Medullary thyroid carcinoma: search for histological predictors of survival (109 proband cases analysis).

A group of 13 pathologists belonging to the French Calcitonin Tumor Study Group (GETC: Groupe d'Etude des Tumeurs à Calcitonine) examined the histological slides and medical records of 109 proband cases of medullary thyroid carcinoma (MTC) diagnosed on clinical features. The cases belonged to the various forms of the disease (80 sporadic and 29 familial MTC). The aim of the study was to detect histological predictors for survival by comparing morphological data from patients killed by the disease versus the others. Twenty-seven histological parameters were considered, including cellular heterogeneity, shape of the cells, and cytoplasmic characteristics. Other parameters such as sex, age, and phenotype of the disease were also studied. First, predictive parameters of interest on survival function were selected by univariate analysis (Mantel-Cox test). Then, the extracted parameters were tested in a multifactorial analysis using the Cox's forward stepping proportional hazard model. Five parameters were significantly associated with a lower survival function: presence of necrosis in the tumor (P = .001), squamous pattern (P = .002), age over 45 years (P = .004), presence of oxyphil cells in the tumor and absence of cells with intermediate cytoplasm (P = .025), less than 50% of calcitonin immunoreactive cells in the tumor (P = .04).

[Fine needle aspiration of the thyroid]. / La cytoponction thyroïdienne à l'aiguille fine.

This article precises the technical conditions of fine-needle aspiration, elements of microscopical analyses which establish the diagnostic, complementary technics, specially immunocytochemistry that could enhance the performance. Limits and worrisome histologic changes following fine needle aspiration are also discussed. Fine needle aspiration results are discussed. The text is fully illustrated.

[Reconstruction of the lateral tibial plateau using a vascular pedicled patellar transplant]. / Wiederherstellung des lateralen Tibiaplateaus durch gefässgestieltes Patellatransplantat.

A case of surgical reconstruction in posttraumatic necrosis of the lateral tibial plateau after impression fracture is presented. Joint reconstruction was performed by transposition of the distally pedicled lateral third of the patella combined with a cancellous bone graft. The surgical procedure is described and the indications for it are discussed.

[Histopathology of the liver and kidney during malaria: relation to malaria-induced dyslipoproteinemia]. / Histopathologie du foie et du rein au cours du paludisme: rapports avec la dyslipoprotéinémie palustre.

A kinetic study concerning histologic and cytologic alterations during Plasmodium chabaudi infection of Swiss mice has been carried out. In liver, a reversible focal and non ischemic necrosis and a vascular congestion were observed together with an accumulation of malarial pigment. The endoplasmic reticulum cisternae and Golgi saccules of hepatocytes were highly distended. Hepatocyte microvilli in biliary canaliculi and in Disse' spaces were markedly less developed and less numerous than in normal liver. Intracytoplasmic lipid globules were found in large amount in hepatocytes before the peak of parasitaemia. Their number and size gradually diminished thereafter. Hepatocytic mitochondria showed important unspecific modifications probably in relation, at last partly, to the tissue anoxia. Some hepatocytic changes (intracytoplasmic lipid globules, enlargement of endoplasmic reticulum cisternae and Golgi saccules) were consistent with an increased synthesis of lipoproteins (VLDL). The kidney showed only minor histological and ultrastructural changes. However haemosiderin was observed in proximal tubules and in their bordering cells. The deposit of immune complex reported previously do not appear associated with tissular or cellular important alterations.

Statistical analysis of histomorphological findings in medullary thyroid carcinoma: distinction between the different familial forms of the disease. G.E.T.C. Groupe d'Etude des Tumeurs a Calcitonine.

A multifactorial analysis of morphological findings was performed on 153 cases of medullary thyroid carcinoma (MTC). The aim of the study was to utilize histological criteria to discriminate between MTC associated with multiple endocrine neoplasia type 2A (MEN 2A) and that associated with the inherited MTC only syndrome. The presence of fusiform cells associated with several other markers seemed to be more predictive of MEN 2A. A comparison of inherited MTC only and sporadic MTC only showed fusiform cells to be significantly less common in inherited MTC only. These results suggest that the inherited MTC only syndrome is a distinct clinical and morphological entity. Further investigations are needed to confirm the findings and understand its implications.