[Elastosonography of thyroid lesions]. / Elastographie ultrasonore des lésions thyroïdiennes.

UNLABELLED: While ultrasound is the imaging modality of choice for diagnosis of thyroid lesions, characterization remains limited and tissue diagnosis frequently is required for management. The availability of additional tools such as elastography may improve lesion characterization and direct management. MATERIALS AND METHODS: A total of 96 patients (11 males and 85 females; 58+/-24 years) referred for fine needle aspiration (FNA) of mainly solid thyroid nodules 9-32 mm in diameter underwent conventional US and elastosonography. Results on elastography were correlated with histological results from FNA and classified as follows: suspected malignant lesion, suspected benign lesion, suspicious, indeterminate. RESULTS: The nodules were classified as follows: 95 nodules were soft (classes I and II) and 13 nodules were hard (classes III and IV). No cancers were detected in class and II lesions and 6 cancers were detected in class III and IV lesions. FNA provided insufficient cellular material for diagnosis in 5 class I-II nodules and 2 class III-IV nodules. CONCLUSION: Real-time elastosonography may be a useful adjunct to conventional US in the evaluation and characterization of thyroid nodules allowing identification of patients at high risk of malignancy for whom tissue diagnosis and/or close follow-up is required.

[Condyloms, dysplasia and carcinomas of cervix: a twenty years experience (1980 - 1999)]. / Condylomes, dysplasies et carcinomes du col utérin: notre expérience en vingt ans (1980 - 1999).

After twenty years of semi-regular detection(1980-1990) concerning 100,358 cervical smears carried out in the Cytology Laboratory in the CHU of Dakar, we have determined the types of cervical lesions in our study. We've found 21.03% of precancerous and cancerous lesions with 17.56% of CIN1, 2.49% of CIN2 and 0.49% of CIN3 and carcinomas. We've observed 9.07% of normal smears, 69.89% of benign cellular modifications, 17.56% of low grade lesions of Bethesda and 3.47% of high grade lesions of Bethesda. These very high figures show that on the one hand precancerous cervical lesions represent a serious public health concern in Senegal, on the other hand regular detection has become an urgent need in Dakar and in the other regions of Senegal where it's not carried out at all at the present time.

Argyrophilic cells and ectocervical epithelium.

The purpose of this study was to determine the nature of the argyrophilic cells in the ectocervix and to analyze the different morphologic varieties of argyrophil cell-containing ectocervical epithelia, notably to reappraise the degree of analogy with transitional epithelium. A systematic study of 39 ectocervices was carried out using histochemical and immunohistochemical techniques. Immunodetection of cytokeratins was used to specify the differentiation of the ectocervical linings. Argyrophilic cells were detected in 43% of our specimens. They have been found in several varieties of ectocervical lining: normal-appearing or hyperkeratotic squamous epithelium, "transitional-like" epithelium extending onto the portio, and immature squamous metaplasia from the transformation zone. The term "transitional-like" refers to a stratified nonsquamous epithelium that differs from true urothelium by the absence of superficial differentiation leading to the layer of "umbrella" cells. Two main types of argyrophilic cells have been delineated: serotonin cells and Merkel-type cells. The nature of the argyrophilic cells was dependent on the type of epithelium: Serotonin cells were essentially associated with "transitional-like" epithelium and Merkel-type cells with squamous epithelium. The latter cells were particularly frequent in hyperkeratotic squamous epithelium from uterine prolapse, reinforcing the homology with epidermis.

[Cytokeratins and exocervical malpighian epithelium. Particular distribution of several cytokeratins]. / Cytokératines et épithélium malpighien de l'exocol. Distribution particulière de certaines cytokératines.

The purpose of this study was to determine tissue distribution of certain cytokeratins along the ectocervical lining. A series of 20 cases was investigated by immunocytochemical labelling with specific antibodies against cytokeratins 19, 18, 8, 7, 10. Monoclonal antibodies were used on frozen sections. Distribution of keratin or alteration in expression was correlated with morphologic changes. All specimens were lined by a normal stratified squamous epithelium which was devoid of argyrophilic cells. Low molecular weight cytokeratins 8, 18, 19 (normally expressed in simple epithelia) were consistently and exclusively expressed through out the basal cell layer of the ectocervical lining. Some other particular immunostainings have been noted. A peculiar staining pattern was observed around some stromal papillae. Development of papillae was accompanied by the expression of cytokeratin 10 (which is commonly detected in skin), and by a reduction in the level of expression of simple epithelial cytokeratins. In addition, in the middle zone, anticytokeratin 10 revealed a mosaic of positive and negative cells even in light microscopically non keratinizing squamous epithelium, with differences of expression from case to case.

Endocrine cells in ectocervical epithelium. An immunohistochemical and ultrastructural analysis.

A systematic study of endocrine cells in the ectocervix was carried out using histochemical, immunohistochemical and ultrastructural techniques. Serotonin and calcitonin immunoreactive cells were demonstrated in this site. Serotonin and calcitonin immunoreactivities were coexpressed in the same endocrine cell. These distinctive cells were encountered in two main morphological varieties of ectocervical epithelium. Normal-appearing stratified squamous epithelium contained only very rare serotonin and calcitonin cells. In contrast, endocrine cells were fairly abundant in a specific epithelium termed "transitional-like". This type of epithelium was not only confined to the transformation zone but could also extend onto the portio as far as the vaginal cut margin. In some cases, transitional-like epithelium bore morphological resemblance to urothelium. In other cases, it could be regarded as basal cell hyperplasia or immature squamous metaplasia. Of interest, serotonin and calcitonin cells have been well-documented as normal inhabitants of some other non-squamous epithelia, such as urothelium or pseudostratified columnar epithelium. Therefore, it is suggested that certain ectocervical epithelia show some similarities to urothelium, in respect of their morphological appearance and endocrine profile. Further investigations using more objective and specific markers of urothelial cells are needed to assess the exact degree of homology connecting all these types of epithelium.

Unusual endocervical polypoid tumor with endocrine cells: an immunohistochemical and ultrastructural analysis.

Light microscopic, immunohistochemical, and ultrastructural features of an unusual polypoid tumor of endocervix are reported. Numerous polypeptide hormone and amine-producing endocrine cells were disclosed. Main conventional characteristics were the architectural growth pattern, with infolding glands giving rise to small secondary glands, the hypermucinous benign-appearing epithelium of endocervical type, and, possibly, the stromal smooth muscle. Ultrastructural analysis showed a highly differentiated tumor. Glandular elements were surrounded by a basal lamina. Mucinous cells, several endocrine cell types, amphicrine cells, nonsecretory ciliated cells, ciliated mucinous cells, and possible reserve cells were observed. This tumor departs appreciably from normal mucosa and common varieties of endocervical polyp, particularly its distinctive endocrine profile. The present case does not correspond to a well-defined type of endocervical neoplasia. It shares morphologic analogies with mucinous tumor of ovary. The malignant potential of this lesion as well as its relationship with minimal deviation adenocarcinoma remain questionable.

Endocrine cells in the female genital tract.

Endocrine cells are normal inhabitants of the para-urethral, Bartholin's and endocervical glands and of mesonephric rests. All these cells were characterized as serotonin-storing cells. In the para-urethral and Bartholin's glands, serotonin-containing cells were most often found in the transitional epithelium of excretory ducts. Endocrine cells participated in some pathological conditions. Abundant argentaffin cells were observed among the terminal ductules in chronic bartholinitis and serotonin-storing cells were identified in a peculiar ectocervical epithelium. Numerous serotonin-storing cells were detected in a well-differentiated adenocarcinoma of cervix occurring in a patient with the Peutz-Jeghers syndrome. Argyrophilic cells were present in cases of endometrial carcinomas; a striking feature was the demonstration of gut peptide hormones in an unusual type of endometrial adenocarcinoma. Finally, serotonin-storing cells were a constituent of Brenner tumours. It is suggested that a similar endocrine pattern may be shared by tissues originating from both Müllerian ducts and the urogenital sinus.

[Clinically isolated discharges from the nipples. Apropos of 74 cases]. / Les écoulements mamelonnaires cliniquement isolés. A propos de 74 cas.

74 cases with discharge from the breasts were treated surgically by pyramidectomy and histology. The histology was studied. The causes were: 1) ectasia (55%), 2) papilloma (30%) and 3), much more rare, cancer (8%). A blood-stained discharge (31 cases, 42%) could be due to these three causes, but the 4 cancers and the 2 borderline lesions belonged to the group of blood-stained discharges. A serious discharge (17 cases, 23%) could be due to ectasia or a papilloma. A thick discharge (16 cases, 21.5%) is always due to ectasia. The lactiferous duct is treated clinically and using X-rays to outline it. X-ray diagnostic methods and cytology are used in making the diagnosis. Clusters of papillae show that there is intra-canular proliferation. The literature is reviewed and a scheme of treatment is outlined.

[Associated Paget's disease of the vulva and of the nipple in the same patient: pathology with ultrastructural study (author's transl)]. / Association d'une maladie de Paget mammaire et vulvaire. Etude optique, ultrastructurale et cytochimique.

A case of Paget's disease of the vulva associated with Paget's disease of the nipple is reported. When the patient was 74-year-old, Paget's disease of the vulva was diagnosed; four years later, Paget's disease of the nipple was detected. Paget's disease of the vulva, although recurrent, is devoid of underlying infiltrating carcinoma. Eccrine sweats glands show different type of lesions consistent with pagetoid extension, in situ carcinoma and epithelial papillary proliferation. Ultrastructural study demonstrates dense granules within Paget's cells. A positive Thiery's cytochemical reaction indicates that these granules contain glycoprotein. Paget's disease of the nipple is associated with an intraductal carcinoma (cribriform type). Some feature of intralobular carcinoma is also observed. No foci of infiltration are found. Oestrogen receptors are detected by the histofluorescence technique of Sin Hang Lee. Few receptors are seen within the intraductal neoplastic cells and within the Paget's cells whereas no receptor at all, are observed within the keratinocytes. Several reports emphasized the relationship between vulvar Paget's disease and infiltrating breast carcinoma. Associated vulvar and nipple Paget's disease is rather rare and was just observed in two cases. These two observations were associated with a mammary infiltrating carcinoma whereas in our case, it remains an in situ carcinoma.

[Behavior of pulmonary parenchyma and the bronchi after subcutaneous graft in the rat]. / Comportement du parenchyme pulmonaire et des bronches après greffe sous-cutanée, chez le rat.

Subcutaneous isografts of small bronchi and pulmonary tissue were carried out, on rats. - 4 1/2 days after implantation, the bronchial epithelium was dedifferentiated, with mitoses. Smooth muscle disappeared. Pulmonary parenchyma was elastic. Such a state persisted until the 7th day. - 10 days after grafting, some bronchial cells had recovered short cilia. - After 2 weeks, the bronchial epithelium was perfectly redifferentiated: it showed goblet cells intermixed with columnar ciliated cells. Smooth muscle was not apparent. Some islets of elastic alveoli remained. - A similar state persisted for a further 8 weeks after transplantation, but the bronchial lumen appeared as a distended retention cyst with slightly flattened epithelium.

[Use of the intravisceral graft technic for the study of histologic changes in the skin after freezing]. / Utilisation de la technique des greffes intraviscérales pour létude de l'évolution histologique de la peau après congelation.

The authors present their technique for freezing thin skin samples which may be used for intravisceral grafts in the testis, the liver and the kidney to test developing potentials for grafts conserved in this manner. In comparison with fresh grafts, they show that frozen samples not only retained their vitality, but the ability to multiply, differentiate and mature. They eliminate any ambiguities in the interpretation of the results. At the same time, they note that the period spent in liquid nitrogen does not prevent graft rejection in the case of allografts.