[Left atrial free floating thrombus without mitral valve disease. Review of the literature apropos of a case]. / Thrombus libre intra-auriculaire gauche en l'absence de pathologie valvulaire mitrale. Revue de la littérature à propos d'un cas.

Free ball thrombi of the left atrium are usually observed with mitral valve disease. The authors report the unusual case of this condition without mitral valve disease. A number of classical echocardiographic criteria suggested the precise nature of this left atrial mass before surgical excision. The diagnosis of a free ball thrombus of the left atrium should lead to urgent surgery because of the high risk of haemodynamic and embolic complications.

[Aneurysmal iliac lymphangiomyoma. Report of a case]. / Lymphangiomyome iliaque à forme anévrysmale. A propos d'un cas.

Single lymphangiomyoma, rarely encountered, is a form of lymphangiomyomatosis with characteristic proliferation of smooth muscle cells in lymph nodes and vessels. We observed a case in a 47-year-old woman with no past medical history. An echography performed for menorrhage revealed a single iliac localization in the right pelvis. The precise pre-operative diagnosis was difficult, but the pathology report formally identified the tumor as an isolated form without thoracic involvement. Unlike lymphangiomatosis itself which involves pulmonary lesions and which may require complementary treatment, total exeresis of a single tumour is the only treatment necessary, as was confirmed in this case.

[Extra-pulmonary lymphangiomyomatosis presenting as an exudative enteropathy with a rapid fatal course]. / Lymphangiomyomatose extra pulmonaire révélée par une entéropathie exsudative d'évolution rapidement fatale.

We report a case of lymphangiomyomatosis (LAM) which occurred in a twenty six year old woman, presenting with protein losing enteropathy and pancreatic fibrosis due to lymphostasis. Despite having no pulmonary lesion, the patient died quickly. The proliferation of smooth muscle involved the mesenteric, peripancreatic lymphatic channels but also the submucosal lymphatic vessels of the duodenum. Only one other case of LAM presenting with protein losing enteropathy has been reported, in which there were no abnormalities in the intestinal tractus or in the pancreas.

[Mesoblastic nephroma in adults. Apropos of a case and review of the literature]. / Néphrome mésoblastique de l'adulte présentation d'un cas et revue de la littérature.

A case of mesoblastic nephroma in a 35-year-old woman is reported. The mass was located in the upper pole of the left kidney with a predominant extrarenal development. It was clinically misinterpreted as an adrenal tumor and was cured by tumorectomy alone. The patient is well three years later.

[Benign tumours of the liver and oral contraceptives (author's transl)]. / Tumeurs hépatiques bénignes et contraception orale.

The pathologic features, the terminology, the etiolgoy, and the causal relations of benign tumours of the liver associated with the use of oral contraceptives were reviewed during a study on six new cases. According to the literature the following points are emphasized: these tumours can be divided into two distinctive conditions, they are commonly called focal nodular hyperplasia and liver cell adenoma, whereas the name hamartoma seems rarely appropriated, they occur without any use of oral contraceptive, but this practice is probably responsible for their increasing number.

[Benign tumours of the liver and oral contraceptives (author's transl)]. / Tumeurs hépatiques bénignes et contraception orale.

PIP: During their observations of 6 new cases of benign liver tunors, the authors review the terminology commonly used to describe such lesions. These tumors belong to 2 different morphological varieties, nodular focal hyperplasia, and liver cell carcinoma. The exact role of estroprogestational agents in the appearance of benign liver neoplasms is still discussed, since such tumors have been described outside of oral contraception, before the existence of oral contraception, and also in men and children. However, statistical studies show that their incidence augments in women on oral contraception; that, possibly, estrogen only is the cause of hepatic lesions, and that duration of treatment does not influence the appearance of such lesions. Benign hyperplasic and benign adenomas are very susceptible of evolution toward malignant tumoral forms.^ieng

[Myospherulosis: a riddle asked by strange bags of marbles. A report of four cases (author's transl)]. / La myosphérulose: une énigme posée par de curieux "sacs de billes" A propos de quatre observations.

Four cases of "myospherulosis" are presented with a review of the thirty cases previously reported in the litterature. The disease is characterized by clusters of spherules, surrounded by a thin membranous bag, within a multicystic reaction of muscular and subcutaneous tissue or of paranasal sinuses. The actual nature of these spherules still remains unknown. Several pathogenic hypothesis are suggested.

[Immunocytochemistry of pancreatic and pancreatico-duodenal apudomas]. / Immunocytochimie des apudomes pancréatiques et pancréatico-duodénaux.

Immunocytochemical techniques, applied to material fixed with Bouin's fluid and using immune sera specific to various hormonal polypeptide(s), give a classification of pancreatic and pancreatico-duodenal apudomas based upon cellular functional activity. With a rane containing a minimum of five antibodies (gastrin, insulin, glucagon, somatostatin and pancreatic polypeptide), 15 tumours could be identified amongst the 22 tested. They were either "monohormonal" tumours (10 cases) or "bi- or polyhormonal" tumours (5 cases). In the remaining 7 cases, only rare cells were immunoreactive. A large number of immunoreactivities thus revealed in histological sections are clinically silent or are present in a "forme fruste".

[A further case of hepatocytic adenoma following oestrogenprogestogen treatment. Review of the literature (author's transl)]. / L'adénome hépatocytaire sous traitement cestro-progestatif. Revue de la littérature à propos d'une observation.

A young woman taking contraceptive hormone treatment for many years developed a hepatocytic adenoma discovered after a massive hemorrhage into the tumor. The patient recovered after a hepatectomy. A total of 160 such cases have been reported in the published literature, and recovery occurred after excision of the lesion in the majority of cases. Stopping the oestrogen-progestogen therapy seems to avoid recurrence but it is still not known whether this is sufficient to produce regression of a benign tumoral lesion.

[Silent pyloroduodenal gastrinomas. Apropos of 3 cases]. / Les gastrinomes silencieux pyloro-duodénaux. A propos de trois observations.

The authors report three anatomoclinical studies concerning apparently moderately aggressive endocrine tumors developped in the sub-mucosa of the duodenal bulb (2 cases) and of the pyloro-bulbar region (1 case), not connected with the pancreas, and occuring in the absence of a parietal ectopic pancreas. Two of these tumors were ulcerous but the associated syndromes (pains and hemorrhage) did not evoke, clinically, a Zollinger-Ellison syndrome. However, examination with immunofluorescence showed the presence of immunoreactive gastrine in a large number of cells. Having found some similar cases in the literature, the authors precise the features of these silent pyloro-duodenal gastrinomas: it is a variety of carcinoids or of "carcinoid-islet cell tumors". The cells contain argyrophile granules (Grimelius stain) which correspond in electron microscopy to neuro-secretory granules that may be quite different from G. granules. In the absence of significant clinical signs and of a radio-immunologic blood test, the presence of immunoreactive gastrin in the cells is the main feature for the diagnostic of these tumors. These tumors seem to arise from the gastrin cells of the mucosa or from their precursors as is suggested by the transitional forms with the fundus of the glands. Whatever the reason of the peculiar functional behavior, these neoplasms can be easily isolated from the anonymous group of duodenal carcinoids.

Segmental necrosis of ascending colon in haemodialysis patients.

A segmental necrosis of the ascending colon sometimes affecting the terminal ileum was observed 13 times in 12 end-stage renal disease patients over a 5400 patient-years observation period. In all but three cases the patient was operated within 24 h of onset of the abdominal pain. Three patients had a bowel perforation; nine had a limited intestinal necrosis. All underwent a partial resection or colectomy. Two died within 1 month. In all cases the mucosa was necrotic, the submucosa small vessels were congested and the mesenteric vessels were normal. Ischaemic bowel disease has been previously reported in uraemic patients, but our cases do not fit with the usual reported features of this complication. The absence of typical mesenteric infarction, vascular thrombosis, stenosis or major atherosclerotic lesions is surprising. The ascending colon topography of the lesions is very unusual. Ischaemia, constipation and other factors may play a role.