In vivo nonspecific macrophage chemotaxis in cancer patients and its correlation with extent of disease, regional lymph node status, and disease-free survival.

We have used a test to evaluate macrophage migration in vivo, derived from the technique of Rebuck. The test is based on counting the absolute number of macrophages that migrate into an inflammatory site determined by a standardized superficial skin abrasion. It was applied to the study of macrophage migration in cancer patients in different clinical situations. Macrophage migration was virtually abolished in patients with metastatic cancer as compared to healthy controls. In patients with resectable breast and lung tumors, the test performed preoperatively correlated closely with lymph node status as determined by pathological examination after operation. Patients without lymph node involvement showed a significantly stronger response than did controls, whereas those with lymph node involvement had a diminished or even an abolished response. Distinctive subgroups were characterized among patients both with and without lymph node involvement on the basis of their macrophage response, and these subgroups proved to have distinctly different prognoses, particularly the patients without lymph node involvement with a poor macrophage response who had an unusually poor prognosis. It is concluded that this test shows potential for predicting the prognosis among categories of patients hitherto considered as homogeneous, although further evaluation in larger numbers of patients is necessary.

Churg-Strauss angiitis. Arguments favoring the responsibility of inhaled antigens.

A 27-year-old man presented with relapsing vascular limb purpura, pulmonary infiltrates and cranial nerve palsies occurring after exposure to pigeons. A lung biopsy specimen showed Churg-Strauss angiitis. Actinomycetes were observed in pneumocytes. The circumstances preceding clinical manifestations and pathologic findings favored the diagnosis of pulmonary vasculitis as a consequence of inhaled antigen. Recovery was obtained after treatment with prednisone, cyclophosphamide, and plasma exchanges.

Bone amyloidoma in a diabetic patient with morbid obesity.

Bone localisations of amyloidosis are rare, usually diffuse and associated with myeloma. We report the case of a patient with massive obesity complicated by diabetes, hypertension, sleep apnea and liver steatosis, who complained of rapidly worsening bilateral polyradiculalgia of the lower limbs. After sufficient weight loss made nuclear magnetic resonance imaging feasible, a spinal tumour was visualised on the 5th lumbar vertebra, extending to soft tissues. Total excision was performed, and pathological studies revealed an amyloid bone tumour with no evidence of myeloma.

Discitis after lumbar disc surgery. Features of "aseptic" and "septic" forms.

Two major types of postoperative discitis have been previously described: septic discitis and "avascular" or "chemical" discitis. Percutaneous discal biopsy is an important way of distinguishing these entities. In a retrospective study of 25 cases of postoperative discitis, three groups have been analyzed with bacteriologic and histologic tests: a group of nine patients (group A) with positive discal bacteriologic cultures; a group of eight patients (group B) with typical septic histologic tests but negative bacteriologic discal procedures; and a group of eight patients (group C) in whom the histologic picture was reminiscent of a mechanical process. No group was unique in any clinical and radiologic parameter. Group A and group B were quite similar in biological features, but group C had erythrocyte sedimentation rate and C-reactive protein serum levels significantly lower than groups A and B (P less than 0.01). After 4 weeks, these differences were still present. This study confirms that there are two main features of postoperative discitis that can be recognized by histologic and biological tests, allowing for different treatments.

The reliability of endometrial biopsy performed during hysteroscopy.

Eighty-nine women were examined using a flexible fiberscope and targeted biopsy was performed. Although the specimens were small (4 mm3 in maximum diameter), 80% reliability was obtained when specimens were compared with full curettage.

[Effects of LAK cells activated by IL-2 on MCF-7 human breast cancer cell line maintained in organotypic culture]. / Effets des cellules LAK en présence d'IL-2 sur la lignée carcinomateuse mammaire humaine MCF-7 maintenue en culture organotypique.

Lymphokine Activated Killer (LAK) cells, stimulated by interleukin 2 (IL-2) have a pronounced antitumor effect in the therapy of melanoma and renal cancers. LAK cells were cultivated in presence of the nodules of the human breast adenocarcinoma cell line MCF-7 maintained in organotypic culture to study the interactions between lymphocytes and breast tumor cells. After two days of co-culture, the proliferation of MCF-7 nodules and that of LAK cells was diminished about five folds. The cytotoxic effect of the latter, appreciated by Chrome 51 release was unchanged after the coculture. In histological sections, the penetration of the LAK cells into the MCF-7 nodules was accompanied by an increase of tumor necrosis but also by a glandular differentiation of cancerous tissue. Polarized epithelial cell formations bording neoplasic lumens with intracytoplasmic vacuoles filled with mucus, appeared in the nodules. The immunohistochemistry underlines the presence of T lymphocytes marked by UCHL1 and CD3 antibodies and of Natural Killer (NK) cells marked by IOT10, located between the MCF-7 cancer cells. In electron microscopy, the membrane contacts were tight and were accompanied by the appearance of secondary lysosomes and nuclear alterations. The relatively low infiltration level of the nodules may lead to the supposition that an indirect mechanism will intervene in this dual action of a LAK cells: increase of necrosis, although partially, and development of glandular and functional differentiation.

Experimental study of suspension-feeding activity in the serpulid polychaete Ditrupa arietina (O.F. Müller).

As time spent feeding can be an index of the feeding intensity, we attempted to describe the filtering activity in the suspension-feeding polychaete Ditrupa arietina. This description was based on the detection of the opening of the gill-crown by an automated image analysis system. The common pattern of activity could be described as the succession of filtering events and resting periods of which the number and the mean duration differed greatly from one worm to another. Filtering activity in D. arietina was neither a continuous process nor even a process having a particular rhythm. Within a same batch of worms, total filtration durations could represent between 12.5 and 87.5% of the total experimental time. Despite a strong inter-individual variability, our results showed the existence of pronounced seasonal variations in the activity of the gill-crown. In May, worms spent less than 25% of time feeding compared to more than 50% during the rest of year. These temporal changes appeared to result from the physiological state of the worms (reproductive period and ageing) at the time of the experiment.

[Subacute myocarditis as a manifestation of acquired immunodeficiency syndrome]. / Myocardite d'évolution subaiguë révélatrice d'un syndrome d'immuno-déficience acquise.

A case of acquired immunodeficiency syndrome associated with myocarditis is reported. The myocarditis was peculiar in that it heralded the syndrome and followed a subacute course. It was most probably of infectious origin, although no pathogen has positively been identified; it may have been caused by a cytomegalovirus or even by the human immunodeficiency virus itself on a background of genetic predisposition. This case shows that while cardiologists are concerned with cardiac disorders occurring during AIDS, they must also consider the possibility of AIDS when confronted with a myocarditis.

[Mesenteric panniculitis simulating Crohn disease]. / Panniculite mésentérique simulant une maladie de Crohn.

Mesenteric panniculitis is a rare disease involving the adipose tissue of the mesentery. We report a case of a 27-year-old woman with mesenteric panniculitis, who presented clinical and radiological features mimicking Crohn's disease. In the outcome, she presented a small bowel perforation, unusual in this pathology, and an annexial involvement. This case reminds us of the role of sepsis and repeated abdominal surgery in relation to the pathogenesis of mesenteric panniculitis. We report the first case of mesenteric panniculitis mimicking Crohn's disease.

Comparative distribution of two antidepressant drugs (imipramine and indalpine) in the rat as determined by analog computer simulation.

A ten-compartment analog computer model is presented to determine the precise distribution and excretion of two antidepressant drugs, LM 5008 AND Imipramine. Eight patterns were simulated using experimental data and drug distribution in the two undetermined compartments were obtained by the analog model. Close agreement with existing experimental data lends confidence in the model as a valuable tool for predictions in a variety of therapeutic situations.

[Primary antiphospholipid syndrome of fatal course and osteoarticular cytosteatonecrosis]. / Syndrome primaire des antiphospholipides d'évolution fatale et cytostéatonécrose ostéoarticulaire.

The antiphospholipid syndrome produces acute occlusions of arteries and veins. This syndrome can cause a multiple organ systems failure whose outcome is often fatal. The authors report a case of the primary, antiphospholipid syndrome characterized by this fatal outcome, a so-called "devastating" syndrome following pulse steroids. In this patient, the antiphospholipid antibodies had been found after presenting bone-marrow fat necrosis, which led to extensive lesions of knees, hips and shoulders. Damage to the cell membranes in necrotic lesions might have promoted the immune response against phospholipids. The potential risks of pulse doses of steroids in the antiphospholipid syndrome are documented by the present observation, which also suggests that antiphospholipid antibodies should be determined in cases of fat necrosis of all origins.

[Multicentric reticulohistiocytosis. A new case]. / Réticulo-histiocytose multicentrique. Un nouveau cas.

Multicentric reticulohistiocytosis is a rare disorder of the skin and joints that possesses distinctive histologic findings. A case is reported with typical features, and ulceration, an unusual outcome of "skin" lesions.

[Hamartomas of the breast. Apropos of 14 histologically controlled cases]. / Hamartomes du sein. A propos de 14 observations histologiquement contrôlées.

14 cases of mammary hamartomas are reported. The WHO describes the mammary hamartoma, as a pseudo-tumor made of ducts and lobules, with fibrosis or adipose connective tissue. The mammogram consists in a well circumscribed tumor generally surrounded by a defined zone of less attenuation. Surgically, the hamartoma can usually be enucleated. Microscopy reveals lobules always but inconstant adipose tissue. Confrontation between gross and histologic features are necessary for the diagnosis. The embryologic development of the mammary gland could help to explain the origin of such a lesion, malformative rather than tumorous.

[Multinucleated cell angiohistiocytoma. Report of 6 cases]. / Angiohistiocytome à cellules multinucléées. A propos de six cas.

Multinucleate cell angiohistiocytoma is a recently described entity. It is a benign vascular proliferation. Clinically, it is characterized by violaceous red papules, often mimicking Kaposi's sarcoma. Acral sites and face were the commonest sites. The six patient's age was between 41 and 64 years and sex ratio was equal. Microscopic features were an increased number of blood vessels together with mononucleated and multinucleated histiocyte-like cells with scalloped borders. Staining of mononucleated cells with CD68, anti vimentin and anti factor XIIIa antibodies emphasized a fibrohistiocytic origin. Loss of factor XIIIa expression in multinucleate cells gets clue to think that these cells are dedifferenciated.

[Sarcoidosis and non-Hodgkin's lymphoma. A non-fortuitous association]. / Sarcoïdose et lymphome non hodgkinien. Une association non fortuite.

The simultaneous disclosure of a lymphoblastic B cell lymphoma and sarcoidosis is reported herein. The initially undiagnosed sarcoidosis leads to discuss the differential diagnosis of a sarcoid-like reaction associated to the lymphoma. The association of sarcoidosis and malignant lymphoproliferative disease is not fortuitous; nevertheless the simultaneity of the two diagnoses, the lymphoblastic type of the lymphoma and the colocalization of granulomatous and lymphomatous lesions in lung and liver are unusual features.

[Aseptic abscesses in eight patients with cryptogenic inflammatory bowel disease]. / Abcès aseptiques chez huit patients atteints d'une maladie inflammatoire cryptogénétique intestinale.

The aim of this study was to describe aseptic abscess related pathologic changes observed in eight patients with inflammatory bowel disease. Patients were 3 men and 5 women whose age ranged from 15 to 60. Seven had Crohn's disease and one had ulcerative colitis. Diagnosis preceded abscess onset in two cases. Bacteriological investigations were performed in all cases and were negative. In all biopsy specimens, Hematoxylin and Eosin, PAS, Grocott, Whartin-Starry, Gram and Ziehl-Nielsen stains were negative. Histological changes were comparable and could be divided into early and older lesions. After discussion of the differential diagnoses, the hypothesis of a new clinico-pathological entity is suggested.

[Bacillary peliosis in AIDS. Anatomo-clinical study of 2 cases]. / Péliose bacillaire au cours du SIDA. Etude anatomo-clinique de 2 observations.

The authors report two cases of peliosis hepatis, occurring in patients with AIDS, who presented a persistent fever and an hepatomegaly. The liver biopsies showed areas of peliosis, where bacilli were observed by Warthin-Starry stain. In one case, techniques of molecular biology allowed the identification of Rochalimaea henselae, pathogen involved in bacillary angiomatosis. This rickettsia has been newly recognized in the United-States, where 17 cases of bacillary peliosis have been published in immunocompromised hosts and mainly in patients with AIDS. These observations illustrate the clinical and histological features of this new opportunistic infection, as it is described in the literature. The clinical signs include an unexplained fever, an hepatomegaly, and in 75% of the cases, a splenomegaly. The cutaneous lesions of bacillary angiomatosis are associated in 40% of the cases. An antibiotic treatment by erythromycin ensures a complete recovery.

[Tumors of the ceruminous glands]. / Les tumeurs des glandes cérumineuses.

Tumors of ceruminous glands, called "ceruminoma" are rare. They arise from the ceruminous glands of the external auditory canal. They realise a group of glandular tumors diversified in histologic pattern and prognosis. Three patients with ceruminous gland tumors are reported: one case of ceruminous adenoma, one case of adenocarcinoma and adenoid cystic carcinoma in the third one.

[Nevus of Ota associated with chronic glaucoma]. / Naevus de Ota associé à un glaucome chronique.

Oculodermal melanocytosis (nevus of Ota) is an abnormally large accumulation of pigment in ocular tissues as well as the skin in the distribution of the trigeminal nerve. Elevated intraocular pressure is a serious complication of this disease, as well as transformation to malignant melanoma. We report a case of nevus of Ota, documented clinically and histopathologically, associated with severe chronic glaucoma.

[From failure to success? A case of reduction of the number of embryos in a septuplet pregnancy]. / De l'échec au succès? Un cas de réduction embryonnaire d'une grossesse septuple.

The authors report a case of septuplet pregnancy that occurred after stimulation of ovulation using h.M.G.-h.C.G. This multiple pregnancy occurred because of failure of the triple surveillance using clinical, biological and ultrasound techniques. The number of embryos was reduced by needling through the abdominal wall. Two procedures were necessary. The technique that was used is described in detail and illustrated. The twin pregnancy that was left carried on successfully. This describes a technique that should be used rarely and should not in any way modify the strict rules for monitoring ovulation.