Translocation (X;1) associated with a nonpapillary carcinoma in a young woman: a new definition for an Xp11.2 RCC subtype.

We report a translocation (X;1)(p11.2;q21) associated with a nontubulopapillary renal cell carcinoma in a 23-year-old woman. To our knowledge this the first report of such an association. A review of the previously published cases of renal cell carcinoma with t(X;1) and its cytogenetic variants with Xp11.2 anomalies is included. The role of this karyotype abnormality as a clinical marker is discussed. The Xp11.2 abnormality could be a primary abnormality characterizing a particular type of RCC appearing in children and young adults of both sexes and in which the histological aspect is not specific.

t(15;17) hypergranular acute promyelocytic leukemia (M3) developing into a t(3;6) M3 without t(15;17) at relapse.

This report describes a case of acute promyelocytic leukemia (APL) M3. At diagnosis, the specific t(15;17) translocation was observed. After chemotherapy including retinoic acid, a complete remission was achieved and the karyotype became normal. At relapse of the M3 leukemia, the t(15;17) clone was no longer observed but a t(3;6) translocation was then detected. Several hypotheses for this unusual cytogenetic course of APL are discussed.

[Simultaneous hepatic cholangiocarcinoma and bone fibrosarcoma 45 years after ingestion of Thorotrast]. / Cholangiocarcinome hépatique et fibrosarcome osseux synchrones 45 ans après injection de Thorotrast.

This case of a 63 year old man reports the simultaneous development of hepatic cholangiocarcinoma and fibrosarcoma of the sacrum 45 years after the systemic injection of Thorotrast. The characteristic radiologic aspect was an important criteria for diagnosis. Biopsies have confirmed the histology of both tumors. We describe the way to thorotrastosis diagnosis and characteristic malignant tumors, especially cholangiocarcinoma, induced by Thorotrast.

[Nephropathy and filariasis from Loa loa. Apropos of 1 case of adverse reaction to a dose of ivermectin]. / Néphropathie et filariose à Loa loa. A propos d'un cas de réaction adverse à la prise d'ivermectine.

A patient with a filarial infection due to Loa loa, received single oral dose of ivermectin A few hours after, he has presented a severe renal impairment. Native of the Cameroons, he was also treated for malaria. A renal biopsy has been done, because of chronic proteinuria. It has showed microfilariae in glomeruli, thickening of the basement membrane and a segmental and focal mesangial hyalinosis. By immunofluorescence microscopy there were granular deposits of IgM and C3 along this membrane. Electron microscopy has showed subepithelial electron- dense deposits. This suggests that the renal disease is immunologically induced. During the therapy, adverse reactions seemed to be related with massive liberation of filarial antigens. This is well known with diethylcarbamazine but also now, sometimes with ivermectin.

[Inflammatory pseudo-tumor of the lung. Clinico-pathologic report of a case]. / Pseudo-tumeur inflammatoire du poumon. Etude anatomo-clinique d'une observation.

One case of a solitary pulmonary nodule occurring in a 54-year-old woman with history of breast carcinoma is presented. Histological examination of the surgical specimen excluded breast carcinoma metastasis and revealed an inflammatory pseudotumor. Principal clinico-pathological findings in previously reported cases are described. Inflammatory pseudotumors may exhibit, as in our case, some nuclear atypia making the diagnosis sometimes difficult with malignancy.

[The intratesticular leiomyoma: an unusual location. Report of a case]. / Le léiomyome intratesticulaire: une localisation exceptionnelle. A propos d'un cas.

Intratesticular location of leiomyoma is unusual. A single case has been published in the literature. We report a case of what we consider to be an intratesticular leiomyoma, with a description of its pathology, a discussion of its differential diagnosis and histogenesis.

[Tumor of the peripheral nerve sheath with rhabdomyoblastic differentiation arising in a ganglioneuroma: neurilemmoma? A fortuitously detected case]. / Tumeur des gaines des nerfs périphériques à différenciation musculaire survenant sur un ganglioneurome: tumeur de Triton?

An otherwise healthy 21-year-old man with no evidence or family history of Von Recklinghausen's neurofibromatosis presented a posterior mediastinal mass detected on routine chest radiographs. The findings of standard light microscopy, ultrastructural examination and immunohistochemical studies suggested the working hypothesis of an unusual malignant "Triton" tumour: -arising in a pre-existing de novo ganglioneuroma; -fortuitously detected; -predominantly made of multinucleated spindle cells with only ultrastructural and immunohistochemical rhabdomyoblastic differentiation.

[Anatomic pathology of testicular tumors]. / Anatomie pathologique des tumeurs du testicule.

Pathological examination of testicular tumours demonstrates the heterogeneity of the histological types encountered. Germ cell tumours, with one or several components, represent 95% of all testicular tumours. The distinction between these various types is always based on morphological criteria, but may also be facilitated by the use of immunolabelling techniques on fixed sections. The local and regional extension and the distinction between seminomatous and non-seminomatous germ cell tumours are important criteria in the subsequent therapeutic strategy. At the present time, there is no consensus concerning the selection of other histoprognostic criteria, which may be observed in the primary tumour it its metastases. Residual masses also have a variable histology and their pathophysiology is sometimes difficult to interpret.

[Severe pulmonary and meningeal cryptococcosis in an immunocompetent Cambodian]. / Cryptococcose grave, pulmonaire et méningée, chez un cambodgien non-immunodéprimé.

A chest x-ray showing a large tumor-like opacity in the left lower lobe and endoscopy visualizing a budding mass suggested a diagnosis of bronchial carcinoma in a 55-year old, tobacco-smoking Cambodian who consulted for hemoptysis and altered general status. Histological study of bronchial biopsies allowed differential diagnosis of cryptococcosis. Serologic tests for human immunodeficiency virus were negative and there was no other cause of immunodepression. Left lower lobectomy was performed at the German hospital of the APRONUC in Phnom Penh. Examination of the surgical specimen confirmed massive bronchopulmonary cryptococcosis. Two months after the procedure the patient was readmitted for neuromeningial cryptococcosis that responded well to fluconazole. Another relapse occurred 5 months later and was treated using the same drug. The patient is currently in remission. An increasingly common deep mycosis that is serious but curable with proper treatment, cryptococcosis deserves the full attention of physicians working in Cambodia where, as in other tropical zones, it is likely that this infection will progress with the incidence of AIDS. Symptoms can be misleading, suggesting neuromeningial or pulmonary tuberculosis. The value of India ink smear which should be performed in all patients presenting lymphocytic meningitis with hypoglycorrhachia must be emphasized. In the present case bronchoscopy was useful to distinguish from bronchopulmonary cancer.

[Malignant triton tumor of the posterior mediastinum treated by thoracoscopic approach. Apropos of a case]. / Tumeur maligne de Triton du médiastin postérieur abordée par thoracoscopie. A propos d'un cas.

A tumour of the posterior mediastinum was removed via thoracoscopy. The histology report was a triton tumour. This is a rare (less than 80 cases reported in the literature) malignant tumour of the nervous system: malignant schwannoma with rhabdomyoblastic differentiation. The characteristics of this rare tumour and the consequences of videoassisted surgery in this specific case are discussed: a second access is required to widen the thoracotomy and complementary radiotherapy is needed.

[Campylobacter pylori and the gastric mucosa. Apropos of the detection of Campylobacter pylori in 12 patients with gastric mucosa lesions]. / Campylobacter pylori et muqueuse gastrique. A propos de la mise en évidence de Campylobacter pylori chez 12 patients porteurs de lésions muqueuses gastriques.

The authors report the results of systematic research on Campylobacter pylori during high endoscopy. Of the 60 patients examined, 12 were found to have the germ in their antral, gastric mucosa. All these patients had a history of chronic gastritis. They recall the role of this germ in creating chronic gastritis, and evoke the hypothesis that the mucosa becomes fragile facilitating the appearance of an ulcer.

[Role of testicular biopsy in the investigation of a carcinoma in situ]. / Place de la biopsie testiculaire dans la recherche d'un carcinome in situ.

Carcinoma in situ (CIS) of the testis is recognized to be a precursor of cancer. Radiological examinations are not sufficient to improve the diagnosis. So the diagnosis is made by testicular biopsy. The indications are controlateral testis biopsy in man with testicular cancer and risk factors (cryptorchidism, dysgenetic gonads...) and extragonadic germ cell tumors. The authors review the risk factors. Chemotherapy is not sufficient to eradicate the CIS. A dose of 16 Gy of localized radiation is curative, excludes bilateral orchidectomy and preserves androgen function and azoospermic patient.

[Pathologic anatomy of tumors of the testis]. / Anatomie pathologique des tumeurs du testicule.

Pathological examination of testicular tumours demonstrates the heterogeneity of the histological types encountered. Germ cell tumours, with one or several components, represent 95% of all testicular tumours. The distinction between these various types is always based on morphological criteria, but may also be facilitated by the use of immunolabelling techniques on fixed sections. The local and regional extension and the distinction between seminomatous and non-seminomatous germ cell tumours are important criteria in the subsequent therapeutic strategy. At the present time, there is no consensus concerning the selection of other histoprognostic criteria, which may be observed in the primary tumour it its metastases. Residual masses also have a variable histology and their pathophysiology is sometimes difficult to interpret.

[Gonococcus producers of beta-lactamase isolated in Dakar. Sensitivity to different antibiotics, auxotype and plasmid content]. / A propos des gonocoques producteurs de bêtalactamase isolés à Dakar. Sensibilité à divers antibiotiques, auxotype et contenu plasmidique.

More than 12.5% of gonococci isolated in Dakar during the first six months of 1984 were penicillinase producers (PPNG). PPNG strains were susceptible to a number of antibiotics: spectinomycin, thiamphenicol and tetracycline. No significant differences were found between distribution of auxotypes in PPNG and in non-penicillinase producing strains. Study of plasmidic content of PPNG (36 strains isolated from 1981 to 1984) revealed that 68.75% were of the "African" type and 31.25% of the "South-East Asian" type. Ratio of isolation of these two plasmidic content types remained consistent throughout the last four years. The criteria defined in 1977 to classify PPNG into two types need to be reviewed, specifically with regard to geographical areas, auxotype and tetracycline susceptibility. We found a significant correlation between the 4.5 Md plasmid (bla+) and the auxotype (PRO-). This finding has been reported by other authors but has not yet been explained.

[Incidence of pathogenic Escherichia coli in acute infantile diarrhea in Dakar]. / Incidence des Escherichia coli pathogènes sur les diarrhées aiguës infantiles à Dakar.

We have studied the incidence of enteropathogenic (EPEC), enteroinvasive (EIEC) and enterotoxigenic (ETEC) Escherichia coli associated with infant acute diarrhoeal disease in Dakar during a period of one year. We report 405 strains of Escherichia coli suspected to be the etiologic agent of the diarrhoea and isolated from 405 diarrheic stools of 0-5 years old children. We have isolated 119 pathogenic Escherichia coli with 63 EPEC (15.5%), 3 ETEC (0.7%) and 53 ETEC (13.1%) including 23 strains releasing heat-labile enterotoxin (LT+) and 30 strains releasing heat-stable enterotoxin (ST+). No ST+/LT+ strain was isolated. Escherichia coli with colonization factor antigens were isolated from 62 children. Almost all of them are CFAI+. Only one strain is CFAII+ and another one agglutinates with both CFAI and CFAII antisera. Among these CFA+ strains 5 belong to the EPEC group, 29 are enterotoxigenic (25 ST+ and 4 LT+) and 28 do not belong to any known etiopathologic group. Near 70% of the pathogenic Escherichia coli are from infants less than one year old, with a highest frequency between 7 and 12 months. Prevalence of ETEC is higher during the raining season. The existence of a great number of strains that belong to none of the 3 groups of etiopathologic Escherichia coli emphasis the need to search other factors of pathogenicity.