosis. Postmortem examination showed pulmonary cavitating papillomatosis and chest wall, vertebrae, and peribronchial lymph node involvement by tumor. Molecular studies (Southern blot, polymerase chain reaction) showed extrachromosomal human papillomavirus-11 (HPV11) DNA in both carcinoma and two laryngotracheal squamous cell papillomas, including one excised 20 years previously. Our observation is analogous to the previously reported cases of spontaneous (not related to irradiation or smoking) malignant transformation of juvenile laryngotracheal papillomatosis. Although HPV11 viral infection likely played a role in the malignant transformation, other less likely factors, such as drugs given for treatment and radiography performed throughout the illness, should be considered. Repeated pulmonary infections and the host immune response are additional considerations.

Adult↗
PubMed1991

[Subacute and subchronic oral toxicity of beta-bis carboxyethyl sesquioxide of germanium in the rat].

After a brief recall of toxicological data about germanium compounds, the authors relate subacute and subchronic oral toxicities of beta bis carboxyethyl-germanium sesquioxide in rats. During 28 days and six months, male and female animals have received 1 mg/kg/day. No particular toxic symptoms, no behaviour trouble except a small decrease of body weight, in male rats, at the end of the 6-month experimentation, were observed. A light decrease of erythropoiesis and a general stimulation of cellular metabolism has been noticed after 28 days. The only marked effect was a moderate renal deficiency characterized by a tubular disease with presence of cylinders, swelling of tubulus cells and floculus amounts after 6 months. Germanium urinary excretion was constant and linked to the received dose. Six months later, no preferential accumulation in organs was observed.

Administration, Oral↗
PubMed1989

[Hancock pericardial prosthesis. Intrinsic dysfunctions].

The frequency of primary dysfunction of 432 Hancock pericardial bioprosthesis was evaluated during a mean follow-up period of 53.1 months per patient. This frequency was 3.20% valve-year in mitral valve prosthesis and 0.92% valve-year in aortic valve prosthesis. Only one case of calcification was noted. Dysfunction was usually due to tearing of one or several pericardial cusps (25 cases), occasionally to tissue retraction (4 cases). Pathological examination of the explanted valves showed fibrin formation followed by organization into fibrous tissue in the host, retracting or fragilizing the pericardial valvular tissue. A preliminary study of the same group had led to discontinuation of Hancock prosthesis. The long follow-up period makes it possible to compare the results obtained with those of pericardial prosthesis of the same generation, to stress the need for echocardiographic monitoring of the implanted valves and to hope that new techniques of pericardial valve fitting will improve the mechanical reliability of prosthesis which, from the point of view of thrombogenesis and haemodynamics, have unquestionable advantages.

Adolescent↗
PubMed1989

[Postoperative pseudosarcomas of the genitourinary tract. A diagnostic trap. Presentation of 4 cases of which 2 were studied immunohistochemically and review of the literature].

Four cases of postoperative pseudosarcomatous nodules of the genitourinary tract are reported. Two occurred in the vagina of 38 and 57 year-old women, 1 and 3 months after vaginal hysterectomy. The third one occurred in the bladder of a 60-year-old man, 1 and 1/2 months after prostatic adenomectomy. The fourth one occurred in the bladder of a 60-year-old woman, 2 months after transurethral cystoscopy with biopsies. On microscopic examination, the lesions were cellular spindle cell proliferations with numerous mitoses and minimal or no cytonuclear atypia. They mimicked sarcoma, with an overall appearance suggestive of leiomyosarcoma. Immunohistochemical studies performed on 2 cases showed strong reactivity of the cells with vimentin. Cytokeratins, desmin, smooth muscle myosin, smooth and striated muscle actins and factor VIII were negative. Despite simple, sometimes partial, local excision of the nodules, there was neither recurrence nor metastasis 8 months to 5 years later.

Adult↗
PubMed1989

[Aortobronchial fistula developing in a pseudoaneurysm of the horizontal aorta].

Amongst the rare causes of haemoptysis rupture of the great vessels is always a possibility. An aorto-bronchial fistula is a rare complication of thoracic aneurysms of the aorta. A fistula starting from a false aneurysm is exceptionally rare. Our observation concerns a patient of 61 with previous vascular problems who was discovered to have a mediastinal tumour following dysphonia and haemoptysis. Aortography and surgical intervention revealed that this was a false aneurysm of the horizontal part of the aorta which had developed a fistula in the bronchus.

Aorta, Thoracic↗
PubMed1988

[Pre- and postoperative study of arrhythmia in atrial septal defects (ostium secundum and sinus venosus)].

An electrophysiological study was carried out pre- and postoperatively in 25 patients (children and adults) presenting with an atrial septal defect of the ostium secundum type (OSASD). The purposes of the study were to find out whether early electrophysiological abnormalities were present in children, to compare the results obtained in children and in adults and to evaluate the impact of surgery by comparing preoperative and late postoperative electrophysiological data. Patients were divided into two groups. Group I was composed of 11 children (mean age 8.18 +/- 1.03 years) with a mean pulmonary/systemic blood flow ratio of 2.33 +/- 0.24. Group II comprised 14 adults (mean age 36.79 +/- 4.89 years) with a mean pulmonary/systemic blood flow ratio of 3.42 +/- 0.24. Preoperatively, in group I 55 p. 100 of the patients (6/11) had sinus node dysfunction, 18 p. 100 (2/11) had disturbances of atrioventricular conduction, and none had atrial dysrhythmia. Preoperatively, in group II 43 p. 100 of the patients (6/14) had sinus node dysfunction, 36 p. 100 (5/14) had disturbances of atrioventricular conduction, and 36 p. 100 (5/14) had sustained atrial dysrhythmia (flutter or paroxysmal atrial fibrillation). The frequency of sustained atrial dysrhythmia correlated positively with the patient's age and with the presence of sinus node dysfunction. Following surgical closure of the atrial septal defect, the electrophysiological parameters were not significantly modified in both groups. This study confirmed the presence of early electrophysiological abnormalities of sinus node function and atrioventricular conduction in children with OSASD. The most significant finding in adults was the occurrence of atrial dysrhythmias in the oldest patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Control of the patency of coronary-internal mammary artery bypasses by non-selective angiography].

98 successive coronary bypasses using the internal mammary artery were controlled systematically, at an early stage, about the 17th postoperative day, by non selective brachial angiography using a retrograde injection. This control method, simple, quick, reliable and non-aggressive, enables to visualize the internal mammary artery and the bypassed coronary vessel, over its entire length. There were no failure in the control, nor any local or general complication during this examination. The overall patency of such bypasses, evaluated with this method, is 98 p. cent in our series, with however, 12 p. cent of angiographic aspects of a poorly functional bypass. These aspects are related to a slow flow in the by-pass (spindly internal mammary artery, anastomotic stenosis or thin distal bed of the bypassed coronary artery), or to a competitive flow (non significant coronary stenosis). The perfusion of the bypassed coronary, which is not so well studied in the literature, is important to analyze and difficult to evaluate with our technique because of the static views that are used. A similar non-selective angiographic method using a dynamic recording (radio-cinema with dual incidence) is currently being evaluated.

Adult↗