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Biomedical subjects

B Cochand-Priollet

Publications and source records attributed to B Cochand-Priollet.

69 records · Page 4Linked to original sources

[Multiple primary intraductal tumors of Wirsung's duct: demonstration of a relation between benign and malignant tumors].

A case of multiple villous and, more rarely, tubulovillous adenomas of the main pancreatic duct, associated with a diffuse infiltrating adenocarcinoma of the pancreas in which evidence for a link between these lesions is supported by histopathologic features, is reported in a 53 year old patient. Clinical presentation included abdominal pain, weight loss and chronic diarrhea with steatorrhea related to pancreatic insufficiency. Retrograde endoscopic pancreatography showed a complete stenosis of the main pancreatic duct located 3 mm beyond the ampulla of Vater. CT scan showed an heterogeneous cephalic pancreatic tumor with extensive enlargement of the main pancreatic duct. After total pancreatectomy, recovery was maintained (follow-up 18 months). By analogy to colorectal tumors, a new pathologic classification of these rare neoplasms may be proposed.

Adenocarcinoma↗

Retroperitoneal lymph node aspiration biopsy in staging of pelvic cancer: a cytological study of 228 consecutive cases.

Knowledge of the status of the pelvic lymph nodes is important for accurate staging and adequate treatment of patients with genitourinary tract cancer (bladder and prostatic carcinoma, testicular tumors, and uterine carcinoma). A total of 228 consecutive patients underwent preoperative evaluation of the lymph node status by lymphangiography combined with fine-needle aspiration biopsy. A lymphadenectomy was performed in 94 patients. The overall diagnostic accuracy was 93%. There were 5% false-negative results and no false-positive diagnoses. Fine-needle aspiration biopsy is an inexpensive method with which to detect the presence of metastatic lymph nodes visualized by bipedal lymphangiography. It is also a safe and well-tolerated method, with a low morbidity and no mortality. The various cytological features are described as are some possible pitfalls.

Adenocarcinoma↗

Neuron-specific enolase and malignant lymphomas (23 cases).

The immunoreactivity of polyclonal antiserum to neuron-specific enolase (NSE) has been investigated. Twenty-three cases of malignant lymphoma (ML) were studied and compared with previously published reports. In our study 11 out of 23 cases showed strong or weak NSE positivity; any type of ML could be positive or negative even among B or T cell ML. This study indicated that polyclonal NSE is not a specific marker; it might be an inconstant marker of ML with no apparent correlation between reactivity and morphology or phenotype.

Antibodies, Monoclonal↗

[Value of cytopuncture associated with microbiopsy in solid masses in the pancreas. Preliminary study].

Efficacy of fine needle puncture and microbiopsy technics was compared in 19 patients with a solid pancreatic mass. Results showed sensitivity and global accuracy of 71 and 72% respectively for cytology, 92 and 82% for microbiopsy and 100 and 94% for their combined use. Global accuracy and negative predictive values reached 100% when repeat samples were collected because of insufficient material. No false positives were noted and no complications in this preliminary series.

Adenocarcinoma↗

Occurrence of a new microsporidan: Enterocytozoon bieneusi n.g., n. sp., in the enterocytes of a human patient with AIDS.

A new microsporidium is reported infesting the enterocytes of a Haitian patients with AIDS. The stages observed were diplokaryotic cells, sporogonial plasmodia, unikaryotic sporoblasts, and spores. Neither a sporophorous vesicle (pansporoblastic membrane) nor parasitophorous vacuole were differentiated around the developmental stages, which were in direct contact with the host cell cytoplasm. The polar tube (5-6 coils) was differentiated before fission of the sporogonial plasmodium. The mature spores measured 1.5 micron X 0.5 micron. The spore wall was very thin as the endospore was absent or poorly differentiated. The organism is named Enterocytozoon bieneusi n. g., n. sp. and is assigned to the suborder Apansporoblastina.

Acquired Immunodeficiency Syndrome↗

Diarrhoea and malabsorption in acquired immune deficiency syndrome: a study of four cases with special emphasis on opportunistic protozoan infestations.

Chronic diarrhoea is frequent in acquired immune deficiency syndrome (AIDS) but has been poorly investigated so far. We report four patients with AIDS in whom diarrhoea and malabsorption were outstanding features, and who underwent extensive digestive investigations. Diarrhoea was a presenting symptom in all subjects and was of secretory type in three of them. D-xylose and vitamin B12 were malabsorbed in all cases; steatorrhea was found in the two patients who could ingest significant amounts of fat. Faecal alpha 1-antitrypsin clearance was increased in all subjects. Search for digestive pathogens showed unusual protozoans in all patients: in case 1, optical and electron microscopy revealed the presence in the cytoplasm of villous enterocytes of Microsporidia protozoans still unreported in AIDS. Stool and jejunal fluid examination showed Isospora belli in case 2 and Cryptosporidium in cases 3 and 4. On histological and ultrastructural study the former was localised in the cytoplasm of a few enterocytes and the latter was scattered throughout the villus and crypt brush border. Otherwise small intestinal histology only showed minor non-specific changes and the enterocytes were ultrastructurally normal. In patient 3 the slow marker intestinal perfusion technique showed a profuse fluid secretion in the duodenum and proximal jejunum. All patients needed prolonged total parenteral nutrition. Cryptosporidium and Microsporidia could not be eradicated despite multiple drug trials. Isospora belli was transiently cured by pyrimethamine-sulphadiazine. Only patient 2 is presently at home, and patients 1, 3, and 4 died after two, six, and nine months of total parenteral nutrition, respectively.

Acquired Immunodeficiency Syndrome↗

[Percutaneous fine needle cytopuncture of lymph nodes opacified by lymphography, in urogenital pathology. Apropos of 174 cases].

Percutaneous fine needle puncture of lymph nodes after lymphography with contrast has been performed in 174 patients with urogenital tumors (bladder: 108, prostate: 41, testes: 25). Conducted under direct television screen control the procedure is simple to perform and provokes little discomfort for the patient, since it is painless and relatively non-traumatic. Needle puncture is a reliable technique resulting in no false positives and very few false negatives when carried out using the previously described technique (routine sampling and technical success). Combining lymphography with needle puncture is of undoubted value for detecting extension of tumor and improving choice of therapy.

Biopsy, Needle↗

[Ruptured angular pregnancy in the 16th week. Apropos of a case].

Angular pregnancies which result from implantation of the fertilised oocyte in the mucosa of a uterine horn are very rare. They are usually demonstrated by a picture of rupture which is associated with severe abdominal pain, the syndrome of internal haemorrhage, often a state of shock and all occurring usually between the 6th and the 12th week of pregnancy. Although many authors have shown that there is congenital abnormality of the uterus in these cases this does not always happen and the aetiology of "idiopathic angular pregnancies" is ill understood. The treatment is carried out according to the clinical state: endometrial curettage under laparoscopic control, removal of the uterine horn together with the tube on the same side or even hysterectomy.

Adult↗

Cell preparation methods and criteria for sample adequacy. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

ISSUES: Cell Preparation Methods Standardized fixation and optimal staining Sampling of cervix, sampling error, homogenization of sample, subsampling Assessment of liquid-based preparations: efficacy and economic impact Training and transitional procedures before full implementation of new technologies Criteria for Sample Adequacy Clinician responsibility for collecting and providing representative sample to laboratory Collection instruments, number of slides Cellular content of samples: evidence of transformation zone (TZ) sampling, number of squamous cells present, obscuring factors Screening issues CONSENSUS POSITION The conventional cervical smear remains the standard method of cervical cancer screening but has limitations in individual test sensitivity and specificity. Sample takers should: (1) receive appropriate training in sample collection, (2) be held responsible for providing the laboratory with appropriate samples, and (3) have their performance monitored. The instruments used for sampling should collect cells from both the ectocervix and endocervix; optimally, TZ sampling, represented by the presence of endocervical or squamous metaplastic cells, should be identifiable in samples other than atrophic specimens. The adequacy of a specimen (as judged microscopically) does not guarantee that it is representative of the cervix. Each cytology report should include a comment on cellular content/adequacy of the specimen. Liquid-based preparations may overcome many of the inherent problems with the conventional cervical smear. ONGOING ISSUES: We need further data on the cost-effectiveness of making two slides from cervical specimens and/or using two samplers rather than a single one. Do we have enough information to make recommendations as to the appropriate type of sampler to be used in particular situations, such as routine screening? What is the best method of screening for/detecting endocervical glandular neoplasia? How are such terms as unsatisfactory and inadequate defined in cervical cytology classifications other than the Bethesda System? What number and types of epithelial cells should be present (visualized) in a cervical smear or liquid-based preparation for it to be considered adequate? Do we need to have evidence of TZ sampling in specimens taken during the follow-up period after treatment of squamous intraepithelial lesion or after detection of endocervical glandular neoplasia? What criteria for obscuring factors, such as blood and inflammation, should be used in assessing adequacy? Cost-benefit analyses of utilizing liquid-based preparations are needed. Should we inform women about the technical details of the test methods available or chosen by the laboratory? Are women in a position to decide which method is the most appropriate to assess their cervical scrape sample? We need to obtain more information about the properties of proprietary liquid fixative/transport media with respect to inactivation of viral pathogens, tuberculosis and other bacterial pathogens and suitability for immunobiologic and molecular tests, etc. We need to obtain more information on the use of stoichiometric stains and the limitations of Papanicolaou stain for image analysis systems. The use of liquid-based preparations for nongynecologic cytopathology and ancillary tests must be considered, including criteria for adequacy. We need to obtain more information on the time required for and best methods of training experienced cytotechnologists to become competent at assessing liquid-based cervical preparations.

Cell Biology↗

Quality assurance/control issues. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial.

ISSUES: General definitions of quality assurance and quality control (QA/C) have existed in many forms for decades, and a new discipline guides their application to diverse industrial and recently medical processes without much fanfare. However, in the field of cervical cytology screening, the range of QA/C options has recently broadened and become controversial. With the advent of new systems of terminology, larger-scale laboratories and new technologies--plus strong governmental and legal pressures in some nations--the range of extremely difficult and sometimes expensive QA/C choices our community faces is greater than ever. CONSENSUS POSITION: At our conference, the basic definitions of QA/C posed little difficulty. Presentation of the range of methods in use today and of those based on new technologies where use is proposed or has just begun also was achieved with little or no dispute. However, there was lack of consensus on exactly how QA/C methods are to be assessed. Indeed, there was little consistency in the use of different outcome measures with which we can judge success or failure of specific QA/C options. In addition, the tension between pressure to adopt sometimes uncertain or expensive method enhancements and pressure to maintain affordability and the widest possible access for populations that most need cervical cytology screening is greater than ever. ONGOING ISSUES: More data are required that would enable assessment of QA/C options with the clearest possible understanding of cost/benefits and current or new assumptions of risk. Other task forces, such as medicolegal, cost/benefit and those devoted to new technologies, are our essential partners in meeting the challenges described above.

Centers for Medicare and Medicaid Services, U.S.↗

Apoptosis and cytologic differentiation in hepatocellular carcinoma on fine needle aspiration samples.

OBJECTIVE: To evaluate possible alterations of the mechanisms leading to apoptosis in hepatocellular carcinoma by studying bcl-2 expression on fine needle aspiration biopsy (FNAB) samples using immunocytochemistry. STUDY DESIGN: The study was performed on a series of 84 hepatocarcinomas aspirated under ultrasound guidance. A Papanicolaou-stained smear for each case was destained and restained for bcl-2 by using the immunoperoxidase technique. bcl-2 Expression was then correlated with cytologic grading and the size of the tumor. RESULTS: In 16 cases (19%), bcl-2 immunostaining gave a specific cytoplasmic signal. Fourteen of these positive cases were well differentiated, and two were pleomorphic tumors. Six positive cases were smaller than 5 cm, 3 were larger than 5 cm, and 7 were diffuse. CONCLUSION: A significant percentage of hepatocellular carcinomas produce and accumulate bcl-2 protein in cell cytoplasm. bcl-2 Expression can be detected on destained cytologic smears. bcl-2 Expression seems to correlate with the cytologic degree of differentiation but not with the size of the tumor.

Apoptosis↗

Altered gap and tight junctions in human thyroid oncocytic tumors: a study of 8 cases by freeze-fracture.

Human oncocytic tumors of the thyroid gland may be either adenomas or carcinomas. The morphology and the ultrastructure of these oncocytes are well-known. Numerous studies have demonstrated the role of gap and tight junctions in experimental and human carcinogenesis; however, the junctional complexes of the oncocytic tumors have never been studied. The aim of this study is to analyze gap and tight junctions in the oncocytic tumors of the thyroid. Because they are morphologically similar, whether benign or malignant, they offer an attractive model for studying the junctional complexes in both benign and malignant lesions. Eight oncocytic human thyroid tumors were collected and studied by freeze-fracture. Four of these cases were benign and four were malignant. Four cases of normal gland were also studied to represent the control group. Normal tight and gap junctions were described for the control group. No gap junctions could be found for the oncocytic tumors. Furthermore, alterations of the tight junctions were described; especially focal tights in the oncocytic adenomas and well organized and labyrinthic tight junctions in the oncocytic carcinomas. The lack of gap junction in the benign as well as in the malignant oncocytomas may suggest that the absence of gap junction is not sufficient for malignancy. The alterations of the tight junctions found in the oncocytic tumors of the thyroid are similar to those observed in poorly differentiated tissues or tumors, and may suggest a cellular regression rather than a tumorogenic factor.

Adenoma, Oxyphilic↗

Comparison of cytologic examination of smears and histologic examination of tissue cores obtained by fine needle aspiration biopsy of the liver.

Biopsies of 30 consecutive suspected liver cancers were performed with 19-gauge fine needles having circumferentially bevelled tips that produced tiny tissue cores suitable for histologic study. The histologic results were compared with the cytologic results on aspirates obtained at the same time with 22-gauge Chiba needles. While cytologic examination of the aspiration smears produced better results than did histologic study of the tiny tissue cores, an improved overall accuracy of 86% was achieved with the combined cytologic and histologic results. The FNA core biopsy technique did not increase the complication rate.

Biopsy, Needle↗

[Lymphography and fine needle puncture biopsy in the evaluation of lymph node involvement. Apropos of 207 cases].

Percutaneous fine needle puncture biopsy was performed on lymph nodes taking up contrast during lymphography in 207 patients with various disorders: urogenital (174 cases), gynecologic (13 cases), hematologic (17), others (3). At the present time, in fact, and simultaneously with the development of physical methods of diagnostic exploration (ultrasonography, computed tomography) needle puncture biopsy has become of increasing importance to confirm a suspected diagnosis. Needle puncture biopsy under television control is a simple, painless and practically nontraumatic procedure. When performed under precise conditions and a strict methodology (routine sampling as a function of the primary glandular chains), it establishes the correct diagnosis in a large number of lymphographies, enabling a rapid and more precise evaluation of the degree of extension and thus a better therapeutic choice.

Adult↗