Vascular damage after acute local irradiation: a light and electron microscope study.
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Biomedical subjects
Publications and source records attributed to C Brocheriou.
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Granulomatous lesions of the cranio-facial area are frequent and various in their nature: lymphohistiocytic with or without eosinophils, tuberculoid-like with epithelioid and giant cells, or sometimes made essentially of giant cells. Their etiology can be known or easy to find: foreign body granuloma, sarcoidosis, leprosy, rhinoscleroma, fungal diseases especially zygomycosis and rhinosporidiosis, parasitic diseases. The lethal midline granuloma is a clinical entity characterized by its necrotic and relentlessly progressive destructive presentation. After elimination of a malignant process, especially lymphoid, and of a Wegener's granulomatosis the diagnosis will be "idiopathic midline non-healing granuloma". Some of them will stay located at the facial area; others will disseminate as a malignant disease. Central giant cell granuloma and histiocytosis X, especially eosinophilic granuloma, are two other varieties of granuloma, different of the former granulomatous infiltrates by their clinical presentation and their evolution.
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Among a group of 863 patients with epithelial tumors of the salivary glands, including 470 with pleomorphic adenomas, the latter were associated with carcinomas in 20 cases and of these two were adenoid cystic carcinoma. In both cases these were isolated parotid tumors, lacking functional symptomatology and failing to recur 2 and 4 years respectively after parotidectomy. Diagnosis was mainly by histology and was based on the finding of a co-existing pleomorphic adenoma and an authentic adenoid cystic carcinoma, not to be confused with the benign pseudo-cylindromatous appearance sometimes detected in simple pleomorphic adenomas. This association of adenoid cystic carcinoma and pleomorphic adenoma increases the risk of recurrence and of metastases--long-term follow up is necessary. Prognosis is dependent mainly on the quality of the initial surgical excision.
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Pigmented lesions of the oral cavity are of multiple origin. They can be subdivided as follows: non tumoral pigmentations, non melanin pigmented tumors or tumor-like lesions, benign melanin pigmented tumors and malignant melanomas. Among non tumoral pigmented lesions, some of them show melanin deposits: they can be associated with a systemic disease (Peutz Jeghers syndrome, Addison's disease) or have a medicamentous origin, or belong to a lichen migricans. Non tumoral and non melanin pigmentations are principally due to a heavy metal accumulation or an accidental tatoo arising after tooth treatment. Peripheral giant cell granuloma, so-called giant cell epulis is the major non pigmented non melanin pseudotumoral lesion; pigmentation is due to hemosiderin deposits. In the oral cavity nevi are principally of the intramucosal type. Blue nevus, the second type in frequency, is usually located on the hard palate. Primary malignant melanomas are rare in the oral cavity, but it is--because its very bad prognosis--the most important lesion. In order to improve the survival it is necessary to do the diagnosis as early as possible.
Our present results were obtained in a histological and histoenzymological study done with an experimental porcine model of high dose local irradiation. This model was chosen to simulate accidents which occurred among humans. It enabled the determination of several post-irradiation phases. After an initial phase, with superficial lesions, ischemic necrosis occurred three weeks after irradiation. After two months, expanding necrosis became obvious in the muscular region preceded by an initial spread of vascular lesions. Histo-enzymological studies of the muscular tissue show metabolic alterations which precede histological modifications. Finally, sclerosis observed was characterized by its mutilating pseudo-sarcomatous aspect.
The authors report four cases of papillary intravascular haemangioendothelioma of P. Masson located on the mucosa of the cheek, lip or tongue. They always presented as a painless submucosal blueish nodule, more or less elevated and firm, appearing as a thrombosed angioma. As a rule, the size was less than one centimeter. Pathological examination shows an angiomatous papillary neoformation, enclosed within a swollen veinous cavity. Diagnosis is easy on an operative specimen. However, on a small biopsy specimen, a capillary angioma, or a malignant haemangioendothelioma may be more difficult to eliminate. Surgical removal, even partial, will allow complete healing.
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"Sea-blue" with prominent blue granules on Giemsa staining have been described in many diseases. The authors report three cases of storage diseases, in which these particular cells have been found. The significance and pathogenesis of "sea-blue" histiocytes are discussed.
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This article describes four cases of non-Hodgkin's lymphomas occurring after successful treatment of Hodgkin's disease (HD). The clinical symptoms consisted of digestive disorders, and the histology confirmed an intestinal involvement in these four patients. In all cases patients had diffuse large cell types (intermediate or high grade). The respective role of HD treatment (combination chemotherapy in 3 of 4 patients with irradiation in 3 of 4 patients) and of other pathogenic hypotheses, are discussed.
Mucocutaneous reactions to graft versus host disease may be acute (maculopapular rash, scarlatiniform rash, epidermal necrosis), related to T lymphocyte aggression to basal layer cells, or chronic (lichenoid, or even poikilodermic and sclerous lesions) when a complex mechanism is involved. The syndrome sicca is a major manifestation of graft versus host disease of a chronic type, histology showing moderate lymphocyte infiltration and then marked fibrosis.
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A study of the effects of the CO2 laser on bone was undertaken using human mandibles obtained from cadavers. Different series of shots were used, varying the power and duration of the shots, as well as the latent period between two impacts with intermittent shooting. For a given impact duration, the depth of penetration increased in proportion to power up to 25 watts. Beyond, penetration was less deep but more extensive. For a given intensity, the duration of the shot did not result in any variation in penetration. These findings and their possible clinical implications are discussed.
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