Biomedical subjects

B Gosselin

Publications and source records attributed to B Gosselin.

At least 109 records · Page 6Linked to original sources

PubMed1993

Role of early splenectomy in malignant lymphomas with prominent splenic involvement (primary lymphomas of the spleen). A study of 59 cases.

The outcomes were analyzed retrospectively of 59 cases of non-Hodgkin lymphoma (NHL) that included prominent splenic involvement (LPS). Forty-three patients had low-grade NHL, and 16 had intermediate or high-grade NHL. Forty of the 59 patients underwent splenectomy. Four patients died postoperatively before any treatment, and 10 others received no chemotherapy or radiation therapy. Twenty-nine splenectomized and 16 patients whose spleens were not removed received chemotherapy or radiation therapy. One or more cytopenias were present in 45 patients (77%). Five (18%) of the 28 patients who initially were cytopenic underwent splenectomies that did not correct their blood disorders. The median actuarial survival was 108 months in splenectomized patients and 24 months in those not treated surgically (P = 0.0001). For the 40 splenectomized patients, a normal postoperative platelet count, an initial hemoglobin level of 110 g/l or more, and a postoperative hemoglobin level 110 g/l or more were associated with prolonged survival. These results suggest that cytopenias are frequent in LPS and that their reversal is observed after early splenectomy in 82% of cases. The absence of cytopenia after early splenectomy is associated with prolonged survival.

Actuarial Analysis↗

PubMed1993

Long-term outcome of follicular low-grade lymphoma. A report of 91 patients.

We retrospectively analyzed overall survival and survival after progression in 91 patients with low-grade follicular lymphoma (LGFL). Histological subtype was B in 75 patients and C in 16 patients. Twelve patients with localized disease received involved-field radiotherapy; seven patients without bulky disease had no initial therapy. The remaining 72 patients received long-term chlorambucil (9 patients), MOPP or COPBleo (42 patients), or a CHOP-derived regimen (21 patients). Forty-two patients (46%) achieved a complete remission (CR) and 28 patients (31%) achieved a partial remission; 48 of these 70 patients relapsed or progressed. Nineteen of the other 21 patients with stable LGFL progressed. Two other patients failed to respond and rapidly died. Thirty-two of the 67 patients with progressive or relapsed LGFL have died. Median overall survival was 111 months. Age > or = 70 years, male sex, B symptoms, histological subtype follicular mixed-cell NHL, tumor size > or = 10 cm, number of extranodal sites of disease > or = 2, pleural effusion, and Ann Arbor stage III or IV were found to adversely influence overall survival. Failure-free survival < 24 months, failure to achieve a CR after the progression, initial histological subtype follicular mixed cell, initial Ann Arbor stage III or IV, and initial tumoral size > or = 10 cm were found to adversely influence survival after progression. Our results suggest that most prognostic factors for overall survival in LGFL are related to histological subtype or tumor burden. Some initial adverse prognostic factors for survival may be also associated with a poor survival after progression.

Adult↗

PubMed1993

Bronchial carcinoids.

Seventy-four bronchial carcinoids were observed over a period of 20 years, representing 69.7% of so-called "benign" tumors and 3.8% of all bronchial tumors resected during the same period of time. The tumors were centrally located in 59 cases and peripheral in 14 cases. From 54 biopsies, the preoperative diagnosis was accurate for 27, presumed for 15, doubtful for 15 and erroneous for 7 patients. Surgery was performed on 73 patients: 7 bronchotomies, 3 enucleations, 2 wedge resections, 5 segmentectomies, 35 lobectomies, 4 lobectomies with sleeve resections, 11 bilobectomies and 6 pneumonectomies. One patient died postoperatively. All the tumors were considered as carcinoids on initial microscopical examination. There were 4 cases of associated tumors. Six patients developed recurrence and 9 patients died from another cause. A pathology review changed the diagnosis into neuroendocrine carcinoma in 2 cases. Carcinoids should be considered and resected as carcinomas in the majority of cases, because of possible errors in diagnosis, of the effect of obstruction, of tumoral associations and of lymphatic involvement. Recurrences are possible.

Adolescent↗

PubMed1993

[Systemic form of sarcoid-like necrotizing granulomatosis with ocular, pulmonary and cerebral involvement].

Sarcoid-like necrotizing granulomatosis is an exceptional condition characterized by lesions of epithelioid granulomatosis and signs of vasculitis. It usually involves the lungs and has a favourable prognosis. We report the case of a young woman with a systemic form of the disease which affected not only the lung, but also the eye and the central nervous system. Under corticosteroid therapy the pulmonary lesions and the biological inflammatory syndrome disappeared, but the brain lesions followed a course of their own despite the addition to steroid treatment of an immunosuppressive therapy. This case highlights the superiority of MRI over CT of the brain in the diagnosis and monitoring of brain lesions: CT became normal after corticosteroid therapy was initiated, where as the neurological signs became worse and the brain lesions progressed on MR images.

Adult↗

PubMed1993

Computed tomography assessment of ground-glass opacity: semiology and significance.

Among the computed tomography (CT) signs of parenchymal lung disease, the ground-glass pattern is the one most difficult to diagnose and most influenced by CT technique. Ground-glass opacity may result from changes in the airspaces or interstitial tissues in acute or chronic infiltrative lung disease. It may also be seen as a consequence of increased capillary blood volume in redistribution of blood flow due to airway disease, emphysema, or pulmonary thromboembolism. Definition of this sign on high-resolution CT (HRCT) images, its various HRCT patterns, and potential pitfalls in its recognition are described with special attention to optimal HRCT technique.

Humans↗

PubMed1993

High incidence of lymphoid infiltration on labial salivary gland biopsy in non-Hodgkin's lymphomas: clinical implications.

Sjögren's syndrome (SS) is characterized by an increased risk of developing a non-Hodgkin's lymphoma (NHL). We performed labial salivary gland biopsy (LSGB) in 103 patients with untreated NHL, negative for human immunodeficiency virus. Median age was 58 years (range 21-79) and M/F 1.3. Using the Working Formulation, 37 patients had low-grade NHL and 66 had intermediate- or high-grade NHL. Dense lymphocytic infiltration (positive focus score 3 or 4) was found in 28 patients. 10 (35%) of these 28 patients fulfilled criteria for possible SS. 15/28 patients had an identical monotypic infiltrate on LSGB and NHL tissue (including two of the 10 patients with criteria for SS). The significance of the lymphoid infiltrate of LSGB was unknown in the five remaining patients with positive focus score. Significant correlations were found between positive focus score and presence of two or more extranodal sites of disease (P = 0.02), impaired performance status (P = 0.004), splenomegaly (P = 0.05), increased gammaglobulin level (P = 0.03), and beta 2 microglobulin (P = 0.004). Considering intermediate- or high-grade NHL, we found significant correlation between positive focus score and unfavourable prognosis according to the two Dana Farber Cancer Institute indexes (P < 0.04), to the LNH-84 index (P = 0.05), and to the international index (P = 0.003). In conclusion, systematic evaluation of LSGB in 103 patients with NHL found lymphoid infiltration in 28% of them, but possible SS could be considered in only 10%. This lymphoid infiltration, though not correlated with any particular histological subtypes, was associated with unfavourable clinical prognostic factors, especially in intermediate- or high-grade NHL.

Adult↗

PubMed1993

Segregation of eosinophil proteins in alveolar macrophage compartments in chronic eosinophilic pneumonia.

BACKGROUND: The objective was to characterise the process and consequences of eosinophil activation and lysis in patients with chronic eosinophilic pneumonia and to compare them with those in patients with eosinophil pulmonary infiltrates from other causes. METHODS: Cells from bronchoalveolar lavage fluid of four patients with chronic eosinophilic pneumonia and four patients with eosinophilic infiltrates associated with Sjögren's syndrome, drug hypersensitivity pneumonia, postradiotherapy fibrosis, and pulmonary disease associated with graft versus host disease were studied ultrastructurally and with immunogold labelled antibodies directed against eosinophil proteins: major basic protein, eosinophil cationic protein, and Charcot-Leyden crystal protein. The concentration of eosinophil cationic protein was also measured in bronchoalveolar fluid. RESULTS: In the four patients with chronic eosinophilic pneumonia, ultrastructural studies demonstrated numerous lysed eosinophils. Further, three released eosinophil proteins were detected in distinct cytoplasmic structures in alveolar macrophages. These features were not found in the four patients with eosinophilic pulmonary infiltrates from other causes. CONCLUSION: Eosinophils in chronic eosinophilic pneumonia show signs of activation with release of eosinophil proteins. The appearance of three of these eosinophil proteins in different macrophage compartments suggests that macrophage uptake, with or without intracellular transport of released eosinophil proteins, involves separate mechanisms. This interaction does not lead to macrophage lysis, however, and one or more of these eosinophil proteins might directly affect macrophage function.

Adult↗

PubMed1993

Lung parenchymal changes secondary to cigarette smoking: pathologic-CT correlations.

To determine the histopathologic basis for computed tomographic (CT) interpretation of smokers' lung and the accuracy of CT in the detection of alterations related to cigarette smoking, parenchymal lung lesions were studied from 41 heavy smokers who underwent thoracotomy for removal of a solitary pulmonary nodule. CT scanning of the resected lungs, corresponding exactly to the sections seen on preoperative CT scans, resulted in the following pathologic-CT correlations. Areas of ground-glass attenuation seen on preoperative CT scans (n = 11 [27%]) were related to three main histologic features: (a) accumulation of pigmented macrophages and mucus in the alveolar spaces, associated with mild interstitial inflammation and/or fibrosis (n = 7); (b) thickening of the alveolar walls with inflammatory cells with normal alveolar spaces (n = 3); and (c) presence of organizing alveolitis (n = 1). Parenchymal micronodules depicted presurgically (n = 4 [10%]) corresponded to bronchiolectases with peribronchiolar fibrosis (n = 4) associated with obliterative bronchiolitis in one patient. When emphysema was detected presurgically (n = 21 [51%]), it was always present at pathologic study to a higher extent than initially suspected.

Bronchitis↗

PubMed1993

Importance of ground-glass attenuation in chronic diffuse infiltrative lung disease: pathologic-CT correlation.

PURPOSE: To correlate areas of ground-glass attenuation at computed tomography (CT) with findings at open lung biopsy in chronic diffuse lung disease. MATERIALS AND METHODS: The cases of 26 patients were included on the basis of (a) extensive areas of ground-glass attenuation as the predominant (n = 17) or exclusive (n = 9) abnormality at CT in the absence of honeycombing and (b) histologic evaluation at open lung biopsy. Severity of ground-glass attenuation was scored in the lobe sampled at biopsy, with separate analysis of associated lung changes. RESULTS: Correlation of CT with histologic findings at the 37 biopsy sites demonstrated that ground-glass attenuation corresponded to inflammation in 24 (65%) cases and to fibrosis in 13 (54%) cases. Eleven of the 13 patients (85%) with fibrosis had traction bronchiectasis or bronchiolectasis. These findings were not present in any of the patients with inflammation. CONCLUSION: In patients with chronic diffuse infiltrative lung disease, areas of ground-glass attenuation not associated with traction bronchiectasis or bronchiolectasis are a reliable indicator of inflammation.

Biopsy↗

PubMed1993

Expression of human mucin genes in respiratory, digestive, and reproductive tracts ascertained by in situ hybridization.

In recent years considerable advances have been made in our knowledge of the peptide moiety of human mucins through cDNA cloning. In many diseases disorders in mucin biosynthesis are observed, which result either from changes in the synthesis of the carbohydrate side chains or from differences in the relative expression of the different apomucins, each of which may affect physical properties of the viscous gel. We describe in situ hybridization studies on healthy human mucosae with five different oligonucleotide probes corresponding to each of the human genes known to date that encode secreted mucins, i.e., MUC 2, 3, 4 (HGM nomenclature) and 5B, 5C (proposed name). These genes present a nucleic tandem repeat organization. The choice of oligonucleotide probes was made to amplify the signal by hybridization of many small probes on the same mRNA molecules. A characteristic pattern of mucin gene expression was observed for each mucosa.

Base Sequence↗

PubMed1993

[Flow cytometry and malignant pleural mesotheliomas. Value in the histologic and cytologic diagnosis].

To contribution the help of flow cytometry in the diagnosis of mesothelioma in pleural effusions, we studied the aneuploid frequency in paraffin-embedded pleural mesotheliomas. The low aneuploidy rate (31%) explains the moderate yield of mesothelioma diagnosis in pleural effusions. Because of the possibility of false aneuploidies, flow cytometry cannot replace of a cytologic or histopathologic evidence.

DNA, Neoplasm↗

PubMed1993

[Hepatic calcifications revealing epithelioid hemangioendothelioma].

This report concerns a case of hepatic epithelioid hemangioendothelioma presenting with liver enlargement, multiple hepatic calcifications on the plain abdominal film and bilateral interstitial pneumonia. Epithelioid hemangioendothelioma is an unusual soft tissue tumor of "intermediate malignancy" characterized by a multicentric involvement of the liver and originating from endothelial cells. Histopathologic diagnosis may be difficult because of possible confusion with sclerosing epithelial tumors.

Adult↗

PubMed1993

[Value of puncture-biopsy under computed tomography of adrenal masses associated with bronchial cancer].

In patients with a non small cell bronchogenic carcinoma, the detection on a CT scan of a uni or bilateral adrenal gland mass requires determination of its metastatic nature. CT guided needle biopsy (CTGB) is a minimally invasive method and allowed us to achieve this goal. From August 1986 to October 1992, 30 patients underwent such a biopsy. In 14 cases, a metastasis was diagnosed and in 13 cases the mass was benign. There were 3 false negative results. Two of these were rectified: one by a second CTGB and the other by adrenalectomy. Our results showed that CT scan was unable to discriminate metastasis from benign masses. Magnetic resonance imaging (MRI) was used for 11 patients and seemed to be a more accurate method: allowing detection of a pheochromocytoma and avoiding a CTGB which may have been dangerous, predicting the benign nature of some masses when they were iso-intense in relation to the liver on T2 weighted images. Thus, even with the contribution of MRI, in most cases of bronchogenic carcinomas coexisting with an adrenal gland mass, CTGB appeared essential to determine correct therapy: surgery or medical treatment.

Adenocarcinoma↗

PubMed1992

[Transplantation for primary hyperoxaluria. Role of oxalate crystal deposits in the occurrence of kidney failure].

We analyzed the records of 3 patients transplanted for end-stage renal failure due to primary hyperoxaluria and evaluated on repeat biopsies the role played by oxalate deposits in the constitution of renal failure after isolated kidney graft, or combined liver and kidney transplantation. Early failure of the renal graft is frequent and often interpreted as the consequence of recurrence because of the presence of oxalate deposits on the graft biopsy. In fact, the decrease in oxalate deposits observed in our 2 cases of combined liver and kidney transplantation despite the progressive renal failure, indicates that crystal deposition is not responsible for the renal lesions. However, we cannot exclude that the oxalate molecule toxicity plays a role in the constitution of the diffuse sclerosis which occurred in these two cases after a primary renal non function, aggravating a hemodynamic process by using cyclosporin. On the other hand, as observed in our isolated kidney graft, renal crystal deposition occurring before the onset of renal failure suggests the true mechanism explaining the slow recurrence of renal oxalosis.

Adult↗

PubMed1992

Immunopathological study of eosinophils in eosinophilic granuloma of bone: evidence for release of three cationic proteins and subsequent uptake in macrophages.

Eosinophils from two patients with eosinophilic granuloma of bone (EGB) were studied by combined immunohistochemical and immuno-ultrastructural methods with antibodies directed against three eosinophil granule proteins: major basic protein, eosinophil cationic protein, and eosinophil peroxidase. Immunohistostaining showed the presence and distribution of large numbers of eosinophils in the granuloma. Immuno-ultrastructural methods showed alterations of eosinophil fine structure associated with some steps in the release of granule proteins. No granule extrusion was seen, but rather cationic proteins diffused within cytoplasmic tubulo-vesicular structures. Furthermore, the three granule proteins were found within phagolysosomes of surrounding macrophages, suggesting an interaction between eosinophils and phagocytic cells at the destructive stage of EGB.

Adolescent↗

PubMed1992

Prognosis and treatment of lymphoblastic lymphoma in adults: a report on 80 patients.

PURPOSE: We analyzed prognostic factors in 80 adult patients with lymphoblastic lymphoma (LBL). PATIENTS AND METHODS: Twenty-one patients received six monthly courses of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and maintenance chemotherapy for 12 months. The LNH-84 protocol (30 patients) consisted of four courses of high-dose CHOP followed by consolidation for 4 months. Both FRALLE (22 patients) and LALA (seven patients) protocols were two intensive chemotherapy regimens for acute lymphoblastic leukemia (ALL) that included an induction with daunorubicin, vincristine, cyclophosphamide, prednisolone (and asparaginase for the FRALLE regimen), consolidation, and maintenance chemotherapy that lasted for 2 years. RESULTS: Sixty-six patients (82%) achieved a complete remission (CR). The CR duration rate and overall survival rate at 30 months were estimated to be 46% and 51%, respectively, with a median follow-up of 55 months. Only two of 37 relapses occurred after 26 months. Chemotherapy protocol did not influence CR rate, CR duration, and survival. A higher CR rate was associated with an age of less than 40 years, lactic dehydrogenase (LDH) level of less than two times the upper limits of normal, and no or one extranodal site of disease. Short survival was associated with a failure to achieve CR, age older than 40 years, B symptoms, LDH level more than two times the upper limits of normal, and hemoglobin level of less than 100 g/L. Bone marrow involvement had no prognostic value. We could not evaluate precisely the prognostic value of Ann Arbor stage because inclusion criteria differed among treatment groups. CONCLUSION: Our findings suggest that age and LDH are two important pretreatment prognostic factors for adult LBL, and that the optimal prognostic staging system remains a controversial issue.

Adolescent↗

PubMed1992

[Primary Aspergillus endocarditis. Apropos of a case and review of the international literature].

The authors report a case of primary aspergillus endocarditis with endophthalmitis and vertebral osteomyelitis. No underlying disease and no predisposing factors were found. Valve replacement plus combined antifungal chemotherapy proved to be effective as the patient is asymptomatic 18 months after the first symptoms. 48 cases of aspergillus endocarditis, without prior cardiac surgery have been reported in the literature. Aspergillus endocarditis was valvular or mural. Extracardiac dissemination was common but endophthalmitis and osteomyelitis were infrequent. In 11 cases, the diagnosis was made by histologic examination of embolectomy or ocular, skin biopsy tissue. All patients were febrile. Blood cultures showed no Aspergillus species. Clinical manifestations of endocarditis were described in less than fifty per cent of cases. Echocardiographic visualization of vegetations was obtained in 5 cases. Many patients experienced embolic phenomena. Mortality from Aspergillus endocarditis is extremely high (96%). Surgery is the main treatment, consisting of valve replacement. Antifungal chemotherapy should be combined. The proper duration and dosage and the combination of antifungal drugs have not been clearly defined.

Amphotericin B↗

PubMed1992

c-ets1 proto-oncogene is a transcription factor expressed in endothelial cells during tumor vascularization and other forms of angiogenesis in humans.

The c-ets1 proteins are transcriptional activators expressed within endothelial cells during blood vessel development in chick embryos. The authors show by in situ hybridization that c-ets1 is transcribed in the endothelia during angiogenesis in human embryos, in granulation tissue, and especially during tumor vascularization. c-ets1 mRNAs were also detected in the fibrocytes of tumor stroma and in the spindle cells of Kaposi's sarcomas, regarded as cells of endothelial origin. It has been shown that the c-ets proteins activate transcription through a PEA3 motif that plays a role in the stimulation of transcription of urokinase-type plasminogen-activator (u-PA), stromelysin and collagenase genes. The authors demonstrate in vitro that the angiogenic factor TNF alpha increases transiently the amount of both c-ets1 and u-PA mRNA in confluent human umbilical vein endothelial cells. Therefore, the authors suggest that the c-ets1 proteins might regulate the transcription of the genes coding for matrix-degrading proteases, which are necessary for both angiogenesis and tumor invasion.

Adenocarcinoma↗