Cat-scratch disease osteomyelitis.

We report on a patient who presented with osteomyelitis of a rib and adjacent abscess as a rare and atypical manifestation of cat-scratch disease. Radiographic findings showed an osteolytic lesion with adjacent mass. Biopsy, serology and polymerase chain reaction technique are essential for the final diagnosis. Prognosis is excellent with full recovery.

Rate of 14CO2 production from variously labeled forms of [14C]glucose in human breast invasive ductal carcinoma tissues.

To establish possible cancerous aggressiveness between the metabolism of variously labeled [14C]glucose in the human breast invasive ductal carcinoma (IDC) tissues, we measured the rates of 14CO2 production from those tissues by using radiorespirometry, expressing the results as initial velocity (V) in nanomoles of 14CO2 min-1 g-1 of fresh tissues. The Vc data were compared with results of the SBR system, which grades up from I to III. Vc,1 values measured with [1-14C]glucose increased from 1.99-2.82 for SBR I to 3.90-4.09 for SBR II, finally reaching 4.83-7.04 for SBR III, thus matching clearly the increase of IDC cancerous aggressiveness. Conversely, data obtained from [3,4-14C]glucose and [6-14C]glucose decreased with increasing cancer stage: i.e., with [3,4-14C]glucose, Vc,3,4 values were 5.79-9.34 for SBR I, 4.45-4.84 for SBR II, and 2.35-1.90 for SBR III; with [6-14C]glucose, the corresponding Vc,6 values were 1.34-1.90, 1.33-1.41, and 0.72-0.79. The Vn,1/Vn,6 ratios were close to unity for normal tissues and for noncancerous tissues surrounding SBRI tumors. For cancerous tissues, however, the Vc,1/Vc,6 ratios were 1.5, 2.9, and 6.1-9.8 in IDC tissues graded as SBR I, II, and III, respectively. The results suggest the possible use of radiorespirometry as a tool to assess IDC aggressiveness.

A proposed estimate of the tumor aggressiveness of human breast cancer using radiorespirometry.

The relationships between carcinomatous aggressiveness and the glucolytic metabolism, namely the rate of 14CO2 production from [U-14C] glucose, are obtained from human breast tissues using radiorespirometry. The values are estimated as the initial velocity (V) expressed in eta 14CO2 x min-1 x g-1 of fresh tissues by [U-14C] glucose metabolism. The aggressiveness of the breast carcinomatous is diagnosed by the SBR grade system. As two control normal tissues, (V) are 0.86 to 0.90 from non-cancer patients. In carcinomatous tissues (Vc), there is an increase from 1.53 to 3.14, but in the corresponding surrounding non-cancer tissues (Vn) these show a decrease from 2.20 to 0.22 for SBR I, SNR II to SBR III. The ratio between (Vc) and (Vn) are found, according to carcinomatous aggressiveness, as 1.45 to 1.54, 1.69, 2.35 to 2.86 and 4.82 to 10.38 respectively for SBR I, lobular carcinoma, SBR II and SBR III; while the ratio is 1.04 for the normal tissue which come from non-cancer patients. The above results suggest the possibility of assessing the carcinomatous aggressiveness by radiorespirometry before a histopathological diagnosis, even in a lower aggressiveness as in SBR I cases which are difficult to diagnose and manage.

[A case of Enterobius vermicularis salpingitis]. / Un cas de salpingite à Enterobius vermicularis.

Enterobius vermicularis peritonitis due to intestinal infection is a common entity described in the literature. We report here an unusual case of unilateral salpingitis associated with the parasite migration through the genital tract.

Two schwannomas presenting as lumps in the same breast.

A case of two benign schwannomas of the right breast in a 25-yr-old woman is presented, including the use of fine-needle aspiration and biopsy diagnosis. A review of the literature did not reveal any such duality in the same breast. The tumors were made of clusters of spindle cells on cytological material. The final diagnosis was established through histological examination of the excised masses.

Imprint and brush cytology in the diagnosis of canine intranasal tumours.

Fifty-four dogs with nasal tumours were included in this study. Based on histopathology 52 tumours were malignant (36 epithelial and 16 mesenchymal) and two were benign (one oncocytoma and one pleiomorphic adenoma). Malignancy was significantly more frequently diagnosed by imprint cytology (81 per cent of the cases) than by brush cytology (56 per cent). Brush cytology was a significantly more sensitive technique in epithelial than in mesenchymal tumours, while the sensitivity of imprint cytology was not affected by the histological type. Brush cytology determined an epithelial origin in 88 per cent of epithelial tumours, and imprint cytology in 90 per cent. In mesenchymal tumours, the scores were significantly lower, the histological type being determined in only 20 per cent and 50 per cent, using brush and imprint cytology, respectively.

Diagnostic approach to pulmonary lymphangioleiomyomatosis.

Pulmonary lymphangioleiomyomatosis is an interstitial lung disease with distinctive clinical, radiologic, physiological and pathological findings. We report an additional case of this rare condition, diagnosed on first medical evaluation by transbronchial lung biopsy and discuss the diagnostic approach.

Thoracoscopy in the diagnosis and management of chronic pleural effusions.

Thoracoscopy was performed in 76 patients with chronic pleural effusions in which thoracocentesis and blind needle biopsy failed to reach a precise diagnosis. Analysis of thoracoscopic biopsies provided a definitive diagnosis in 53 of the 76 subjects. The diagnoses included 35 malignant diseases in which the macroscopic appearance was diagnostic in only 27 patients. Among these 76 patients, a talc dusting was performed in the management of recurrent effusion in 33 patients. No recurrence of pleural effusion was observed after 1 month in 87% and after 6 months in 76% of patients with recurrent pleural effusion. We confirm that thoracoscopy is a safe and useful technique for the diagnosis of pleural effusion which substantially decreases the necessity for diagnostic thoracotomy and that talc dusting is effective to achieve pleurodesis.

Thoracoscopic lung biopsy in interstitial lung disease.

Thoracoscopic lung biopsy has been proposed as an alternative to open lung biopsy for the diagnosis of interstitial lung disease. We performed thoracoscopic lung biopsy under local anesthesia and diathermic coagulation in 33 non-immunocompromised patients with interstitial lung disease. A diagnosis was obtained in all patients. No severe complication was observed. The average time of drainage was 4 days. We confirm that this technique has advantages compared to open lung biopsy.

Primary sclerosing cholangitis and idiopathic pulmonary fibrosis: a case report.

Primary sclerosing cholangitis (PSC) and idiopathic pulmonary fibrosis (IPF) were each separately described in association with a variety of chronic idiopathic inflammatory diseases such as retroperitoneal fibrosis, Sicca complex or Riedel's thyroiditis. We report a case which may be the first description of the association between PSC and IPF. The physiopathogenic implications of such an association are discussed.

Bronchoesophageal fistula caused by pulmonary aspergillosis.

A 29-year-old patient developed a bronchoesophageal fistula after expectorating a mycetoma caused by Aspergillus fumigatus. After failure of medical therapy, a retrosternal coloplasty was performed. Pulmonary aspergillosis can be the cause of a bronchoesophageal fistula.

The pancreatic polypeptide cells in the human pancreas: the effects of age and diabetes.

Pancreases from insulin-dependent diabetics (IDDM), noninsulin-dependent diabetics (NIDDM), and nondiabetic subjects were analyzed by stereological and morphometrical methods in order to determine the weight of the lobe rich in pancreatic polypeptide (PP) cells in relation to the total weight of the pancreas and the volume density of PP cells in both parts of the gland, those rich and poor in PP cells. In control subjects, neither the relative weight of the lobe rich in PP cells, nor the volume density of PP cells varied significantly with aging. In IDDM and NIDDM, the volume density of PP cells was similar to that observed in control subjects. The total weight of the pancreas was markedly decreased in IDD because of an almost selective atrophy of the lobe poor in PP cells; the relative weight of the lobe rich in PP cells was thus much higher than that in control subjects. A less marked atrophy, restricted to the lobe poor in PP cells, was also observed in NIDDM. It is suggested that PP may exert a local trophic role which protects the lobe of the pancreas rich in PP cells from atrophy in diabetic patients. The results further show that the elevated levels of PP in the plasma of elderly or diabetic subjects cannot be ascribed to a hyperplasia of PP cells.

Cell populations in the endocrine pancreas of human neonates and infants.

Pancreases from normoglycaemic neonates (less than 15 days), infants (6 months) and adults were examined using immunoperoxidase techniques. Sections taken from five regions of the gland were analysed by morphometry. The volume density of total endocrine tissue was found to be higher than previously reported: 15% in neonates, 6-7% in infants and 2-3% in adults. In neonates, many endocrine cells were located in small clusters, sometimes budding from ducts, and up to 15% were isolated in ducts and acini. Similar clusters were still present, though less frequent, in infants. The relative proportion of all cell types varied only slightly between the different regions, except in the posterior part of the head, which comprised 90% of all PP(polypeptide) cells. With age, the proportion of somatostatin cells decreased (from about 30% in neonates to about 10% in adults), that of insulin cells increased (50 to 70%) and that of glucagon cells remained stable (20%). In the posterior part of the head, the proportion of PP cells tended to be higher in adults than in neonates or infants. This study shows that both the endocrine cell populations and the proportion of endocrine tissue in the pancreas change markedly in early life. It also suggests that "nesidioblastosis" is a normal feature of the pancreas of normoglycaemic neonates and young infants.