[Low cost telepathology]. / Télépathologie à moindre coût.

Low cost, high-quality consumer-type digital cameras are now available on the market to be used for taking macrophotographs and microphotographs by simply fixing the camera over the eyepiece of a conventional light microscope using an adaptator. The quality of the images obtained is as good as obtained with more expensive materials using Tri CCD cameras. Using the JPEG format for compression, the image file size is approximately 180 Ko. We present a low cost approach we have tested for one year in our pathology department.

Giant-cell tumour involving the cranial vault: imaging and treatment.

A giant-cell tumour involving the cranial vault was diagnosed in a 37-year-old man who presented with a large swelling at the vertex. The role of imaging in the diagnosis and treatment of this tumour is described. On CT and MRI the appearances were nonspecific and the diagnosis was established by histological examination after removal of the tumour. A preoperative angiogram showed a tumour blush and before surgery, embolisation was performed via the percutaneous and transarterial routes.

[Disseminated peritoneal leiomyomatosis. Apropos of a case]. / La léiomyomatose péritonéale disséminée. A propos d'un cas.

The authors report a case of disseminated peritoneal leiomyomatosis (DPL) occurring in a post-menopausal woman not using hormone replacement therapy. Her past history included a subtotal hysterectomy, with preservation of the adnexae, for metromenorrhagia due to a leiomyomatous uterus. This case confirms data in the literature concerning presentation, symptomatology, macroscopic appearance and histology. No electron microscopy study was undertaken, nor were hormonal receptors evaluated. The originality of this case lies in the onset of DPL in a post-menopausal (with laboratory confirmation) woman with very slow progression over several decades confirming the hormone-dependent nature and the good prognosis of this rare condition.

[Inflammatory polyp: a rare benign endobronchial tumor]. / Le polype inflammatoire: une tumeur endobronchique bénigne rare.

We report a case of inflammatory polyp in a male patient, which was totally obstructing the left main bronchus but could be removed by simple endoscopic traction. The polyp was responsible for an absence of left lung ventilation which in turn produced by reflex an absence of left lung perfusion completely reversible after removal of the polyp. Inflammatory polyp is a rare benign tumour. Its physiopathology is controverted, but it seems to result from local irritation of the bronchial mucosa. Bronchial endoscopy is the essential examination which in most cases make it possible to diagnose and treat the tumour.

[Ovarian tumors and cysts after 50 years of age. Retrospective study from 1979 to 1989 at the Foch hospital]. / Tumeurs et kystes ovariens après 50 ans. Etude rétrospective des années 1979 à 1989 au C.M.C. Foch.

This is a retrospective study carried out between the years 1979 and 1989 to look at the anatomopathology of tumours and ovarian cysts occurring in women over 50 years of age who had operations in our department. We found a raised incidence of malignant tumours (30%) when a late diagnosis is made (70% diagnosed at stages 3 and 4). There was a higher incidence of fibrothecomas (10%) along with the nine tumours. This is an important finding because functional cysts have only been found in non-menopausal women or in women who have recently had their menopause who have been taking hormone replacement therapy. Ovarian cysts in menopausal women are therefore primarily organic. This result makes it possible to outline a therapeutic regime specifically designed for the menopausal women. In effect the proposed treatment would either be laparoscopic surgery or laparotomy because it is very doubtful whether ultrasound puncture should be carried out because one cannot be sure that it is not a malignant cyst. The authors take the occasion of this study to view the complimentary tests that can be carried out for ovarian cysts. These are mainly ultrasounds and estimations of CA125. The therapeutic methods that are available are then transparietal cystectomy or intraperitoneal cystectomy or intraperitoneal cystectomy which means laparotomy with removal of the cyst.

[Ovarian cysts in women over 50 years of age. A retrospective study from 1979 to 1989 at Foch Medicosurgical Center]. / Les kystes de l'ovaire après 50 ans. Etude rétrospective des années 1979 à 1989 au C.M.C. Foch.

This was a retrospective study for the years 1979 to 1989 involving histological examination of ovarian cysts in women over 50 years who underwent surgery in our Department. A higher incidence of malignant tumours was found (32%), associated with a late diagnosis (70%) diagnosed stage III or IV). There was a higher incidence of fibrothecomas (10%) among benign tumours and functional cysts were only found in non menopausal or recently menopausal women taking hormone replacement therapy. There results allow a more specific therapeutic attitude in menopausal women i.e. laparoscopic surgery or laparotomy. Ultrasound puncture is very debatable, since this is inappropriate for an organic cyst. The authors review the complementary investigations performed for ovarian cyst, these include essentially ultrasound and Ca 125. Possible therapies include transparietal cystectomy, intraperitoneal cystectomy or laparotomy and excision.

[In search of the lymphatic system of the central nervous system]. / A la recherche du système lymphatique du névraxe.

Lymphatic flow in the brains and lymphatic vessels in the meninges are recognized through the intra-cerebral injection of a dye specific to the lymphatic system. The confluence of these two components can only be at the level of the cerebro spinal fluid (CSF), which lends support to the hypothesis that the CSF itself constitutes the lymph of the nervous system. The authors report the results of a study based on a necropsic investigation and an experimental animal model, contributing new facts in favor of this hypothesis. For a certain number of inflammatory diseases of the central nervous system (CNS) when the initial phase is still limited to the brain or to the spinal chord tissues, it is usually asymptomatic; only when it reaches the meninges, that clinical symptoms be seen: this can be explained by the presence of such lymphatic circulatory system. Stasis of the cerebral lymphatic circulation, should be regarded as a new etiologic factor in the onset of brain oedemas. This concept, already taken into account by some investigators, deserves consideration in the study of most CNS diseases.