Mesenteric inflammatory myofibroblastic tumor: MRI and CT imaging correlated to anatomical pathology.

Inflammatory myofibroblastic tumor (IMT) is a rare tumor, classified by WHO of intermediate biological potential with tendency for local recurrence and small risk for distant metastasis. Histologically IMT is a mixture of inflamma- tory cells and myofibroblastic spindle cells proliferation. To our knowledge there is no MRI description of mesenteric IMT in the literature. We would like to emphasize the correlation between medical imaging and anatomical pathology based on our experience of a mesenteric IMT in a 28-year-old patient.

Adult liver transplantation at UCL: update 2002.

The authors present the results of a single centre study of 587 liver transplants performed in 522 adults during the period 1984-2002. Results have improved significantly over time due to better pre-, peri- and post-transplant care. One, five, ten and fifteen year actuarial survivals for the whole patient group are 81.2; 69.8; 58.9 and 51.2%. The high incidence of de novo tumors (12.3%), of cardiovascular diseases (7.5%) and of end-stage renal function (3.6%) should be further incentives to tailor the immunosuppression to the individual patient and to direct the attention of the transplant physician to the long-term quality of life of the liver recipient.

[Persistent neonatal hyperinsulinism: new pathological findings which clarify the physiopathology of the syndrome and direct the therapeutic approach]. / Hyperinsulinisme néonatal persistant: les nouvelles découvertes en pathologie eclairent la pathophysiologie du syndrome et en dirigent l'approche thérapeutique.

Our morphological studies of the pancreas of patients suffering from neonatal persistent hyperinsulinemic hypoglycemia of infancy (PHHI), enabled us to discover the existence of two different forms of the syndrome, focal and diffuse. We defined precise morphological criteria allowing their differential diagnosis, even for intraoperative examination of frozen sections of small biopsies from the various areas of the pancreas. Together with selective venous catheterization, morphology can thus guide the surgeon when deciding between partial pancreatectomy in case of focal PHHI. and near-total pancreatectomy in case of diffuse PHHI. Among neonates affected by PHHI, about 40% suffer from the focal form of the syndrome and have clearly a better prognosis than those suffering from the diffuse form, in that they do not need a subtotal pancreatectomy with its complications. The second part of our work was devoted to analyze the pathogenesis of PHHI. We demonstrated that diffuse PHHI is not the result of an abnormal proliferation of b cells, and thus that nesidioblastosis is not the underlying pathological condition of the disease. By contrast, in total concordance with its genetic background, the focal PHHI lesion has a very high proliferation index, not observed in insulinomas, the other pancreatic endocrine lesion responsible for hyperinsulinemia. Comparing the focal lesion in focal PHHI with insulinomas, we found that not only their morphological features are different, but also their functional characteristics studied by morphological and quantitative approaches. However, some insulinomas share similarities in their molecular background with focal PHHI. Finally, we recently identified an atypical form of PHHI, characterized by a mosaicism of islets. This new form is currently under investigation.