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Biomedical subjects

G Molas

Publications and source records attributed to G Molas.

At least 73 records · Page 4Linked to original sources

[A case of esophageal papillomatosis in adults].

The authors report the case of a 60 year-old woman patient with esophageal papillomatosis, revealed by slowly progressive dysphagia and digestive hemorrhage. Multiple warty tumors were found at endoscopy, starting at approximately 23 cm from the dental ridge, increasing in size into the lower esophagus where they were responsible for stenosis. Pathological examination demonstrated epithelial proliferation with lengthened papillae, hyperkeratosis, hyperacanthosis and severe dysplasia. No extra-esophageal papillomata were discovered. Subtotal esophagectomy was performed and pathological examination with immune markers suggested a human papilloma virus (HPV) infection. However, search for HPV DNA was negative. To our knowledge, this constitutes the fifth case reported in the literature. The principal problem posed by this rare disease is the possible association with and/or progression to carcinoma, the diagnosis of which may be difficult, and particularly, with verrucous carcinoma. With this diagnostic uncertainty in mind, the authors suggest total surgical removal of the esophagus in this situation.

Esophageal Neoplasms↗

[Hypergastrin and hyperprolactin syndrome caused by mucinous cystadenoma of the ovary].

We report a case of a clinically and biologically typical hypergastrinemia syndrome due to ovarian mucinous cystadenoma. When examined under histoimmunofluorescence, this "border-line" tumor was shown to contain a polymorphous endocrine cell proliferation, composed primarily of G cells and, to some degree, of D cells. Electron microscopic study further evidenced a small amount of prolactin containing cells, which coincided with elevated prolactin-levels in blood. Ovariectomy combined with vagotomy and pyloroplasty resulted in a prompt disappearance of both clinical and biological abnormalities. Ovarian mucinous cystadenomas have been known for a long time to contain endocrine cells, but only five cases, including the present one, have been described with fully developed endocrine expression. We suggest that this particular condition could be more frequent than generally admitted, and could justify systematic screening for mucinous cystadenoma in the case of peptide hormone dysfunction.

Adult↗

[Digestive lymphomatous polyposis: study of a case diagnosed by rectal biopsy].

We report a case of gastrointestinal lymphomatous polyposis revealed by a rectal tumor. Numerous polypoid lesions, 5 to 20 mm in diameter, were found at various levels of the gastrointestinal tract. Microscopic examination of gastric, duodenal, colic and rectal specimens led to the diagnosis of small cleaved-cell type lymphoma. The immunohistochemical study showed a monotypic surface staining of the lymphomatous cells with anti-IgM, IgD, kappa, C3b, and CD5 antibodies. This type of lymphoma is rare and presents as multifocal polyposis of the gastrointestinal tract. Only histologic and immunohistologic studies can establish diagnosis. Gastrointestinal lymphomatous polyposis is classified as a low-grade malignant lymphoma, with frequent nodal, hepatosplenic, bone marrow, and blood involvement. Chemotherapy is the appropriate treatment.

Aged↗

Lymphoid stromal reaction in gastrointestinal lymphomas: immunohistochemical study of 14 cases.

The lymphoid stromal reaction, particularly the T lymphoid reaction, was studied immunohistochemically on cryostat sections in 14 cases of primary gastrointestinal B lymphomas, and compared with the type and distribution of lymphoid cells in three cases of gastric lymphoid hyperplasia. A pronounced T lymphoid reaction, mainly of the T helper phenotype, occurred in both lesions. Most of these T cells bore HLA-DR antigens, but only a few of them had the receptor for interleukin 2. The T lymphoid reaction was observed inside the lymphomas in seven of a total of 14 cases, and around the lymphomas in four of the six cases clinically classified as stage I. Perivascular mucosal and submucosal nodules, entirely composed of T cells, seemed characteristic of gastric lymphoid hyperplasias. A T lymphoid reaction in lymphoid hyperplasias suggests an amplification of the cell mediated immune response; in lymphomas it could represent a host reaction against the lymphomatous infiltrate, therefore favouring a better prognosis.

B-Lymphocytes↗

[Intramural diverticulosis and cancer of the gallbladder].

Two cases of gallbladder carcinoma occurring in intramural diverticulosis (adenomyomatosis) are reported. The first was adenocarcinoma associated with cholesterolosis without gallstone formation. The second was squamous cell carcinoma. Four other carcinomas developing on diverticulosis were reported in the literature, none of them being squamous cell carcinoma. Our cases and those of the literature show that diverticulosis, a benign condition, can be associated with carcinoma which can make the pathological diagnosis difficult.

Adenocarcinoma↗

[Small-cell anaplastic neuroendocrine carcinoma of the rectum].

A pediculed tumor of the rectum was discovered in a 63 years old man. Within the tumor adenomatous dysplastic proliferation was associated with a neuroendocrine small-cell anaplastic carcinoma. The neuroendocrine nature of the tumor was suspected on conventional optic microscopy and confirmed by a positive Grimelius technique. Specific typical granules were also found on electron microscopy. Immunohistochemical techniques using neurospecific enolase were also positive. Carcinomatous invasion was limited to the submucosa, but the surgical specimen showed that one lymph node was metastatic. Three months later, hepatic metastasis was suspected on physical examination and the patient died of hepatic failure ten months after the discovery of the tumor. Twenty-two similar cases were found in the literature: of these five cases were associated with benign adenomatous lesions. In all cases the patients died of early metastatic diffusion. This tumor raises the problems of diagnosis, terminology, classification and therapy: only aggressive chemotherapy, similar to that applied to the same type of carcinoma in the respiratory tract might improve prognosis.

Carcinoma↗

[Epidermoid cancer of the thoracic esophagus following mediastinal irradiation].

Squamous cell carcinoma of the esophagus induced by radiation therapy is a rare entity. We report 4 cases observed during the past 4 years. Three women and one man aged from 47 to 78 years developed squamous cell carcinoma of the esophagus 8 to 11 years after radiation therapy. The 3 women had been irradiated for breast cancer and the man for Hodgkin's disease with 40 to 57.5 Gy. Three patients were operated on and the immediate postoperative course was uneventful. Culling data from this report and from the literature we reviewed the different steps concerning the diagnosis and the treatment of this complication of radiation therapy. We suggest that diagnostic and therapeutic modalities should follow the same guidelines as in other esophageal cancers.

Aged↗

Gastrointestinal Richter's syndrome.

The development of a diffuse large cell lymphoma of the stomach in a patient who had chronic lymphocytic leukemia is reported. Richter's syndrome localized to the gut has not been described previously. Morphologic and immunologic studies suggest that the diffuse large cell lymphoma arose from the same clonal proliferation, IgG lambda, as the initially detected serum monoclonal protein associated with the chronic lymphocytic leukemia.

Aged↗

Pathological features and mucin histochemistry of primary gastric stump carcinoma associated with gastritis cystica polyposa. A study of six cases.

Six unusual cases of primary gastric stump carcinoma associated with gastritis cystica polyposa and arising in old gastrojejunostomy stomas are presented. The clinical data, the gross and microscopic pathological features, and the histochemical mucin profile of these two lesions are described in detail. A review is undertaken of the most relevant and previously published reports concerning, separately, either primary gastric stump carcinoma or gastritis cystica polyposa. The findings available in these reports are compared with those observed in our six cases. Some aspects of gastritis cystica polyposa are not unlike those seen in the solitary ulcer syndrome of the rectum and Ménétrier's disease. The histological type and mucin profile of primary gastric stump carcinoma parallel those recorded in gastric cancer arising in the unoperated stomach. However, the role of intestinal metaplasia and its histochemical typing appear somewhat different in primary gastric stump carcinoma.

Adenocarcinoma↗

Condylomata acuminata, giant condyloma acuminatum (Buschke-Loewenstein tumour) and verrucous squamous carcinoma of the perianal and anorectal region: a continuous precancerous spectrum?

Seven patients with perianal and anorectal giant condyloma acuminatum (Buschke-Loewenstein tumour) are presented. In five of these patients histopathological examination of the lesions disclosed varying degrees of dysplasia and/or squamous carcinoma. The clinicopathological features and aetiology of perianal and anorectal condylomata acuminata, giant condyloma acuminatum and verrucous carcinoma are discussed. The viral induction and malignant transformation of these papillomatous squamous lesions are emphasized.

Animals↗

Myeloid metaplasia, perisinusoidal fibrosis, and nodular regenerative hyperplasia of the liver.

We describe two patients with myeloid metaplasia in whom portal hypertension resulted, not from infiltration of the liver sinusoids by myeloid cells, but from perisinusoidal fibrosis and nodular regenerative hyperplasia of the liver. We hypothesize that myeloid metaplasia induced the development of perisinusoidal fibrosis, which resulted in heterogeneous hepatic tissue blood perfusion, with atrophy of the liver cells in the underperfused areas and nodular regenerative hyperplasia in the normally perfused areas.

Aged↗

Collagenous colitis. Ultrastructural study and collagen immunotyping of four cases.

We studied four cases of collagenous colitis (CC), which is characterized by thickening of the subepithelial collagenous layer of the colorectal mucosa and is associated with chronic watery diarrhea. Eighteen cases of CC have been previously reported in the literature, to our knowledge. In our four patients, ultrastructural study and collagen immunotyping demonstrated that the basement membrane over the thickened collagen was normal. We found no similar collagenous thickening in a series of 96 biopsy specimens of chronic inflammatory bowel diseases, but collagenous thickening was noted in 17 (25%) of 68 colonic metaplastic polyps. The cause of CC is unknown. The pericryptal fibroblastic sheath of the colonic mucosa has a probable role in the development of CC and metaplastic polyps. The role of the numerous mast cells present in our four cases of CC is currently unknown.

Adult↗

[Primary histiocytic lymphoma of the liver. Study of 2 cases and review of the literature].

The authors report two cases of primary histiocytic malignant lymphoma of the liver successfully treated by right hepatectomy. The first case, was free of secondary spread with a follow-up of ten years, although he received no adjuvant therapy. The second patient developed skin, bone and brain metastases, which disappeared after chemotherapy and radiotherapy. He has been free of recurrence for four years. Such primary liver tumors are very rare and are worth knowing because of the efficiency of treatment and of their rather good prognosis. Evolution is different from that observed in histiocytic malignant lymphomas developed in other sites. It is suggested that, in the liver, this tumor might originate and grow from Kupffer's cells. This histologic origin might explain the particular clinical and evolutive features of primary histiocytic malignant lymphomas of the liver.

Adult↗

[Adenomatous lesions of the papilla in familial adenomatous rectocolic polyposis. Value of duodenoscopy].

When compared to the general population, individuals with Gardner's syndrome may have a 100- to 200-fold increased risk of developing periampullary carcinoma. This prospective work was undertaken in order to study the endoscopic aspects and to perform biopsies of the papilla in 9 patients (7 males, 2 females, aged 18-65 years) with familial polyposis coli or Gardner syndrome. In 4 cases the papilla was endoscopically grossly polypoid and biopsies showed adenomatous lesions. In 5 cases, the papilla appeared endoscopically normal; in 2 cases, the papilla appeared endoscopically normal; in 2 of these cases biopsies showed adenomatous proliferation; in the 3 other cases, the biopsies were normal. In 5 cases, there were adenomatous duodenal lesions outside the papilla. These results suggest that: a) adenomatous lesions of the papilla are frequent in familial polyposis coli and Gardner's syndrome; b) the endoscopic gross aspect of the papilla may be normal even when there are adenomatous lesions; c) adenomatous lesions of the papilla may be associated or not with adenomatous lesions of the 2nd duodenum; d) as the natural history of these lesions is not known and because of the risk of cancer of Vater's ampulla, it seems reasonable to perform routine duodenoscopies with biopsies in order to ensure early diagnosis of cancer.

Adenoma↗

[Tropical sprue. Apropos of a case observed in the Paris region].

A case of tropical sprue in a 73-year old parisian male returning from endemic areas is reported. Clinical manifestations were megaloblastic anemia, malabsorption and protein-losing enteropathy. Biopsy of the jejunal mucosa showed partial villous atrophy with thickening of the basement membrane region; fat droplets were observed inside and close to the epithelial cells on electron microscopy study. Fat intestinal absorption after a test meal was delayed. Clinical, biological and histological improvement was obtained with tetracycline and folic acid therapy. The particular clinical and anatomical features of this case, as well as the difficulties for establishing the diagnosis of tropical sprue in non-endemic areas are analyzed.

Aged↗