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P Michenet

Publications and source records attributed to P Michenet.

At least 19 recordsLinked to original sources
PubMed2006

[Value of vacuum assisted biopsies under sonography guidance: results from a multicentric study of 650 lesions].

OBJECTIVE: With this retrospective, multi-centric study, the authors are showing the technique of Vacuum assisted biopsies under ultrasound guidance and comparing it with the other widely used diagnostic techniques. Material and method. Six hundred and fifty biopsies were performed between May 2000 and December 2004, on 644 patients, in 3 centres, following a unique protocol. Lesions were categorized, using the classification from Stavros, between "probably benign", "indeterminate", "probably malignant" and "malignant" Histology was validated only after review of the clinical and radiological data, as well as surgical data when available. All benign cases were included in an on-going follow-up protocol. RESULTS: We have identified 471 benign lesions and 179 malignant lesions. The mean size of the lesions was 9 mm. Three cancers were diagnosed in the cases of "probably benign lesions" and in the cases of "probably malignant lesions" 18 (27%) were inflammatory disorders. In 5 cases vacuum biopsy underestimated the pathology with regard to surgery: 2 cases of atypical duct hyperplasia (HCA) were in situ ductal carcinoma (DCIS) at surgery and 3 cases of DCIS were infiltrative ductal carcinoma (DCI) at surgery. With this technique we have avoided surgery for 71% of all women who presented an "indeterminate" or "probably malignant" condition. Specificity is excellent with no cancer detected so far among the patients with benign findings, under follow-up. CONCLUSION: Ultrasound guided Vacuum assisted biopsy is a fairly recent minimally invasive technique, with short learning curve. The ability to collect a larger volume of tissue overcomes the targeting issues on small lesions and avoids underestimation of heterogeneous and larger abnormalities and some specific at-risk lesions such as papilloma. This technique thus appears indicated in such cases because it overcomes some of the limitations of core needle biopsy and should be considered as an alternative to surgical biopsy.

Adult↗
PubMed2005

Pathological prognostic factors of invasive breast carcinoma in ultrasound-guided large core biopsies-correlation with subsequent surgical excisions.

Core biopsy is currently used as the initial diagnostic procedure in breast cancer. Prognostic information is required before decisions on subsequent therapy are possible. The aim of this study was to compare prognostic data observed in ultrasound-guided core biopsies and in surgical specimens. We conducted a retrospective study of a mean of 1.2 biopsies from a total of 110 consecutive malignant breast masses. Histological tumour type and grade, presence of a ductal carcinoma in situ (DCIS) component and hormonal status were evaluated. Our results showed excellent sensitivity (100%) of core biopsy for the diagnosis of breast cancer and for the assessment of tumour type (concordance of 73.6%). We also reached a reasonable level of agreement between core biopsy and surgical excision specimens for histological grading (73.1%). Underestimation of grading on core biopsy was due predominantly to underscoring of mitotic counts (32.3%). The presence of DCIS associated with infiltrative carcinomas was widely underestimated in biopsy specimens. There were good levels of agreement for oestrogen receptors and for progesterone receptors: 90.3% and 89.3%, respectively. Diagnoses were made on the basis of a small number of ultrasound-guided core biopsy specimens taken from breast masses. Grade and hormonal status were reliably evaluated.

Automation↗
PubMed2005

[Can US-guided vacuum-assisted biopsies be an alternative to diagnostic surgery in cases of non-diagnostic core needle biopsy?].

PURPOSE: To assess US-guided vacuum-assisted biopsies in the diagnosis of suspicious sonographic breast lesions after non-diagnostic core needle biopsies (CNB). PATIENTS AND METHODS: Retrospective study of 42 females with suspicious breast lesions at US. CNB previously performed were non-diagnostic. Because of the larger sample size, vacuum-assisted biopsies were performed, instead of surgical biopsy. RESULTS: Vacuum-assisted biopsies showed 32 benign lesions. Histologic examination of the CNB showed non-specific fibrous tissue in 43% of cases as opposed to 7.1% for vacuum-assisted biopsies. The latter provided a more specific diagnosis (mainly fibrocystic breast disease). From a total of 4 lesions that were suspicious at CNB, 3 were diagnosed as malignancies after vacuum-assisted biopsy and one case was a "borderline" lesion. Three additional malignant and three additional borderline lesions were diagnosed on vacuum-assisted biopsies. In 11 cases, surgical excision was performed, and all diagnoses from vacuum-assisted biopsies were confirmed at microscopy, except in one case where it was underestimated (ADH versus DCIS). CONCLUSION: US-guided vacuum-assisted biopsy is a reliable technique. Because it provides more tissue than CNB, it can be an alternative to diagnostic surgery after non-diagnostic CNB. Indeed, it allows confirmation of the diagnosis and provides a more specific diagnosis of benign lesions. With regards to malignant and borderline lesions, it avoids the risk of false-negative CNB and overlooking carcinomas.

Adult↗
PubMed2003

[Value of ultrasound detection of post-Mammotome scar for preoperative localization of breast microcalcifications].

PURPOSE: We attempted to find ultrasound scar subsequent to vacuum assisted breast biopsy (Mammotome system) previously performed, and to enhance its value for preoperative localization. MATERIALS AND METHODS: Our study included 34 females requiring needle localization prior to surgery. They previously had Mammotome core biopsies for clustered microcalcifications. US examination was systematically performed before insertion of the metallic marker, in order to detect a scar. Identification of the scar allowed ultrasonographic guided localization. The accuracy was correlated with histologic findings. RESULTS: Ultrasonography detected a scar in 21 of the 34 patients (63%). Among all these cases, a perfect correlation could be established between ultrasound target and histologic scar revealed by microscopic examination. CONCLUSION: Ultrasound detection of scar allows ultrasonographic guidance and can therefore be the only alternative in cases of absence or displacement of the marker clip.

Adult↗
PubMed2001

[Post-vaccination granuloma due to aluminium hydroxide].

Post-vaccination granulomas a well-known reaction due to aluminium adsorbed vaccines. We report three cases of children who developed subcutaneous nodules at the site of a previous injection of Tetracoq*vaccine (tetanus, diphtheria, Bordetella pertussis, poliovirus). Histologically, the lesions were characterized by a necrotizing granulomatous reaction with eosinophilic crystalline material. This material stained positively with the solochrome cyanine stain and was pink-purple. This aluminium stain enabled diagnosis of post-immunization injection-site reaction due to aluminium.

Aluminum Hydroxide↗
PubMed2000

[Duodenal somatostatinomas associated with von Recklinghausen's neurofibromatosis. Apropos of 2 cases].

Somatostatinomas are rare neuroendocrine tumors; they are essentially located in the pancreas and in the duodenum. The association with a neurofibromatosis type I is especially observed when the tumor is located in the ampulla of Vater. These tumors are not associated with a "somatostatin syndrome", but often present with gastrointestinal bleeding, abdominal pain and obstructive jaundice. The diagnosis is confirmed by immunohistochemical studies. The aim of this study is to report 2 cases of metastazing duodenal periampullary somatostatinomas associated with von Recklinghausen's disease and to discuss the prognosis of these tumors. Future genetic research are necessary as point out the familial feature of this association in one of our cases.

Duodenal Neoplasms↗
PubMed1999

Alternaria infection of the skin and joints. A report of two cases involving the hand.

Alternaria is a fungus that is usually saprophytic but occasionally causes skin infections. Involvement of other structures is exceedingly rare. We report two cases in which a joint was also affected. The possible precipitating role of intraarticular glucocorticoid therapy is discussed. Both patients achieved a full recovery after itraconazole therapy, given for 12 and seven months, respectively.

Adult↗
PubMed1998

Sacrococcygeal chordomas: potential role of high LET therapy.

Chordomas are rare malignant neoplasms representing less than 3% of all primary bone tumors. They usually have a benign histological appearance and a slow growth rate. Their locoregional progression nearly always causes suffering and eventually death. Efforts to increase local control have included aggressive surgery, radiation therapy or combined approaches but locally free survival rates remain relatively low and have not exceeded 30% at 5 years. Sacrococcygeal chordomas, which represent approximately 50% of the localizations, have been investigated less frequently than those at the base of the skull or cervical region with primary or post-operative radiation therapy. The disappointing results with photon therapy in a multimodality approach and the good results reported by Schoenthaler with charged particles in the Lawrence Berkeley laboratory led us to propose fast neutron therapy in the management of inoperable or recurrent sacrococcygeal chordomas. Preliminary results obtained from only 12 patients indicate that high linear energy transfer (LET) therapy seems to be a good alternative for radical treatment of chordomas in the case of microscopic or macroscopic residual tumor.

Chordoma↗
PubMed1998

[Microscopic thyroid papillary cancers presenting as cervical lymph node metastases].

Microscopic papillary thyroid cancer (< 1 cm in diameter) is reputed to have an excellent prognosis. In 10 to 20% of cases, it presents in the form of lymph ode metastases. Immediately metastatic forms can be associated with unfavourable prognostic factors, such as multifocal tumours, extension to adjacent tissues, capsular effraction and development of distant metastases. We report 4 cases of microscopic papillary thyroid cancer presenting in the form of lymph node metastases. No primary thyroid lesion was palpable in any of these patients, but the subsequent course was complicated by ling metastases in one case. All patients underwent total thyroidectomy with lymph node dissection followed by adjuvant therapy with radioactive iodine and thyroxin inhibitory treatment. Lung metastases were observed in one case. The authors propose a therapeutic approach based on analysis of severity factors, which determine the recurrence rate.

Adult↗
PubMed1995

[Primary retroperitoneal mucinous cystadenoma: a case treated by celioscopic surgery].

We used laparoscopy to treat a case of primary retroperitoneal mucinous cystadenoma. This tumours is rarely encountered and has been reported in 22 cases in the literature. The histogenesis is uncertain. Diagnosis is never made preoperatively since primary retroperitoneal mucinous cystadenomas are usually mistaken for cystic lymphangiomas of the retroperitoneum. Surgery is the only treatment. Laparoscopic surgery can be used only if the cystadenocarcinomatous nature of the tumour is ruled out.

Cystadenoma, Mucinous↗