Malignant histiocytosis in childhood: clinical study and therapeutic results in 22 cases.

Twenty-two children with malignant histiocytosis ranging in age from 2 to 13 1/2 years are described. In 10 cases, the correct diagnosis was only made retrospectively. The most salient pathologic features were found in lymph node biopsy specimens. Fever and wasting were the most prominent symptoms in 21 cases, and abdominal pains were striking in 9. Peripheral lymphadenopathy, mostly of the cervicoaxillary type, was present in 21 patients, with marked tenderness in 14. Abnormal mediastinal and/or paraaortic lymph nodes were detected radiographically in two-thirds of the patients. Other prominent features included subcutaneous inflammatory infiltration in 12 patients and skin nodules in 8. Pleural effusions were seen in 8 children. The haematologic findings are described. Only 5 of 19 children had bonemarrow involvement. Fifteen patients died, one to 45 months from onset of their illness (median survival time, five months). Nine patients are alive with no evidence of disease 21 to 46+ months (median, 40 months) after the time of diagnosis and 8 have currently been off treatment for periods ranging from three to 29 months; they all have been treated with vincristine, prednisone, cyclophosphamide, and adriamycin and 4 have achieved remission after treatment with vinblastine, bleomycin, and CCNU or cytosine-arabinoside. It is concluded from this study that clearly delineated clinical features of malignant histiocytosis in childhood should allow more rapid determination of the proper diagnosis and should result in early treatment by means of intensive systemic combination chemotherapy, which has dramatically improved the prognosis.

[The investigation of pancreatic pathology by "grey range" echotomography. Study of 80 cases (author's transl)]. / Exploration pancréatique par l'échotomographie "gamma des gris". Etude de 80 dossiers.

Over an 18-month period, the authors studied 305 cases of patients with or suspected of having pancreatic disease. Although atraumatic and free of danger, it must be borne in mind that echotomography is hampered by the air and water barrier of the hollow organs of the intestines since 20% of subjects cannot be explored. Well defined full or empty pancreatic tumours and acute inflammatory syndromes have well defined echographic appearances. In cases of chronic pancreatitis or poorly defined tumours the diagnosis is more difficult and ultrasound examination often only provides an additional element in a clinical argument. The great reliability of this examination should lead to its use at the beginning of investigations, with the possibility of the result orienting the clinician towards less harmless examinations.