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M J Lacombe

Publications and source records attributed to M J Lacombe.

At least 37 records · Page 2Linked to original sources
PubMed1985

Analysis of local-regional relapses in patients with early breast cancers treated by excision and radiotherapy: experience of the Institut Gustave-Roussy.

Between 1970 and 1981, 436 patients with T1 and small T2 breast carcinoma were treated by tumor excision followed by radiotherapy at the Institut Gustave-Roussy. The mean follow-up was 5 years, with 50% of patients followed 5 years. Twenty-four patients have experienced a local-regional (LR) relapse for an actuarial LR control rate of 93% at 5 years and 90% at 10 years. Potential prognostic factors for all 24 local-regional recurrences and for the subgroup with relapses in the breast were analyzed. A high Bloom grade and low Nominal Standard Dose (NSD) were significant prognostic factors for predicting LR relapse in both groups. Disease-free survival (from initial presentation) was not adversely affected by a solitary breast recurrence, when patients with successful salvage treatment were considered disease free. However, the group of patients with nodal or dermal recurrences had a much worse prognosis. This paper describes the natural history of breast cancer following a local-regional relapse in irradiated patients without mastectomy. Most importantly, we observed that breast relapses following radiotherapy become clinically apparent more slowly than chest wall failures after mastectomy, and if detected early, that these patients may be successfully retreated.

Adolescent↗
PubMed1985

[Alveolar soft part sarcomas. Apropos of 6 cases and review of the literature].

This is a clinicopathologic study of 6 cases of alveolar soft-part sarcoma. The patients age ranges from 8 to 47 years. All patients are women. In 5 cases the localization of the primary tumor is the lower extremities. Histologically the tumors have a distinctive organoid pattern outlined by thin-walled capillaries and are composed of nests of large polyhedral cells with abundant finely granular, acidophilic cytoplasm. Two tumors, among the 4 tested cases, have cytoplasmic PAS positive diastase-resistant crystalline structures. Electron microscopic study of one tumor shows intracytoplasmic glycogen, small membrane-bound electron-dense granules, Golgi lamellae and crystalline structures. Immunoperoxidase study performed in one case reveals a positivity with antikeratin and anti-enolase (NSE) antibodies. The prognosis of this tumor is poor. The main metastasis are in the lung and in the brain. Often the patients develop metastasis before detection of the primary tumor. The histogenesis of alveolar soft part sarcoma and the identity of the characteristic crystalloids remain open for discussion.

Adult↗
PubMed1985

[Aschoff's center of proliferation. Experience of the Gustave Roussy Institute].

"Le Centre de Prolifération d'Aschoff" (CPA) has many synonyms: radial scar, benign sclerosing ductal proliferation, non encapsulated sclerosing lesions, fibroelastic center, fibroadenosis with fibroelastic core etc... In a retrospective study from the files of the Gustave-Roussy Institute, 88 cases were found: 18 cases between 1955 and 1959 and 70 cases more recently, between 1976 and 1981. CPA is an unusual lesion, observed in 2% of benign breast lesions, and in less of 1% of malignant breast lesions. Macroscopically, when CPA is not associated to a carcinoma, it has either a pseudotumoral feature (46% of the cases), or only a microscopic appearance (54% of the cases). In these last cases, it is always found by chance at the time of the examination of specimens of fibrocystic disease. When it is associated to a carcinoma, these two features are less well individualized. Mammographically and macroscopically, they are often problematical. They cause considerable diagnostic problems because of their pseudotumoral features, being similar to small stellate carcinomas. Two cases were misinterpreted at the time of the extemporaneous examination for a carcinoma and in 36 other cases, the diagnosis was uncertain and the definitive report was delayed. For the non-pseudotumoral form, a relationship was found in this series between previous cytological aspirations and CPA. The evolution of this lesion was difficult to evaluate because of the great number of the patients lost to follow up in this series. Although a slight trend was observed for patients to subsequently develop a breast carcinoma, no statistically significant difference was observed. From this study, close follow-up of these patients is considered necessary.

Adult↗
PubMed1985

[Analysis of the expression of the oncogene c-myc in human breast adenocarcinoma].

The c-myc oncogene was characterized and its expression analyzed in 32 mammary adenocarcinomas and in 2 benign breast tumors from 34 untreated patients. Southern blot hybridization experiments have demonstrated the amplification of the oncogene (3 to 30 fold) in 3 carcinomas. The analysis of total RNA by Northern blot revealed the presence of a 2.4 kb c-myc RNA band. In 7 out of 10 carcinomas from patients with 3 or more than 3 lymph node metastases the level of c-myc expression evaluated by dot blot analysis was 4 to 14 fold greater than that of normal human tissues. In only 5 out of 22 carcinomas from patients without lymph node metastases or less than 3 invaded nodes the level of c-myc expression was also higher (4 to 10 fold). The level of c-myc expression was not significantly enhanced in the 2 benign tumors. It is suggested that the c-myc gene activation could be associated to a higher degree of malignancy of mammary carcinomas.

Adenocarcinoma↗
PubMed1985

Contribution of computed tomography in six sacrococcygeal chordomas.

Six sacrococcygeal chordomas were studied with CT at the Institut Gustave-Roussy. Only one was examined at the time of the initial diagnosis and CT made a valuable contribution to this. In other cases, CT determined the possibility of initial surgical excision and the field of radiotherapy and helped make a reliable diagnosis of local recurrences. CT seems to be the best examination to use for the early diagnosis of chordomas and recurrences, which will perhaps help improve the prognosis of this serious disease.

Adult↗
PubMed1984

Asymptomatic encephalic intraparenchymatous neuroepithelial cysts.

The authors report three cases of intraparenchymatous neuroepithelial cysts, which did not communicate with the ventricular system and the subarachnoid space. They were located in (1) the right frontal lobe, (2) the left cerebral peduncle and pons, and (3) the right cerebellar hemisphere. All of them were asymptomatic, despite their volume and location, and presented as incidental autopsy findings. A developmental origin is likely for these non-neoplastic cysts.

Aged↗
PubMed1984

[Soft tissue clear cell sarcomas. Reevaluation of clear cell sarcomas of the tendons and the aponeuroses in 14 cases].

A retrospective study is realized including 14 cases of clear cell sarcomas of tendons and aponeuroses, found in the files of Institut Gustave-Roussy (1969-1983). The main microscopic features are emphasized. In comparison with other soft tissue sarcomas, clear cell sarcomas are clinically characterized by a great frequency of local lymph node metastases (4 of 14 cases). The prognosis is usually particularly poor. The exact histogenesis remains obscure, but the results of special stains, support origin from migrated neural crest cells: melanin is visualized in 2 out of 12 tumors in which Fontana-Masson is performed. S 100 protein, a neuroectodermal marker, is positive by immunoperoxidase technique (PAP) in 6 of 10 tested cases. A better diagnostic approach is allowed with the help of ultrastructural study performed in 3 cases. These tumors must be separated from synovialosarcomas. Because the histogenesis is not actually sure, it is preferable to call them "soft tissue clear cell sarcomas".

Adolescent↗
PubMed1983

Intracranial lesion resembling giant lymph node hyperplasia.

A 30-year-old woman, who, since the age of 20, had epileptic seizures, was hospitalized in 1972 because of frontal headaches, nausea, and vomiting. Clinical examination revealed a right cerebellar syndrome; gamma-encephalogram showed a focus of subtentorial hyperactivity; iodoventriculography showed a deformation of the aqueduct. At surgery, a posterior fossa tumor implanted on the dura mater and tentorium of the right cerebellar fossa was enucleated. The histologic features were those of giant lymph node hyperplasia. Postoperative craniospinal radiotherapy was administered. Ten years later the patient was in good health and neurogically normal.

Adult↗
PubMed1983

[Malignant lymphomas and other hematosarcomas with initial breast localization. Retrospective study of 20 cases].

A review of 20 cases of malignant lymphomas and other hematopoietic sarcomas initially localized in the mammary gland permitted us to determine some main clinical and morphologic features. Ages range from 14 to 74 years. Clinical features consist of two principal aspects: a radiologically homogeneous, well circumscribed mass or an inflammatory tumor. After staging, one half of the cases remain localized only in the mammary gland (extranodal stage I). Granulocytic sarcoma, monoblastic sarcoma and Hodgkin's disease are very rare. Non Hodgkin's lymphomas are the most frequent. In 40 per cent of the cases, it is a diffuse, large non cleaved cell type, according to the working formulation for clinical usage (centroblastic in the Kiel classification). These are probably B cell derived malignant lymphomas. Eleven per cent of the cases fall into the large cell with multilobated nuclei type according to Pinkus, which probably is a T cell derived malignant lymphoma. Treatment consists of radiotherapy and/or chemotherapy, mastectomy is not advisable. Like any malignant lymphoma localized in other sites, prognosis depends on two main data: clinical stage of the disease and histologic type. Ten patients are in complete remission, the median survival being 3.5 years.

Adolescent↗
PubMed1981

[Acute chondrolysis following slipped capital femoral epiphysis. A study of 41 cases (author's transl)].

The authors have seen 41 instances of chondrolysis following slipped capital femoral epiphyses. Most of the cases were followed-up for more than five years. The main clinical features are reviewed. There is joint stiffness and generalised narrowing of the joint space during the year following the initial lesion. The evolution of the lesion is unpredictable. A number of possible radiological changes may develop including renewal of the joint space, modifications in the femoral head with a tendency towards protrusio, and osteophyte formation at the lateral margins of the acetabulum. In five cases a biopsy was performed which showed a non-specific dystrophy of the acetabular and femoral cartilage, with sub-chondral bony change different from that found in epiphyseal necrosis. The synovium did not show inflammatory change. The treatment should not be surgical at an early stage but the effectiveness of traction was uncertain. Later, corrective osteotomies may be indicated. Definitive surgical procedures such as arthrodesis or arthroplasty should not be made early because late clinical recovery has been noted. Cup arthroplasties gave deceptive results. The etiology of this disease is discussed.

Adolescent↗
PubMed1979

[Humeral lytic lesions and circulating anticoagulant in secondary syphilis (author's transl)].

A case of secondary syphilis revealed by rheumatic complaints is described. Arthralgia and myalgia were associated with lytic lesions and periostitis of both humerus. A more diffuse skeletal involvement was detected by bone scanning. A genital ulceration 4 months before, diffuse lymphadenopathy and a strongly positive serological reaction ascertain the diagnosis. The association of a circulating anticoagulant is discussed. All manifestations cleared with penicilline treatment.

Adult↗
PubMed1978

Genetic control of sensitivity to Moloney-virus-induced leukemias in mice. I. Demonstration of multigenic control.

The appearance of hematopoietic malignancies and the level of viremia were studied in mice of different inbred strains and their F1 or F2 hybrids inoculated with the Moloney leukemia virus (MLV). The viremia was regularly measured in individual mice by radioimmunoassay of the major internal virion component p30. A complex genetic control was found. (1) The level of circulating virus was controlled by at least two genes. An H-2 linked gene, tentatively called Rmv-1, displayed a dominant sensitivity. Alleles for resistance existed in H2b and H-2r haplotypes and alleles for sensitivity in H-2a, H-2d and H-2f. Another gene with dominant resistance mapped outside the H-2 complex and probably interacted with Rmv-1. (2) A good correlation existed between viremia and the appearance of leukemias, the most viremic strains being also the most leukemic. (3) Nevertheless, additional genes which were not involved in the viremia control could be determinant in the induction of malignancies. One of them with a resistant allele in DBA/2 mice seemed to inhibit the appearance of leukemia despite a high level of viremia. Another gene controlled the spleen involvement resulting in generalized leukemias in sensitive lines contrasting with mainly thymus-localized tumors in resistant animals.

Animals↗
PubMed1978

[Aleukemic chloroma. review of literature and diagnostic problems: 1 case].

The authors report the case of a 30-year-old man with granulocytic sarcoma of the chest wall presenting as a swelling with axillary lymphadenopathy followed by pleuropericardial effusions. The myeloblastic nature of the tumor cells was confirmed on the adenogram by the detection of granulations, rare Auer bodies and myeloperoxydase activity. It was confirmed by the presence of numerous granulations by electron microscopy and by that of a chloracetate esterase activity detected using Leder's protocol (9) on sections of material mounted in paraffin wax after formol fixation. Four marrow biopsies form different sites were normal. The course was fatal in six months, despite multiple chemotherapy, with massive invasion of the thorax by the tumor without the presence of myeloblasts in the circulating blood. The autopsy confirmed the preponderance of thoracic involvement (greenish in colour) and the presence of diffuse marrow myeloblastosis. In the light of this case, the rare instances (of the order of 10) of aleukaemic chloroma recorded in the literature are reviewed, emphasising the difficulties of diagnosis of these tumours and the ways in which they may be overcome.

Adult↗
PubMed1976

Flaujeac factor deficiency. Reconstitution with highly purified bovine high molecular weight-kininogen and delineation of a new permeability-enhancing peptide released by plasma kallikrein from bovine high molecular weight-kininogen.

Flaujeac trait is the functional deficiency of a plasma protein of the intrinsic coagulation, kinin-forming, and plasma fibrinolytic pathways. The Flaujeac factor in man has been isolated and tentatively identified as a kininogen of high molecular weight (HMW). Highly purified bovine HMW-kininogen, but not bovine low molecular weight kininogen, repaired Flaujeac factor deficiency. The two subspecies of this molecule, HMW-kininogen a and HMW-kininogen b, also corrected Flaujeac factor deficiency. When bovine HMW-kininogen was incubated with bovine plasma kallikrein, kinin-free HMW-kininogen, bradykinin, and a glycopeptide fragment (peptide 1-2; 12,584 daltons) were rapidly released. None of these fragmentation products corrected Flaujeac factor deficiency alone or in mixtures. The function of HMW-kininogen appeared to depend upon the structural integrity of the native molecule. When injected in concentrations of 2 pmol-8 nmol/0.1 ml, peptide 1-2 caused increased vascular permeability in rabbits, rats, or guinea pigs. The enhanced permeability was maximal within 1-2 min and terminated in 5-10 min, differing from that of bradykinin or histamine. Injected together in equimolar amounts, peptide 1-2 and bradykinin produced a synergistic permeability response which was immediate in onset as well as prolonged in duration. Peptide 1-2 is a rapidly acting, highly basic glyco-peptide which mediates increased vascular permeability in a complementary and synergistic manner with bradykinin.

Animals↗
PubMed1975

[Hereditary deficiency of a new coagulation factor acting at the "contact" level: the "Flaujeac" factor].

The observation of a coagulation defect which has been observed in an adult French woman is reported. This deficiency which induces no bleeding tendency is characterized by a considerable lengthening of the activated Partial Thromboplastin Time and an abnormality of the fibrinolysis activation. Circulating anticoagulant is absent. The levels of HF, PTA, AHF, PTC are normal and mutual correction with Fletcher factor deficient plasma is obtained. This result leads to the conclusion that patient's plasma is dificient in a hitherto undescribed coagulation factor. This factor seems to interfere, in vitro process, at the level of glass activation, and after the activation of Hageman factor.

Blood Coagulation Disorders↗
PubMed1975

Flaujeac trait. Deficiency of human plasma kininogen.

Flaujeac trait plasma resembled Hageman trait or Fletcher trait, in that the intrinsic coagulation pathway, plasma fibinolytic pathway, kinin-forming system, permeability factor of dilution (PF/dil) phenomenon were abnormal. The defect in each assay was reconstituted by afactor separable from Hageman factor or Fletcher factor. This substance was an alpha-globulin with an approximate mol wt of 170,000. Flaujeac plasma did not release a kinin upon incubation with kallikrein and was deficient in total kininogen antigen. Antiserum to kininogen inhibited the activity of the factor in solution. Flaufeac factor was identified as a kininogen of high molecular weight (HMW-kininogen). The mean total kininogen antigen in four children of the proposita was 51% (range 34-62%) of normal. A functional coagulation assay of HMW-kininogen in the children was 34% (range 23-55%). The results were consistent with autosomal recessive inheritance. The plasma pathways of intrinsic coagulation, fibrinolysis, kinin formation, and PF/dil generation are dependent upon HMW-kininogen. We believe this is the first demonstration of biological function for a kininogen apart from its role as a substrate for kallikreins.

Antigen-Antibody Reactions↗