Generation and characterization of dromedary Tenascin-C and Tenascin-W specific antibodies.

Tenascin-C (TNC) and tenascin-W (TNW), large hexameric glycoproteins overexpressed in the tumor microenvironment, are useful tumor biomarkers for theranostic applications. For now, polyclonal and monoclonal antibodies, as well as aptamers targeting TNC and TNW have been developed. However, the immunostaining sensitivity of antibodies is very heterogenous. The main aim of this study was to generate antibodies in dromedary that detect TNC and TNW, respectively. We show that immune sera from immunized dromedaries are able to specifically bind native TNC and TNW by ELISA and also to detect TNC and TNW in matrix tracks of mammary tumors by immunostaining. Furthermore, we demonstrate that purified IgG subtypes are able to interact specifically with TNC or TNW by ELISA and immunostaining. These camelid antibodies are a good basis to develop tools for the detection of TNC and TNW in the tumor microenvironment and could potentially have a broader application for early diagnosis of solid cancers.

Tenascin-W Is a Novel Stromal Marker in Biliary Tract Cancers.

Extrahepatic cancers of the biliary system are typically asymptomatic until after metastasis, which contributes to their poor prognosis. Here we examined intrahepatic cholangiocarcinomas (n = 8), carcinomas of perihilar bile ducts (n = 7), carcinomas of the gallbladder (n = 11) and hepatic metastasis from carcinomas of the gallbladder (n = 4) for the expression of the extracellular matrix glycoproteins tenascin-C and tenascin-W. Anti-tenascin-C and anti-tenascin-W immunoreactivity was found in all biliary tract tumors examined. Unlike tenascin-C, tenascin-W was not detected in normal hepatobiliary tissue. Tenascin-W was also expressed by the cholangiocarcinoma-derived cell line Huh-28. However, co-culture of Huh-28 cells with immortalized bone marrow-derived stromal cells was necessary for the formation and organization of tenascin-W fibrils in vitro. Our results indicate that tenascin-W may be a novel marker of hepatobiliary tumor stroma, and its absence from many normal tissues suggests that it may be a potential target for biotherapies.

Role of Computed tomography in predicting prognosis of Hepatic portal venous gas.

BACKGROUND: The aim of this study was to report through 13 cases the particularities of abdominal computed tomography (CT) aspects of hepatic portal venous gas (HPVG) and its correlation with patient prognosis. METHODS: We analyzed abundance of HPVG and its association with pneumatosis intestinalis (PI) in correlation with fatal outcome using chi-square tests. RESULTS: Etiologies were mesenteric infarction (n=5), sigmoid diverticulitis (n= 1), septic shock (n=1), postoperative peritonitis (n=1), acute pancreatitis (n=1), iatrogenic cause (n=3) and idiopathic after a laparotomy (n=1). The outcome was fatal in for 6 patients. Abundance of HPV was expressed in total number of hepatic segments involved. The involvement of 3 or more segments was a sensitive sign for lethal outcome with high sensitivity (100%) but it was not specific (50%). Negative predictive value of this sign was 100% (p≤0.005). Positive predictive value of PI for death was 100% (p≤0.001). DISCUSSION: Abundance of HPVG is correlated with prognosis. The presence of PI announces poor outcome Negative predictive value of presence of HPVG in 3 or more segments is interesting. Predicting prognosis with CT can help surgeons to assess the most adequate treatment. Iatrogenic causes are increasingly described after interventional radiology procedures with favorable course. CONCLUSION: The first etiology radiologists should look for in front of HPVG involving more than 3 hepatic segments and associated with PI is intestinal necrosis which announces a poor prognosis. This study shows that outside of shock situations, HPVG involving 2 or less hepatic segments without PI predicts a good outcome.

Computed Tomographic presentation of obstructive jejunal adenocarcinoma associated with celiac disease and incomplete intestinal malrotation.

INTRODUCTION: Small bowel adenocarcinoma is a rare entity most frequently observed with celiac disease. This is the first case report on the association of celiac disease, small bowel adenocarcinoma and intestinal malrotation. CASE REPORT: A 40 year-old male patient diagnosed with celiac disease since the age of 5 years complained of epigastric pain and vomiting for three days. Computed tomography (CT) showed a significant gastroduodenal dilatation with thickened intestinal wall proximal to the duodenojejunal flexure. The lumen contained a food bezoar in the center. The duodenojejunal angle was abnormally on the right side of the abdomen and the superior mesenteric vein was anterior to the superior mesenteric artery. Endoscopy after aspiration found a hemi-circumferential and irregular mass which bled at the contact of fibroscope. Biopsies showed an adenocarcinoma and small bowel resection was performed. DISCUSSION: Celiac disease is associated with a high risk of small bowel cancer. The association of incomplete intestinal malrotation, duodenojejunal flexure tumor and celiac disease made the surgery challenging. CONCLUSION: Patients with celiac disease should be carefully monitored and endoscopic or radiologic investigations should be carried out in patients with any doubtful symptoms.

Conservative treatment of a cervical twin pregnancy with uterine artery embolization.

Cervical pregnancy is a rare form of ectopic pregnancy. Its treatment has been described by different authors. We report our successful experience of a cervical twin pregnancy that was diagnosed by transabdominal and transvaginal ultrasound and confirmed by magnetic resonance imaging. To preserve fertility, our patient was treated by a bilateral hyperselective uterine artery embolization followed by dilatation and curettage of the cervical canal without ancillary procedures for cervical hemostasis. Arterial embolization by a resorbable agent reduces arterial circulation by providing a temporary occlusion of the vessels in order to decrease the risk of massive hemorrhage.

[Percutaneous bile drainage: complications and efficiency at short and mean terms: about 50 cases]. / Drainage biliaire percutané: efficacité et complications a court et a moyen terme a travers une série de 50 cas.

PURPOSE: Our purpose is to evaluate the efficiency and mean term complications in percutaneous bile drainage through a retrospective study of 50 cases METHODS: Fifty patients aged from 24 to 87 years underwent perecutaneous bile drainage in the Radiology Department of Mongi Slim hospital. Patients had external drainage, internal drainage or endoprotheses. Clinical and biological features were used to evaluate efficiency and complications. RESULTS: Bile drainage was successful in 49 cases. Intra hepatic bile ducts were dilated in most of the cases (40 patients). A right lobe puncture was performed preferentially (41 patients). Fifteen patients had endoprotheses, 3 patients had internal drainage and 31 patients had external drainage. Clinical and biological improvement was noted in all patients. Complications were noted in 16 cases mainly in patients with neoplastic obstruction. CONCLUSION: Percutaneous bile drainage is an effective method for the treatment of biliary obstruction. Complications are rare, occurring most frequently in patients with neoplastic obstruction.

Pseudo-tumoral renal actinomycosis.

Actinomycosis is a rare granulomatous chronic infection that is localized most frequently in the cranio-cervical region. Renal localization is exceptional. The authors report a new case of pseudo-tumoral actinomycosis and discuss diagnostic and treatment issues of this disease.

[Acrania ultrasonography diagnosis: a rare embryologic malformation]. / Diagnostic échographique de l'acranie: malformation embryologique rare.

The authors report a case of acrania diagnosed on antenatal period in a routine morphologic ultrasonography at 19 weeks of intra uterine gestation on a 20-year-old patient, gravida 1, para 0. Acrania associated with exencephaly is a rare and lethal malformation characterized by a defect of development of the flat bones of the scalp whereas cerebral tissue is present often abnormal. Ultrasonography had allowed to find besides the cerebral malformation, spinal and visceral fetal malformations as well as cord abnormality that included only two vessels.

[Acute pancreatitis due to a metallic foreign body]. / Pancréatite aiguë à corps étranger métallique.

We report a case of acute pancreatitis caused by a metallic foreign body located in the pancreatic head in a 38-Year-old woman. Only 15 cases of acute pancreatitis due to foreign bodies, metallic in five cases, have been published to date. In our case, diagnosis was established by the computed tomography scan. The patient declined surgery.

[Jaccoud arthropathy and pyrophosphate arthropathy: a rare association]. / Arthropathie de Jaccoud et chondrocalcinose articulaire: une association rare.

Jaccoud's arthropathy (JA) is a chronic deformity affecting hands and feet, which are voluntarily correctable by the patients. JA was usually reported in association with rheumatic fever and systemic lupus erythematosus. We describe an exceptional association between a pyrophosphate arthropathy and JA of the hands. It is a 48-year-old woman, having a 13 years history of polyarthritis involving shoulders, elbows, hips and knees, and 4 years after, a progressive unlar deviation of the fingers of the hands. Calcium pyrophosphate dihydrate crystals were identified in the synovial knee biopsy. Hands x-rays as RMI don't identify erosions and confirmed the JA.

[A voluminous foraminal and extra foraminal disk hernia mimicking a tumor]. / Une grosse hernie discale extra foraminale d'aspect pseudo tumoral.

In some cases, disc herniation can be voluminous and can then constitute a differential diagnosis with tumours. We report the case of a 46 years-old female with sciatica and crural neuralgia which resisted to medical treatment. X-rays exams were normal, but the computerized tomography showed a voluminous mass in contact with the L5 nervous root and which was developed in the psoas major muscle. The MRI revealed a voluminous foraminal and extra foraminal herniation at the L4-L5 vertebral disc, extended up to the psoas major muscle and associated with an important inflammatory infiltration. Surgical treatment was successful with a follow up of 8 months.

[Bilateral primary non-Hodgkin's lymphomas of the adrenals]. / Lymphome malin non-hodgkinien primitif bilatéral des surrénales.

Bilateral primary non-Hodgkin's lymphomas of the adrenals are rare: only 32 cases have been reported to date in the literature. We report a new case and recall the contribution of radiography to diagnosis.

[Isolated splenic metastasis revealing colon cancer]. / Métastase splénique isolée révélant un cancer du colon.

Splenic metastasis of colon cancer is uncommon especially when isolated. In fact, they are usually associated to multi visceral location. Malignant melanoma, cancer of breast and lung and ovarian carcinoma are the most common cancer which metastases in spleen. Splenic metastasis of colon cancer is rare and exceptionally isolated. Ten cases of isolated splenic metastasis in colon cancer are reported in literature. We report a new case of intra splenic kystic metastasis revealing an asymptomatic sigmoid cancer in a 63 years old patient.