Biomedical subjects
Publications and source records attributed to E Philippe.
Methods for sampling of the placenta for the purpose of microscopic examination are described, taking into account functional topography and changes significantly linked to foeto-placental pathology. A table shows the chief histological changes seen in the placenta, together with a list of the chief diagnoses in placental pathology.
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Comparing the cytogenetic and morphological data on cases of hyperplasia and neoplasia of the trophoblast allows some conditions to be better defined and separated. The term partial mole or embryonic mole should be replaced by the term triploid syndrome because of the especially strong correlation between the triploid caryotype and the special aspect of the placenta. Triploidy is usually the result of fecundation of a haploid ovule by two spermatozoids, probably due to the similarity of the haploids of the two parents, as is suggested by the study of HLA antigens. Classical hydatidiform mole, or perivillous trophoblastic hyperplasia, is usually discovered earlier, during an ultrasound examination or abortion and its histological diagnosis is easy. The caryotype of complete hydatidiform mole is diploid, nearly always XX, with the two sex chromosomes coming from the father (the maternal sex chromosome being eliminated). The caryotype of vesicular dystrophia without trophoblastic hyperplasia is, on the other hand, normal. Trophoblastic microcarcinomas have a better known presentation. And trophoblastic carcinomas are distinct from non-trophoblastic neoplasms which secrete HCG and from benign trophoblastic pseudo-tumors which are often non-secretory.
When perforation of the uterus occurred while a therapeutic termination of pregnancy was being carried out in a 25-year-old woman it was shown that the monomorphic trophoblastic pseudotumour was invading the myometrium. It was not secreting HCG when it was diagnosed and it had not recurred 19 months after the diagnosis and hysterectomy.
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A histochemical, ultrastructural and fluorescent light study in a case of amnion nodosum showed that the matrix of the granulation tissues came from the breakdown of fetal erythrocytes.
Diffuse placental metastases brought about an early onset of labour and neo-natal death of the infant without cancer being found at autopsy. They were evidence of the generalised blood spread of the immature epidermoid cancer which was responsible for the death of the mother six months after delivery.
The study was carried out on 42 ova that had developed to the 8th to 17th days stages inclusive and that were removed by chance when endometrial biopsy was carried out. This study shows that there were 12 normal or nearly ova and 30 pathological ones. The pathology consists of an alteration of the embryonic stock without affecting the placenta, of an embryo-placental hypoplasia and of maternal vascular troubles that lead to complete necrosis of the ovum. The risk of a defective egg is raised when the oocyte remains in the follicle for more than 14 days.
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The pathological study of all placentas from women smoking at least five cigarettes daily during pregnancy (248 cases) and of those placentas from a corresponding control group randomised among all the non-smokers (196 cases) has been set up at the maternity hospital of Haguenau (France) since 1974. The systematic histological examination has shown among smokers a higher frequency of abonormal trophoblast and especially of nuclear clumps in the syncytiotrophoblast. On the other hand, according to a standard protocol, the grouping of various abnormalities has shown, among smokers, a higher frequency of "signs of hypoxia". The lack of relationship between these "signs of hypoxia" and the well-known decreased birthweight among smokers suggests that smoking during pregnancy could always go with a decreased birthweight without a corresponding decreased placental weight, and seldom with an intra-uterine hypoxia. These two effects are independent.
Description of a case of a mixed Mullerian tumour of the body of the uterus, with histologically benign epithelial and connective components, developing in a 72-year-old woman. A cervical recurrence and perineal metastasis were solely leiomyomatous in terms of their structure and were associated with peritoneal carcinomatosis and pulmonary involvement. Death occurred three years after subtotal hysterectomy and five years after the first clinical manifestations.
From anatomical and cytogenetic studies of 1500 spontaneous abortuses attempts were made to establish correlations between the phenotype and karyotype of the specimens. The criteria used to determine the phenotype were based on estimated developmental age and macroscopic and microscopic examinations of embryo and placenta. Main features were described permitting, on anatomic examination of the conceptus, diagnosis of genetic anomalies, and in some instances possibly assigning the type of chromosomal aberration: viz., in monosomy X, triploidies, tetraploidies, and some trisomies. Phenotypic expression at the cellular level was studied by morphometry of the placenta and by study of in-vitro growth charcteristics of cells lines initiated from aneuploid embryos. Study of growth rate characteristics may reveal the basis for the pathogenesis of developmental arrests.
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