Chromosomal changes in a documented case of malignant histiocytosis: significance of polyploidy.

A case of malignant histiocytosis was studied by cytology, cytochemistry, electron microscopy, and cytogenetics. It was shown that the malignant cells expressed a fully differentiated histiocytic pattern with high macrophagic activity. This correlated with the presence of polyploid metaphases. The significance of polyploid cells in the definition of malignant histiocytosis is discussed.

Modifications of collagens in the course of inflammatory tracheal stenoses.

A comparison was made between the biochemical and histological properties of collagens contained in samples of normal tracheas obtained at autopsy or of stenosed tracheas obtained during surgery. The amounts of total collagen solubilized by pepsin was increased seven times in the pathological samples, and the proportion of cartilage type II collagen decreased by about one half, being replaced by type I collagen, whose ratio was increased five times. Microscopic studies confirmed that cartilage underwent a degenerative process and was progressively infiltrated by fibrils of interstitial collagen.

[Metastatic cancers of the thyroid gland. Diagnostic difficulties]. / Cancers métastatiques de la glande thyroïde. Difficultés diagnostiques.

Metastatic carcinoma of the thyroid is uncommon in surgical pathology and may masquerade as primary thyroid cancer. We studied 6 cases of biopsied and/or surgically resected metastatic carcinoma of the thyroid and their corresponding primary carcinoma, with emphasis on the differential diagnosis. There were 4 men and 2 women patients aged 44 to 77. The primary carcinoma was a breast infiltrating duct carcinoma (3 cases), a colorectal adenocarcinoma (2 cases) and a bronchial oat-cell carcinoma (1 case). The interval between primary carcinoma and secondary thyroid carcinoma was 2 to 9 years in 4 cases; 2 other cases showed simultaneous occurrence. Five patients died with widespread metastases 1 to 14 months following the diagnosis of secondary carcinoma of the thyroid; 1 patient was alive after 24 months. The histological differentiation of secondary from primary thyroid cancer may be difficult in the following situations: clear-cell, Hürthle-cell and signet ring cell changes; positivity of mucins stains; production of melanin; epidermoid differentiation; very rare miscellaneous tumours ("columnar cell carcinoma" and primary thymoma of the thyroid). Immunoperoxidase methods and mucin histochemistry may help.

[Malignant histiocytofibroma of the heart simulating myxoma of the left atrium]. / Histiocytofibrome malin du coeur simulant un myxome de l'oreillette gauche.

The authors report a case of malignant fibrous histiocytoma of the left atrium which was excised but rapidly recurred in a 47-year-old woman. Clinical examination, echocardiography and the absence of biochemical abnormalities were in favour of the diagnosis of left atrial myxoma. This report illustrates the clinical similarity between myxoma and sarcoma of the left atrium. Very careful anatomopathological examination of multiple sections of the tumour are necessary to distinguish it from benign tumours, especially myxomas.

[Lymphocytic ascites revealing systemic mastocytosis]. / Ascite lymphocytaire révélatrice d'une mastocytose systémique.

Systemic mastocytosis is a chronic disease with proliferation of mastocytes in organs separate from skin. We report the case of a systemic mastocytosis revealed by a lymphocytic ascites in the absence of cutaneous involvement. The diagnosis was established by the ultrastructural examination of the bone marrow. Identification of few mastocytes in ascites suggested a mast cell infiltration of the peritoneum. A treatment by alpha-2b interferon was unsuccessful, and death rapidly occurred.

[Hemangioendothelioma of the right supra-clavicular region. Clinicopathologic study and management. Report of a case (author's transl)]. / Hémangioendothéliome du creux sus-claviculaire. Aspect diagnostique et thérapeutique. A propos d'une observation.

The authors present a case of hemangioendothelioma of the right supra-clavicular region in a 14-year-old boy. Interest of scanner in extension bilan and supraselective arteriography with tumor embolisation are stressed. Complete excision was possible and no sign of recurrence is noted 18 months later. Essential characteristics of a such tumor are reviewed.

[Malignant histiocytosis simulating histiocytosis with massive sinusal lymphadenopathy, on the first lymph node biopsy (author's transl)]. / Histiocytose maligne, simulant une histiocytose sinusale massive hémophagocytaire, sur une biopsie ganglionnaire initiale.

The case of a 36 year old man who presented prominent bilateral cervical lymphadenopathies is reported. The diagnosis of sinus histiocytosis with massive lymphadenopathy (Rosai and Dorfman, 1969) was retained on account of a massive hyperplasia of foamy histiocytes with PAS + inclusions, lipidic storage and hemocytophagy in the sinuses and cords of the lymph nodes. The patient died after 34 months evolution. At the autopsy an important proliferation by large atypical sometimes multinucleated cells in the lymph nodes, liver, bone and spleen was found, as observed in malignant histiocytosis. The ultrastructural study confirmed the histiocytic nature of the cells. The interest of immunohistochemical studies on paraffin embedded material with characterization of tumor histiocytes with lysozyme and alpha 1 antichymotrypsin is discussed. This report described an unusual form of malignant histiocytosis simulating on his early phase sinus histiocytosis with massive lymphadenopathy.

[Fatal cytomegalovirus pneumonia in a non-immunodeficient adult. Diagnostic contribution of in situ hybridization]. / Pneumopathie fatale à CMV chez un adulte non-immuno-déprimé. Apport de l'hybridation in situ au diagnostic.

A case of fatal cytomegalovirus pneumonia in a non-immunocompromised 65-year old man is reported. The patient presented with symptoms of a lower respiratory tract infection. The diagnosis of cytomegalovirus pneumonia was made after histopathological examination of the open lung biopsy. Confirmation of cytomegalovirus infection was made with in situ DNA Hybridization. The outcome was rapidly fatal. This case demonstrates the value of DNA probe analysis for diagnosis. This case is also unusual in that a non-immunocompromised adult had severe evolution of cytomegalovirus infection.

[Intramural pseudo-diverticulosis of the esophagus or cystic esophagitis? Study of an unusual surgical case]. / Pseudo-diverticulose intramurale de l'oesophage ou oesophagite kystique? Etude d'un cas original opéré.

The authors report an unusual case of oesophageal pseudo-diverticulosis. A 63-year-old male patient presented with dysphagia. A preoperative diagnosis of oesophageal intramural tumour was made on radiological and endoscopic abnormalities. The histopathological study of the involved oesophagus showed a pseudocystic dilatation of glandular ducts in the submucosa with a lymphocytic infiltrate. The authors review the relevant literature on oesophageal intramural pseudodiverticulosis and suggest a possible pathogenesis for this rare and benign entity.

[Labial embryonal rhabdomyosarcoma. Value of cell culture and electron microscopy, histogenesis]. / Rhabdomyosarcome embryonnaire labial. Apport de la culture cellulaire et de la microscopie électronique, histogenèse.

The authors report the case of a labial embryonal rhabdomyosarcoma of a baby. This appears to be an exceptional localization. The study of the first biopsy which was too superficial leads to the thought of a capillary angioma. At the age of 6 months the lesion is 35 mm in diameter, a lobulated formation, typically botryoid. The excision after a frozen section control was in healthy tissue. At the age of 10 months, there is a local relapse with a nodule of 18 mm with left submandibular lymph nodes. A second surgical operation allows the culture of the tumoral tissue. The conventional histopathological examinations shows the aspect of an embryonal rhabdomyosarcoma. On the ultrastructural examination one can visualize in some cells an intracytoplasmic filamentous material. The cellular proliferation in culture, after May Grunwald Giemsa coloration is monomorphous, spindle shaped and of fibroblastic aspect. The ultrastructural study of this cellular proliferation after trypsinization on the 7th day shows some cells including an intracytoplasmic filamentous material. On the data of the cellular culture, the ultrastructural studies and the review of the literature, the authors discuss the possibility of the relationship between the cells of embryonal rhabdomyosarcomas and the fibroblasts and myofibroblasts. Embryonal sarcoma seems to be a better denomination than embryonal rhabdomyosarcoma, as regards the histogenesis.

[Immunohistochemical study of plasmocytes and T-lymphocyte subpopulations in Hashimoto's thyroiditis]. / Etude immunohistochimique des plasmocytes et des sous-populations T lymphocytaires dans la thyroïdite de Hashimoto.

In Hashimoto's thyroiditis, there is a diffuse interfollicular infiltration of lymphocytes and plasmocytes and lymphoid collections with germinal centers. Eleven cases of Hashimoto's disease were studied with immunocytochemical methods for characterization of intracytoplasmic immunoglobulins (IgA, IgG, IgM, Kappa and lambda light chains). Most of the cells are plasmocytes stained positively for intracytoplasmic IgG; IgA positive cells were less frequent and IgM positive cells are rare. Kappa positive plasma cells are more numerous than lambda positive cells in the germinal centers and the interfollicular infiltration. By an indirect immunofluorescence technique in frozen tissue, we have studied with four monoclonal antibodies (OKT3, OKT4, OKT8, B1) the T cells subsets populations in two cases.

[Thymic carcinoid tumors. A clinico-anatomic study of 3 cases]. / Carcinoïdes du thymus. Etude anatomo-clinique de 3 cas.

The carcinoid tumour of the thymus was first detailed by Rosai in 1972. The authors describe three cases of this tumour with particular reference to their histogenesis. It appears to be a tumour predominantly affecting males with an often unfavourable, though slow, progression. Some pathological associations are frequent and characteristic. In one third of cases there is an associated endocrine neoplasia. As a rule the tumour is sited in the anterior mediastinum. The precise diagnosis rests on histochemical criteria (specific granulations). These carcinoids are tumours of the APUD system of endodermal origin. The treatment is surgical.

[Bronchial biopsy, curative treatment for cancer in situ?]. / Le prélèvement biopsique bronchique, traitement curatif des cancers in situ?

Bronchial carcinoma in situ is an intra-epithelial proliferation of tumour which does not cross the basement membrane and is asymptomatic. The evidence for this cancer often rests on a biopsy carried out on a bronchus which may show simple inflammation or may even be normal. We report a new observation on a bronchial carcinoma in situ which was completely ablated after a bronchial biopsy. However surgery remains the first form of treatment for bronchial cancer. If the patient is inoperable, endobroncho-cryotherapy, radiotherapy or phototherapy may be tried but tumour recurrence remains a possibility.

[A case of Carrington's chronic eosinophilic pneumonia associated with bronchocentric granulomatosis in an asthmatic patient]. / A propos d'un cas de pneumonie chronique à éosinophiles de Carrington associée à une granulomatose broncho-centrique chez une asthmatique.

A case of Carrington's chronic eosinophilic pneumonia associated with bronchocentric granulomatosis in a young asthmatic woman is reported. Among the numerous forms of "eosinophilic lung", the characteristic features of these two diseases in asthmatic patients are briefly described. Concerning the association, the authors have found that some authors suggest a common nosological framework with many transitional forms.