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Biomedical subjects

C Rigaud

Publications and source records attributed to C Rigaud.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Papillary carcinoma of the thyroid: development of the histological criteria for diagnosis. Study of 29 cases and review of the literature].

Papillary carcinoma (PAP) is the most frequent malignant tumour of the thyroid. PAP and follicular carcinoma of the thyroid are two biologically different tumours, without any intermediate or mixed form. Therefore the differentiation between PAP and follicular carcinoma is essential. The histological diagnosis of PAP is based upon several criteria, the most important being the papillae, the "ground glass" nuclei, and the psammoma bodies. The value of the "ground glass" nuclei in the diagnosis of PAP has been particularly emphasized in the last 10 years. The need to take into account all the diagnostic histological criteria of PAP is necessary in the definition of the different variants of PAP, particularly its follicular variant. We report 28 cases of PAP and one case of insular carcinoma, the latter probably originating from a PAP. "Ground glass" nuclei often associated with "grooved nuclei", were identified in the paraffin sections of 7 PAP. One case was classified as a follicular variant of PAP. Psammoma-bodies were seen in 6 PAP. Eleven PAP were less than 1 cm in diameter (microPAP). One microPAP presented with important lymph node metastases and blood vessels' involvement; 2 others microPAP arose in a vesicular adenoma. Six PAP were entirely encapsulated, without any lymph node metastasis or vessel invasion. Six PAP presented with lymph node metastases associated with lymphatic and/or blood vessels invasion. Lymphatic and blood vessel invasion was seen more often in association with PAP extending to the thyroid capsule. The histological classification and prognostic criteria are discussed and compared with those previously described in the literature.

Adenocarcinoma↗
PubMed1987

"Mucin secreting" and "mucinous" primary thyroid carcinomas: pitfalls in mucin histochemistry applied to thyroid tumours.

Forty primary carcinomas of the thyroid of different histological types were reviewed and studied histochemically, with the aim of identifying and assessing "mucin secretion". The patterns of extracellular "pure alcianophilia" and "mixed alcianophilia" were noted in 7.5% and about 50% of these tumours, respectively. A critical review of the pitfalls in methods and interpretation of mucin histochemistry--as performed in previously reported cases of "mucin secreting" or "mucinous" primary thyroid tumours--is presented. The apparent "mucin secretion" described in these unusual neoplasms could be due to histochemical staining of carbohydrate components or breakdown products of thyroglobulin and colloid.

Alcian Blue↗
PubMed1987

[Metastatic cancers of the thyroid gland. Diagnostic difficulties].

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.

Adenocarcinoma↗
PubMed1986

Interactions of oestradiol benzoate and promegestone upon basal and TRH-induced prolactin secretion in postmenopausal women.

The interactions of ovarian steroids with PRL secretion in women are still controversial. Ten healthy postmenopausal women, on no medication, received during the first period of 2 months later in a cross-over design study, i.m. injections of 0.625 mg of oestradiol benzoate (EB) alone for 10 d or in combination with 750 micrograms/d of a pure progestin promegestone for 10 d. A TRH (200 micrograms i.v.) stimulation test was performed before the start and at the completion of each treatment period. Basal plasma gonadotrophins, PRL and oestradiol were measured every day by radioimmunoassay. The EB-induced rise in oestradiol levels was similar during the two periods. In response to EB treatment serum PRL levels increased from 6.1 +/- 0.9 ng/ml to 22.9 +/- 3.4 ng/ml. With the addition of promegestone, the increase in PRL, from 6.7 +/- 1.3 ng/ml to 13.8 +/- 2.5 ng/ml, was significantly diminished (P less than 0.001). The PRL release induced by TRH was significantly greater with EB treatment than was the response with the combined treatment (P less than 0.05, Wilcoxon test to compare the areas under the curves). These data suggest that in postmenopausal women oestrogens act as stimulators of PRL release and promegestone is able to partially counteract the stimulatory effect of oestradiol benzoate upon basal and TRH-stimulated PRL secretion.

Drug Interactions↗
PubMed1985

Steroid therapy for male infertility associated with antisperm antibodies. Results of a small randomized clinical trial.

Ten infertile men with significant titres of antisperm antibodies were entered into a randomized double-blind study to test the efficacy of corticosteroid therapy compared to a placebo. Prednisolone was given orally at a dose of 1 mg/kg/day for 9 days repeated over 3 cycles (their wives' menstrual cycles). This treatment had no significant effect, when compared to placebo, on fertility, serum antibody levels or semen characteristics. A slight decrease in the titre of seminal antibodies was, however, observed in patients receiving prednisolone. In individuals, there were important fluctuations in antibody levels which were independent of drug administration.

Adult↗
PubMed1985

Mucin producing microfollicular adenoma of the thyroid.

An unusual case of a mucin secreting benign microfollicular adenoma of the thyroid in a 30 year old euthyroid woman is reported. Histologically, the lesion was characterised by follicular cells with the appearance of signet ring cells. Histochemistry showed the mucin content of these cells to consist uniformly of sulphated acid mucins; positive thyroglobulin immunostaining was also shown. The published work on primary mucin secreting tumours of the thyroid gland is reviewed. Dual differentiation is thought to be responsible for combined mucin secretion and hormone production in this type of neoplasm.

Adenoma↗
PubMed1985

[Malignant lymphomas (primary and secondary) of the thyroid. Description of 9 case reports and review of the literature].

Malignant lymphomas of the thyroid are rare and represent approximately 0.3 to 8.9% of thyroid malignant neoplasms. We report 9 new cases; their clinical and histopathological features are discussed and compared with those of previously published series. Malignant lymphomas of the thyroid raise a number of issues: primary or secondary origin, histological typing (50% of cases are high grade lymphomas), differential diagnosis with either Hashimoto's chronic thyroiditis (often associated with thyroid lymphomas) or genuine anaplastic carcinoma of the thyroid. Routine histological study can be complemented by immunohistochemistry.

Aged↗
PubMed1984

Androgen metabolism in hirsute patients treated with cyproterone acetate.

Cyproterone acetate (CPA) in association with percutaneously administered estradiol has been used for the treatment of 150 hirsute patients for periods ranging from 6 months to 3 years. A spectacular clinical improvement ensued. Plasma testosterone (T) and androstenedione (A) fell from 69.0 +/- 24 to 33.0 +/- 8 and 210 +/- 103 to 119 +/- 25 ng/dl (mean +/- SD) respectively after 3 months of treatment and remained low thereafter. In contrast, T glucuronide (TG) and 3 alpha-androstanediol (Adiol) remained high during the whole course of treatment: 37 +/- 9 and 115 +/- 43 micrograms/24 h respectively. In vitro T 5 alpha-reductase activity (5 alpha-R) in pubic skin decreased from 147 +/- 34 to 79 +/- 17 fmol/mg skin after 1 year of treatment. To elucidate the discrepancy between plasma and urinary androgens levels, T production rate (PR) and metabolic clearance rate (MCR) were measured with the constant infusion technique in 7 patients before and after 6 months of treatment. PR decreased from 988 +/- 205 to 380 +/- 140 micrograms/24 h (mean +/- SD). In contrast MCRT increased from 1275 +/- 200 to 1632 +/- 360 1/24 h; this increase in MCRT explains the striking plasma T concentration fall and the high TG and Adiol excretion relative to the decrease in PR. Antipyrine clearance rate (n = 8) increased from 36.3 +/- 5.2 to 51.5 +/- 7.4 ml/min whereas 6 beta hydroxycortisol remained unchanged. In conclusion, CPA acts through several mechanisms: (1) it lowers the androgen input to the target cells by (a) depressing T production through its antigonadotropic effect and (b) accelerating T metabolic inactivation due to a partial enzymatic inducer effect on the liver; (2) at the target cell level it competes with any remaining T for the receptor binding sites; (3) the decrease in the androgen-dependent skin 5 alpha-R is a consequence of both actions of androgen suppression and androgen receptor blockade; it reinforces the antiandrogenic effect of CPA.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMed1983

[Treatment of hirsutism with cyproterone acetate and percutaneous estradiol].

One-hundred and fifty hirsute women (68 with type I or II polycystic ovary syndrome and 82 with idiopathic hirsutism) were treated for periods of 6 to 48 months with oral cyproterone (CPA), a drug with peripheral antiandrogenic, antigonadotrophic and progestative properties, and 17 beta-estradiol given percutaneously to ensure estrogenic impregnation. CPA was administered in daily doses of 50 mg from day 5 to day 25 of the menstrual cycle, and E 2 (3 mg/day) from day 16 to day 25. The dramatic regression of hirsutism observed after 3 to 6 months of treatment was paralleled by a marked decrease of plasma testosterone and delta 4-androstenedione levels and a decrease of the androgen-dependent skin testosterone 5 alpha-reductase. The CPA-percutaneous E 2 combination also has contraceptive properties. Beside its remarkable therapeutic effectiveness, it has the advantages of avoiding the adverse reactions reported with higher doses of CPA and the metabolic and vascular effects of synthetic estrogen administered orally.

Administration, Oral↗
PubMed1983

Treatment of hyperandrogenic states in women.

Hyperandrogenic states have to be treated according to their etiology. But, idiopathic hirsutism represents the majority of observed cases. Its pathophysiology is still under discussion. The ovary and/or adrenal origin has led to various treatments with corticoids or combined estrogen-progestogen preparations. However, practical problems are different. After ruling out a tumoral process or mild congenital adrenal hyperplasia, a rational and efficient treatment must be proposed. It has now become possible with the use of both antiandrogen and antigonadotropin drugs. Cyproterone acetate is the best therapeutic agent because of its antiandrogen, antigonadotropin and progestogen properties. Because of its antiestrogen effects, cyproterone acetate must be used in combination with estrogens as a substitutive therapy to permit regular bleeding.

Androgens↗
PubMed1983

[The mechanism of action of cyproterone acetate in the treatment of hirsutism].

Cyproterone acetate (CPA) in association with percutaneously offinistered estradiol has been used for the treatment of 150 hirsute patients for periods ranging from 6 months to 3 years. A spectacular clinical improvement ensued. Plasma testosterone (T) and androstenedione (A) fell from 69 +/- 24 to 33 +/- 8 and 210 +/- 103 to 119 +/- 25 ng/dl (mean +/- SD) respectively after 3 months of treatment and remained low thereafter. In contrast, T glucuronide (Tg) and 3 alpha-androstanediol (Adiol) remained high during the whole course of treatment: 37 +/- 9 and 115 +/- 43 micrograms/24 h respectively. In vitro T 5 alpha-reductase activity (5 alpha-R) in pubic skin decreased from 147 +/- 34 to 79 +/- 17 fmol/mg skin after 1 year of treatment. To elucidate the discrepancy between plasma and urinary androgens levels, T production rate (PR) and metabolic clearance rate (MCR) were measured with the constant infusion technique in 6 patients before and after 6 months of treatment. PR decreased from 988 +/- 205 to 380 +/- 140 micrograms/24 h (mean +/- SD). In contrast MCRT increased from 1275 +/- 200 to 1632 +/- 360 1/24 h; this increase in MCRT explains the striking plasma T concentration fall and the high TG and Adiol excretion relative to the decrease in PR. Antipyrine clearance rate (n = 8) increased from 36.3 +/- 5.2 to 51.5 +/- 7.4 ml/min whereas urinary/6 beta hydroxycortisol remained unchanged. In conclusion, CPA acts through several mechanisms:(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗