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Biomedical subjects

R Loubiere

Publications and source records attributed to R Loubiere.

At least 19 recordsLinked to original sources

Intestinal and extraintestinal Isospora belli infection in an AIDS patient. A second case report.

A 30-year-old black female, from Burkina Faso, had AIDS in 1990. She died in March 1993 following a cachexia secondary to a chronic intestinal isosporiasis. The autopsy revealed a massive parasitic infection by I. belli of the small intestine mesenteric and mediastinal lymph nodes and liver and spleen. The parasite stage observed in extra intestinal sites corresponded to unizoite tissue cysts. This is the first report of I. belli infection in liver and spleen.

AIDS-Related Opportunistic Infections↗

Cutaneous spindle-cell pseudotumors due to Mycobacterium gordonae and Leishmania infantum. An immunophenotypic study.

We report two patients with AIDS who had cutaneous spindle-cell pseudotumors caused by Leishmania infantum in one instance and by an atypical mycobacterium in the other. The lesions mimicked neoplasms with predominantly spindled macrophages, similar to those seen in the histoid variant of leprosy. This histoid reaction is known to be related to mycobacteria. To our knowledge, this is the first case of histoid reaction due to leishmania. In both cases, the histiocytic cells were positive for vimentin and desmin but negative for alpha-smooth muscle. In addition, the immunostaining by lysosyme and alpha 1 antitrypsin was positive in both and in one the S-100 protein was positive. This reaction suggests dual myofibroblast and histiocytic differentiation.

Adult↗

[Toxoplasmosis in AIDS patients. Pathoclinical study of 78 cases].

We report 78 cases of toxoplasmosis diagnosed between 1987 and 1992, from an autopsy study of 205 patients infected by the human immunodeficiency virus (HIV). Of the 78 patients 22 were females (28%) and 56 males (72%). Risk factors were as follows: intravenous drug addiction (44 cases, 56%), homosexuality or bisexuality (18 cases; 36%) and multiple blood transfusions (6 cases). Cerebral toxoplasmosis (CT) was diagnosed in 73 cases (93%) and was characterized by abscesses (59 cases), diffuse encephalitic lesions (8 cases), isolated cysts without inflammation (3 cases) and hemispheric involvement with ventricular hemorrhage (3 cases). Cerebral involvement were isolated (55/78 cases; 70%) or associated with multi-visceral diffusion (18/78 cases; 23%). Isolated extracerebral localization was observed in 5 cases. The most frequent extracerebral sites were: cardiac (21 cases), pulmonary (14 cases) and pancreatic (7 cases). Immunohistochemical study with anti Toxoplasma gondii antibodies allowed to a diagnosis of extracerebral localization in 8 cases. Ultrastructural features of Toxoplasma gondii were studied on post mortem myocardial samples (2 cases) open lung biopsy (1 case) and bladder biopsy specimen (1 case). Antemortem diagnosis of cerebral toxoplasmosis was performed on CT-scan in 59/73 (80%). Antemortem diagnosis of extracerebral toxoplasmosis was performed or suspected in 8/23 cases (34%): by isolation of trophozoites in bronchoalveolar lavage (2 cases), on an open lung biopsy (1 case) and on a bladder biopsy specimen (1 case), and by clinical and echocardiographic data (4 cases). Anti-toxoplasmic serology allowed to the diagnosis of toxoplasmosis in 12/78 cases (15%) by showing high levels of IgG in the serum.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗

[Cytological study of the duodenal mucosa during chronic diarrhea in HIV-positive patients].

The cytologic findings of duodenal smears in diarrheic HIV-positive patients were compared with results of histologic and ultrastructural studies. This study included 50 diarrheic patients undergoing upper gastrointestinal endoscopy. Duodenal biopsies were taken with touch preparations. Smears were stained with Giemsa and then with Ziehl-Neelsen or the PAS method. The biopsy specimens were then processed in a standard fashion for histologic and electron microscopy examination. Cytologic findings included 8 cases of intestinal microsporidiosis, 4 cases of cryptosporidiosis, and 3 cases of atypical mycobacteriosis. Histologic and ultrastructural studies confirmed these diagnoses and showed 8 cases of CMV enteritis, of which 4 were associated with other enteric pathogens. Duodenal cytology complements endoscopic biopsy in the work-up of diarrhea in AIDS patients and may provide a rapid diagnosis especially in the case of intestinal protozoonosis or atypical intestinal mycobacteriosis.

AIDS-Related Opportunistic Infections↗

Malignant pancreatic oncocytoma. An unusual cause of organic hypoglycemia.

A case of malignant islet-cell tumor with oncocytic features occurring in a 54-year-old woman with symptoms of organic hypoglycemia is reported. The tumor was composed of ribbons of cells arranged in an endocrine pattern. The cytoplasm of these cells was eosinophilic and finely granular. Ultrastructurally, the cells contained numerous mitochondria and dense-core neurosecretory granules. Tumor cells were focally immunoreactive for neuron-specific enolase, insulin, glucagon and VIP. Capillaries invasion and metastases to lymph nodes argued in favor of malignancy but there was no subsequent malignant involvement during a 3-year follow-up after surgery. Such insulinomas with oncocytic features have not been previously described. Endocrine features in oncocytomas of the pancreas and of other locations are discussed.

Adenoma↗

[Histopathologic features of opportunistic infections of the small intestine in acquired immunodeficiency syndrome].

The frequency of the opportunistic infections of the duodenum in AIDS patients was determined by way of histologic study in 207 patients between January 1987 and June 1991. All cases had serial paraffin sections, run through HES, PAS, Giemsa, Brown-Brenn, and Zieh-Neelsen stains, and 20 cases had in addition cytologic and electron microscopic study. 63 patients had opportunistic infections (10 cryptosporidiosis and 2 isosporiasis; 12 mycobacterial enteritis; 15 CMV enteritis; 7 candidosis; 7 intestinal microsporidiosis confirmed by electron microscopic examination; 12 Giardiasis; 3 duodenal leishmaniasis; 1 intestinal cryptococcosis). Multiple concurrent infections were noted in 6 cases. A mild to severe villous atrophy was observed in 28 cases, associated with opportunistic infection. A patchy distribution of pathogen agent was noted in 34 cases, and 37 cases were associated with oesophagal candidosis. This study points out the value of histologic examination of intestinal biopsy for the diagnosis of systemic infections as well as of unusual parasitosis, and the necessity for multiple endoscopic biopsies because of the frequent patchy distribution of pathogens.

AIDS-Related Opportunistic Infections↗

[Gingival hyperplasia secondary to the use of calcium antagonists: analysis].

Calcium antagonists are drugs restricting transmembrane calcium delivery. They possess a wide range of action against vasoconstriction and spastic reactions and were therefore initially recommended for the treatment of angina pectoris. With the increasing number and classes of calcium antagonists new therapeutic indications have emerged. Cases of gingival hyperplasia associated with their use are repeatedly reported, therefore the question deserves to be restated. The aim of the present study was to discuss the clinical, pathologic and pathogenetic features bases on an investigation carried out in a Department of Cardiology, on a case observation and on review of published cases in the international literature.

Adult↗

Embryology of the hair follicle.

A study of hair follicle development has enabled us to differentiate four stages by relating them to corresponding gestation ages. Stage I of the hair bud is characterized by an epiblastic proliferation penetrating the subjacent mesenchyma at the extremity of which mesenchymal cells accumulate. This appears, at the level of the lower lip, before the 11th week of intrauterine life. Stage II of the hair bulb is reached on the 12th-13th week of intrauterine life, as soon as the distal extremity of the hair bud, which has extended, becomes depressed at the mesenchymal papilla level. Stage III is defined by the observation of hair cone and rough sebaceous glands on the 15th week of intrauterine life. Finally, stage IV shows a differentiated sebaceous gland with a hair which comes through the skin surface on the 18th week of intrauterine life.

Fetus↗

Embryology and secretory activity of labial salivary glands.

This study was carried out on the heads of 20 foetuses aged between 11 and 26 weeks. Four stages were distinguished in the development of labial salivary glands, each stage corresponding to gestational age. Stage I is characterized by a localized, rounded thickening of the stomodial epiblast into the mesenchyma of the mucosal side of the lower lip. This occurs at the 9th-10th week of gestation. Stage II is reached when the epiblastic thickening assumes the form of a single cord. It is oval when sectioned transversally and is the result of the proliferation of epiblastic cells into the underlying mesenchyma during the 11th-12th week. Stage III corresponds to a branching process which takes place at the 13th week. The single cord branches to form the future secretory lobes, which rapidly assume a grape-like appearance. The number of rudimentary glands increases during the first three stages of development, i.e. as long as the first formed glands have not developed ducts. Stage IV corresponds to the process of duct formation at the 18th week. Simultaneous differentiation of acinal and duct cells is observed and this procedes the onset of secretory activity.

Basement Membrane↗

[Cardiac lesions in acquired immunodeficiency syndrome (AIDS). Apropos of an autopsy series of 25 cases].

The pathologic study of the cardiac lesions in 25 persons who died of AIDS were studied from autopsies. Most of these patients were intravenous drug abusers (14 cases). Heart failure was symptomatic and lead to death in 4 cases. This study showed histological abnormalities in 76% of the cases. We observed 12 myocarditis. In 6 cases, pathogenes were found: Toxoplasma gondii (2), Cryptococcus neoformans (2), Candida (1), Aspergillus (1). A lymphocytic myocarditis was observed in 6 hearts. By immunohistochemical technique, we could distinguish 2 toxoplasmic myocarditis, and in 4 cases, solitary cysts in the myocardium without inflammation. The remaining lesions comprised respectively: 3 lymphocytic pericarditis, 2 marastic endocarditis and 1 dilated myocardiopathy.

Acquired Immunodeficiency Syndrome↗

[Isolated involvement of the central nervous system in cysticercosis. Anatomo-clinical study of a case].

We observed one case of neurocysticercosis due to Taenia Solium. The patient had stayed at the Green Cap Islands and in Portugal until 1987, when he arrived in France and died one month later. The diagnosis had been suspected from the results of computerized tomography and serological examination. Finally, we confirmed that diagnosis by the post mortem parasitology study of the specimen of brain.

Adult↗

Gingival granular cell tumor of the newborn: immunoperoxidase investigation with anti-S-100 antiserum.

The gingival granular cell tumor (GGCT) of the newborn is a rare, benign tumor, most often observed in the canine area of the maxilla of female infants. The main histologic features are not controversial and involve the occurrence of sheets of granular cells and a prominent vascular component. Conversely, ultrastructural studies agree on limited features and give rise to different hypotheses of mesenchymal origin. S-100 immunoperoxidase investigation of one case shows that, unlike those of granular cell tumor (granular cell myoblastoma) granular cells of GGCT do not react positively for S-100 protein, thus suggesting that the GGCT and the granular cell myoblastoma have a different histogenesis. It confirms also the occurrence of smaller, isolated, spindled, nongranular S-100-positive cells of indeterminate nature, distributed at the periphery of some blood vessels.

Female↗

Stereologic analysis of histologic parameters of a twice-recurrent ameloblastic fibroma.

The behavior of the odontogenic tumors with time remains a subject of controversy. A case of ameloblastic fibroma with two recurrences is presented. It represents further evidence of the ability of the ameloblastic fibroma to recur, although recurrences may have resulted from incomplete initial removal. The volumetric density of the odontogenic epithelium (Vvoe) was evaluated stereologically for the initial tumor and for each recurrence. Analysis of the results shows that a maturation process, which was statistically significant, occurred between the initial tumor and the first recurrence but not between the first and second recurrences.

Child↗

[Congenital tracheal stenosis associated with aberrant left pulmonary artery. Apropos of a severe form with neonatal disclosure].

The case report is presented of a newborn infant afflicted with extensive congenital tracheal stenosis associated with anomalous left pulmonary artery, proving rapidly fatal. The possibility of tracheal anomaly must be envisaged in the face of any neonatal respiratory distress unexplained by pulmonary parenchymatous pathology. Diagnosis of this complex malformation relies on endoscopy and oesophagogram and tracheo-bronchogram contrasts.

Abnormalities, Multiple↗

[Histopathology of bilharziasis].

Our conception of Bilharziosis, one of the oldest known illness, has been considerably modified during the last twenty years with the development of Immunology. In fact, it is now established that the severity of the illness depends upon the importance of granuloma which arises round the emprisoned egg in the tissues and the sclerosis mutilation which follows. It is possible to describe, successively around the egg, exsudative granuloma, productive granuloma, and sclerocicatricial nodule whose size will depend upon the tissular immunity. In particular this granuloma will be practically non-existent when the endogenic desensitization of the subject is maximal. In this case the egg will remain undestroyed and there will be egg's calcification in the tissue. Contrarily, in the case of minor tissular immunity there will be serious collagenous mutilations as in Symmers hepatic fibrosis. It is therefore preferable that a histopathological study be part of the routine investigations of this disease: it confirms itself as one of the best prognostic criteria.

Granuloma↗