Cellular expression of growth hormone and prolactin receptors in human breast disorders.

Growth hormone (GH) and prolactin (PRL) exert their regulatory functions in the mammary gland by acting on specific receptors. Using isotopic in situ hybridization and immunohistochemistry, we have localized the expression of hGH receptor (hGHR) and hPRL receptor (hPRLR) in a panel of human breast disorders. Surgical specimens from adult females included normal breast, inflammatory lesions (mastitis) benign proliferative breast disease (fibroadenoma, papilloma, adenosis, epitheliosis), intraductal carcinoma or lobular carcinoma in situ, and invasive ductal, lobular or medullary carcinoma. Cases of male breast enlargement (gynecomastia) were also studied. In situ hybridization analysis demonstrated the co-expression of hGHR and hPRLR mRNA in all samples tested. Epithelial cells of both normal and tumor tissues were labelled. Quantitative estimation of receptor mRNA levels was regionally measured in areas corresponding to tumor cells and adipose cells from the same section. It demonstrated large individual variation and no correlation emerged according to the histological type of lesion. Receptor immunoreactivity was detected both in the cytoplasm and nuclei or in the cytoplasm alone. Scattered stromal cells were found positive in some cases, but the labeling intensity was always weaker than for neoplastic epithelial cells. Our results demonstrate the expression of the hGHR and hPRLR genes and their translation in epithelial cells of normal, proliferative and neoplastic lesions of the breast. They also demonstrate that stromal components express GHR and PRLR genes. Thus the putative role of hGH or hPRL in the progression of proliferative mammary disorders is not due to grossly altered levels of receptor expression.

[Noninvasive hemodynamic monitoring in gynecologic laparoscopy]. / Surveillance hémodynamique non invasive dans la coelioscopie gynécologique.

A new non-invasive haemodynamic monitoring technique was investigated on twenty female patients submitted to gynaecological laparoscopy under general anaesthesia. Continuous aortic output was measured with an echo-Doppler oesophageal probe specially developed by the authors. Peritoneal insufflation was performed with an average of 4 +/- 0.750 l CO2 at an average insufflation rate of 0.666 l X min-1; intraperitoneal pressure increased on average by 11.57 +/- 1.60 mmHg during insufflation. Aortic output changes were related to changes in the patient's position. In initial horizontal dorsal decubitus position, average aortic output was 2.83 +/- 0.642 l X min-1. Trendelenburg position (28 +/- 2 degrees) induced a transient 9.54% increase (p less than 0.05), while a return to the horizontal position was marked by an 11.3% increase (p less than 0.01) of the aortic output. No significant change was observed during insufflation and exsufflation (-2.13 and -5.3% respectively). Mean arterial pressure rose by 16.4% after insufflation (initial values: 90 +/- 15.08 mmHg; p less than 0.01). Total vascular systemic resistances were significantly higher at the end of insufflation (2.999 +/- 376 dyn X cm X s-5; + 18.04%; p less than 0.05). Heart rate did not change significantly. Aortic output monitoring with this non-invasive, easy-to-handle technique enabled early detection of haemodynamic changes during laparoscopy. These changes frequently preceded significant blood pressure or heart rate variations.

[Cytogenic chorionic nodule of the uterus]. / Le nodule du chorion cytogène de l'utérus.

The authors report five observations of endometrial stromal nodules. These nodules are composed of cells identical to those of the endometrial stroma. They constitute the benign form of endometrial stromal tumors. From the macroscopic point of view, they present as nodular formations, most often single, well defined, non-fasciculated, whitish or yellowish sometimes cystisized. From the microscopic point of view, these nodules contain areas of plexiform or glandular arrangement with, occasionally, pseudo-rosettes. Small collagenous zones can often be observed. E.S.N. should be distinguished on the one hand from endolymphatic stromal myosis, and on the other hand from sarcoma of the endometrial stroma. Histogenesis of the lesion is also discussed.

Structure and composition of microcalcifications in benign and malignant lesions of the breast: study by light microscopy, transmission and scanning electron microscopy, microprobe analysis, and X-ray diffraction.

Microcalcifications previously located by radiography were extracted from 25 fresh specimens obtained from patients who had undergone tumorectomy or systematized mammary exeresis. Two principal types of microcalcifications were distinguished: Type I microcalcifications were amber in color and generally crystalline on scanning electron microscopy, with only one calcium peak on microprobe analysis; x-ray diffraction revealed that weddellite was involved. Type II microcalcifications were whitish, nonbirefringent under polarized light, and generally ovoid or fusiform, with two peaks, one calcium and the other phosphorus, on microprobe analysis; these microcalcifications were composed of calcium phosphate, the most characteristic form of which is hydroxyapatite, in the form of needles arranged in rosettes on transmission electron microscopy. Type I microcalcifications were observed in four of eight benign breast lesions, in two of three in situ lobular carcinomas, and in no intraductal adenocarcinomas or infiltrating carcinomas. Type II microcalcifications were present in all infiltrating carcinomas and intraductal adenocarcinomas; they were also found in benign lesions (four of eight) and even associated with type I microcalcifications in one in situ lobular carcinoma. There are, therefore, no "benign" or "malignant" microcalcifications; however, the presence of weddellite is a strong indication that a lesion is benign or, at most, an in situ lobular carcinoma.

[Basement membranes of epithelial tumors of the ovary. Histochemical and immunohistochemical study using antibodies to collagen IV, III, I and to laminin]. / Les membranes basales des tumeurs épithéliales de l'ovaire. Etude histochimique et immunohistochimique à l'aide d'anticorps anti-collagène IV, III, I et anti-laminine.

Thirteen ovarian tumours were the subject of a histochemical and immunohistochemical study using antibodies to collagen IV, III, I, and to laminin. Our study shows that it is not possible to assess the integrity of the basement membrane using simple histochemical methods (P.A.S., Gordon Sweets staining). In contrast, in benign epithelial tumours, a continuous basement membrane may be visualized beneath the epithelium of the cysts using antibodies to collagen IV and to laminin, collagen IV and laminin being two of the constituents of basement membranes. In malignant epithelial tumours, the immunoreactive material of collagen IV type or of laminin type, is arranged in a distinctly discontinuous manner, and is of unequal thickness around the edge of the cysts or of the neoplastic clusters. In three cases of borderline epithelial tumours, the discontinuity of the immunoreactive material (collagen IV or laminin) lying beneath the epithelium of the cysts, is not so pronounced. In comparison with studies carried out on the cervix uteri, this latter type of tumor, because of the constitution of its basement membranes, would appear to occur at a particular moment in their evolution, i.e. when they pass from the intra-epithelial stage and become infiltrative.

[Tubal epithelium. Scanning electron microscopy in the menstrual cycle, in pregnancy and in the menopause (author's transl)]. / L'épithélium tubaire. Microscopie électronique à balayage au cours du cycle menstruel, de la grossesse et de la ménopause.

The Fallopian tubes of 18 women who were either in reproductive age or were menopausal were studied by scanning electron microscopy. There were different cells seen in the epithelium. These were ciliated and non-ciliated cells, and cells, with a single cilium which was central and cells with short cilia. These elements undergo cyclical changes: secretory phenomena are at their maximum during the ovulatory phase. There is no sudden desquamation in tubal epithelium, nor is there massive deciliation. All the same, there are images that look like marguerites (described in the text) which are evidence of cellular regeneration. The appearance suggests a state of rest in precocious menopausal women and in pregnancy. The phenomena seen during the secretory phases disappear and the distribution of the cells is modified. Deciliation is found 20 to 30 years after the menopause. The physiological significance of these phenomena is still uncertain and their role in pathology has still to be defined.