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Ann Pathol ; 2019 Mar 27.
Artigo em Francês | MEDLINE | ID: mdl-30928254


We report the case of a 22-year-old patient with acute abdominopelvic pain. The diagnosis of hypercalcemic small cell carcinoma (SCCOHT)/ovarian rhabdoid tumor has been made. Small cell carcinoma of hypercalcemic type is a rare and aggressive tumor that occurs in young women. The diagnosis of this tumor and the management must be rapid in view of its aggressiveness. Through this observation, we specify the epidemiological, diagnostic, molecular aspects and discussions about its name.

Abdom Radiol (NY) ; 42(6): 1762-1772, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28246921


Uterine myometrial tumors are predominantly benign conditions that affect one-third of women and represent the main indication for hysterectomy. Preoperative imaging is of utmost importance for characterization and for precise mapping of myometrial tumors to best guide therapeutic strategy. New minimally invasive therapeutic strategies including morcellation, myolysis, uterine artery embolization and image-guided radiofrequency or focused ultrasound ablation have been developed for the treatment of uterine leiomyoma. However, preoperative differentiation between atypical leiomyomas and leiomyosarcomas is critical on imaging as uterine sarcoma requires a specific surgical technique to prevent dissemination. A single, rapidly growing uterine tumor, associated with endometrial thickening and ascites, in post-menopausal women is suspicious of uterine endometrial stromal sarcoma and carcinosarcoma. Suggestive magnetic resonance imaging features have been described, but overlap in imaging appearance between uterine leiomyosarcomas and cellular leiomyomas makes it challenging to ascertain the diagnosis. This review aims to illustrate the imaging features of uterine sarcomas and potential mimickers to make the reader more familiar with this serious condition which needs special consideration.

Imagem por Ressonância Magnética/métodos , Neoplasias Uterinas/diagnóstico por imagem , Carcinossarcoma/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Leiomiossarcoma/diagnóstico por imagem , Sarcoma do Estroma Endometrial/diagnóstico por imagem
Autoimmunity ; 48(1): 40-5, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25028066


UNLABELLED: Introduction: In this prospective multicenter study, we aimed to describe (1) the outcome of pregnancy in the case of previous chronic histiocytic intervillositis (CHI), (2) the immunological findings and associated diseases, (3) the treatments, and (4) the factors associated with pregnancy loss. METHODS: We prospectively included all patients with a prior CHI with ongoing pregnancy between 2011 and 2013. RESULTS: Twenty-four women (age 34±5 years) were included in this study. An autoimmune disease was present in seven (29%) cases. Twenty-one prospective pregnancies were treated. The number of live births was more frequent comparatively to the previous obstetrical issues (16/24 versus 24/76; p=0.003). Most of the pregnancies were treated (88%), whereas only 13% of previous pregnancies were treated (p<0.05). No difference was found with respect to the pregnancy outcome in the different treatment regimens. In univariate analyses, a prior history of intrauterine death and intrauterine growth restriction and the presence of CHI in prospective placentas were associated with failure to have a live birth. DISCUSSION: In this multicenter study, we show the frequency of the associated autoimmune diseases in CHI, as well as the presence of autoantibodies without characterized autoimmune disease. The number of live births increased from 32% to 67% in the treated pregnancies. Despite the treatment intervention, the risk of preterm delivery remained at 30%. Last, we show that the recurrence rate of an adverse pregnancy outcome persisted at 30% despite treatment intervention. CONCLUSION: CHI is associated with high recurrence rate and the combined regimen seems to be necessary, in particular, in the presence of previous intrauterine death.

Aborto Habitual/imunologia , Doenças Autoimunes/complicações , Vilosidades Coriônicas/imunologia , Histiócitos/imunologia , Trabalho de Parto Prematuro/imunologia , Aborto Habitual/tratamento farmacológico , Aborto Habitual/patologia , Adulto , Aspirina/uso terapêutico , Autoanticorpos/sangue , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/patologia , Movimento Celular , Vilosidades Coriônicas/patologia , Feminino , Morte Fetal/prevenção & controle , Heparina de Baixo Peso Molecular/uso terapêutico , Histiócitos/patologia , Humanos , Hidroxicloroquina/uso terapêutico , Recém-Nascido , Nascimento Vivo , Trabalho de Parto Prematuro/tratamento farmacológico , Trabalho de Parto Prematuro/patologia , Prednisona/uso terapêutico , Gravidez , Estudos Prospectivos , Recidiva
Arch Gynecol Obstet ; 291(6): 1229-36, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25416199


OBJECTIVES: Chronic intervillositis of unknown etiology (CIUE) is characterized by an intervillous infiltrate of mononuclear cells and a high recurrence rate of adverse obstetrical outcomes. The aim was to describe obstetrical history in patients with at least one event characterized by CIUE, and the possible impact of systematic investigation of an underlying autoimmune disease on the obstetrical outcome of subsequent pregnancies. METHODS: We retrospectively reviewed all pregnancies in patients having experienced at least one adverse obstetric outcome associated with chronic intervillositis of unknown etiology diagnosed by placental histological analysis between 2004 and 2011 in our university hospital. For each patient, data pertaining to obstetrical history, treatments during pregnancies, the results of systematic investigation of an underlying autoimmune disease, and treatments as well as obstetrical outcome in subsequent pregnancies, were collected. RESULTS: Twelve patients with 38 pregnancies were included [median age 30 (22; 40 years)]. Autoimmune disease or autoimmune antibodies (AID group) were found in 7/12 patients: primary antiphospholipid syndrome (APS) (n = 4), Sjögren's syndrome (n = 1), pernicious anemia (n = 1) and celiac disease (n = 1). When comparing pregnancies of patients with and without AID, there was no difference with regard to the type of obstetrical events or live-born babies, in spite of appropriate treatment. Corticosteroids (prednisone 10 mg/day) were used in only 2 cases with AID (Sjögren's syndrome and APS; n = 1 each), and these 2 pregnancies resulted in live-born babies. CONCLUSION: This study shows that the immunological assessment in patients with CIUE raises the possibility of a specific severity when AID or obstetrical APS is associated with CIUE, since conventional treatment did not improve obstetrical outcome in these patients as compared to those without autoimmune diseases. The benefit of immunosuppressant agents in this subset of patients needs further evaluation.

Síndrome Antifosfolipídica/complicações , Doenças Autoimunes/complicações , Doenças Placentárias/imunologia , Adulto , Síndrome Antifosfolipídica/epidemiologia , Autoanticorpos/imunologia , Doenças Autoimunes/epidemiologia , Vilosidades Coriônicas/imunologia , Doença Crônica , Feminino , Humanos , Doenças Placentárias/patologia , Prednisona/administração & dosagem , Gravidez , Complicações na Gravidez/imunologia , Estudos Retrospectivos , Adulto Jovem
Fertil Steril ; 94(7): 2909-12, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20605145


In this prospective comparative study, compared with fertile control subjects (n = 12), infertile patients with hydrosalpinx (n = 18) had lower E-cadherin and a trend toward decreased N-cadherin H-scores in the endometrium (3.6 ± 0.6 vs. 2.4 ± 0.8 and 0.57 ± 1.0 vs. 0.52 ± 0.5, respectively). In hydrosalpinx, epithelial N-cadherin expression was discontinuous and disappeared in atrophic patches.

Antígenos CD/metabolismo , Caderinas/metabolismo , Endométrio/metabolismo , Doenças das Tubas Uterinas/metabolismo , Receptores de Hialuronatos/metabolismo , Infertilidade Feminina/metabolismo , Atrofia/metabolismo , Biópsia , Estudos de Casos e Controles , Endométrio/patologia , Doenças das Tubas Uterinas/patologia , Tubas Uterinas/metabolismo , Tubas Uterinas/patologia , Feminino , Humanos , Infertilidade Feminina/patologia