Biomedical subjects
J Audouin
Publications and source records attributed to J Audouin.
[Idiopathic granulomatous hepatitis and lymphoma of serous membranes].
We described the case of a woman with idiopathic granulomatous hepatitis who developed a type B lymphoma with serous effusion six years later. This association raised the hypothesis that sarcoidosis or lymphoma could present as idiopathic liver granuloma. We suggest that lymphoma developed in our patient as a consequence of the granulomatous hepatitis. This lymphoma was particular because only sera were involved.
[Hodgkin's disease. One or many diseases?].
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Lymph node interdigitating cell granuloma associated with non-Hodgkin's malignant lymphoma. A case report and review of the literature.
We report a new case of histiocytic proliferation, which histologically resembles histiocytosis X, in a lymph node affected by non-Hodgkin's malignant lymphoma. This brings the total number of such reported cases to 12. Histiocytosis X cells, with folded nuclei, expressed S100 protein and an antigen recognized by anti-CD1 monoclonal antibodies. Ultrastructural study did not show any Birbeck granules and demonstrated a morphology similar to that of interdigitating cells. In the absence of Birbeck granules, the term 'Langerhans' cell granulomatosis' is not correct and should be replaced by either 'interdigitating cell granuloma' according to immunohistochemistry and ultrastructure or 'histiocytosis X-like granuloma' according to optical morphology. The fact that some cells with folded nuclei were positive for lysozyme argues in favor of the existence of transitional cells between histiocytes hnd interdigitating cells. The 11 other reported cases were reviewed. In 6 cases, this type of granuloma was associated with B cell lymphoma. In 3 cases the lymphoma was also probably of B cell type. In 2 cases, no information could be found. We could speculate that these histiocytosis X-like lesions are reactive, resulting from immune disturbances due to the lymphoma and/or the treatment.
Malignant lymphoplasmacytic lymphoma with prominent splenomegaly (primary lymphoma of the spleen).
Eleven patients (age range 51-65 years) presenting with primary splenic lymphoma of lymphoplasmacytic type are described, together with detailed histological, immunohistochemical, and ultrastructural findings. The subclassification of this type of lymphoma is considered, and the prognosis discussed.
Incipient malignant lymphoma: definition and histopathology.
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Ultrastructural study of 4 cases of Ki-1 positive large anaplastic cell malignant lymphoma.
The ultrastructural morphology of 4 cases of large anaplastic cell malignant lymphoma (Ana ML) is reported. Three cases were primary Ana ML and one pleomorphic large T cell lymphoma with some Ki-1 positive cells. All were confirmed by immunohistochemistry on frozen and paraffin sections. The Ki-1 and EMA positive tumour cells had an abundant cytoplasm, with no differentiation and large pale nuclei with multiple compact or dispersed nucleoli. The morphology is that of an activated cell engaged in protein synthesis and/or in the mitotic cycle. These tumour cells resemble to the Hodgkin's and monolobated Reed-Sternberg cells described in Hodgkin's disease.
Angio-immunoblastic lymphadenopathy (AIL) or T-cell malignant lymphoma of AIL-type. A histopathological, immunohistochemical and ultrastructural study of 8 cases.
Eight cases of AIL-type T-cell malignant lymphoma are reported. The clinical symptoms are the same as those described in AIL: fever, malaise, weight loss, skin rashes, polyadenopathy, and splenomegaly. However, some differences can be noted: the absence of hepatomegaly in all cases but one, the absence of polyclonal hypergammapathy in all cases but one, and predominance in females. The lymph node modifications comprise diffuse infiltrations of lymphoid cells with irregular nuclei and pale cytoplasm, associated with a large number of immunoblasts and plasma cells. Some eosinophilic granulocytes and epithelioid cells can be seen. Hyperplasia of the vessels and remnants of follicles, sometimes with proliferation of follicular dendritic cells, are prominent features. The immunolabelling study demonstrates the presence of an important T-cell population all expressing a high predominance of CD 4 phenotype. These findings are in accordance with those published in Europe and in contrast with those of some of the Japanese cases, particularly the first patients published by Shimoyama et al. The differential diagnosis with AIL is based on the presence of clusters of mainly large cells with a pale cytoplasm, on the loss of expression of one T cell marker, as in 3 cases of our series, and on the presence of a high percentage of lymphoid cells engaged in the mitotic cycle as demonstrated with the Ki 67 monoclonal antibody. However, to draw a clear cut difference between AIL-type T-cell lymphoma and AIL considered as a prelymphomatous dysimmune lymphadenopathy, only the demonstration of cytogenetic abnormalities, as in one of our cases or of rearrangement of the genes coding for beta and/or gamma chain of the antigen receptor of T-cell are valuable criteria. The follow-up of our series is not long enough to appreciate the prognosis. Three patients died, one from a glioma. All the other cases, treated with polychemotherapy show total remission with an evolution of 10 to 39 months.
Association of splenoma, peliosis and lipid histiocytosis in spleen or accessory spleen removed in 2 patients with chronic idiopathic thrombocytopenic purpura after long term treatment with steroids.
In 2 patients with a long lasting cortico-dependent chronic idiopathic thrombocytopenic purpura, splenectomy in one and ablation of an accessory spleen in the other, disclosed a complex association of splenoma, peliosis and lipidosis of the spleen, with a secondary sea blue histiocytosis in one case. The relation of this curious association with thrombocytopenia and with the long treatment with corticosteroids is discussed, with a review of the literature.
[Reactive cells in non-Hodgkin's malignant lymphoma].
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[Malignant lymphomas and other malignant proliferations in hematopoietic organs in HIV-positive patients].
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[Malignant peripheral T-cell lymphomas: morphologic and immunopathologic bases of the classification proposed by Lennert and Suchi].
In the last few years advances in immunopathology have demonstrated the T cell origins of some malignant lymphoma (ML). Histopathological criteria have been suggested for classifying several varieties of T cell ML. Peripheral T cell ML are the result of proliferation of T cell lymphocytes with markers which distinguish between the enhancing-inducer and suppressor-cytotoxic forms. The diagnosis is made from the appearances of the cell, the presence of vascular hyperplasia and associated lesions. The numbers of small, medium and large cells and clinical follow-up of these tumors have provided a means of distinguishing between low and highly malignant tumors. Some peripheral T cell ML have associated lesions due to the secretion of lymphokines which give characteristic histopathological appearances (lympho-epithelioid T cell ML, AIL type T cell ML). The authors discuss the respective places of each variety of peripheral T cell ML in Lennert and Suchi's classification which is an extension of that proposed by Kiel, and their prognostic signification.
[Spontaneous dactylolysis or ainhum. Histopathologic study].
Ainhum or dactylolysis spontanea is characterized by the occurrence of a circular constriction located at the root of the 5th toe, rarely of a finger. It deepens, the toe becomes disabled and finally amputation occurs, spontaneously or by surgery. It is a tropical disease of the adult, the origin of which remains obscure. It seems frequent in Niger. 7 cases have been histologically studied. Classical features have been found, including hyperkeratosis, chronic dermatitis, osteoporosis with cortical bone resorption. This study has also revealed in all cases complete ligamental destruction. Moreover, vegetal foreign body granulomas have been found in 4 cases, lying deep in the dermis and in one case in a synovial membrane. Ainhum is compared with pseudo-ainhum seen in genodermatosis, in yaws and in congenital strictures. Among the usually considered etiopathogenetic hypotheses, our findings are in favor of a mechanical and inflammatory origin.
Lymphoid tissue changes in HIV-infected patients.
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Idiopathic thrombocytopenic purpura in patients at risk for acquired immunodeficiency syndrome. Histopathologic study, immunohistochemistry, and ultrastructural study on six spleens.
Some cases of idiopathic thrombocytopenic purpura (ITP) may be related to the prodromal phase of the acquired immunodeficiency syndrome (AIDS). The morphologic features of six spleens removed in this context were studied. In the white pulp, lymphoid follicular hyperplasia was constant but hardly distinguishable from that of control ITP on routine light microscopic grounds. Moreover, its bland appearance contrasted with the major histopathologic changes usually described in lymph node biopsy specimens from patients with AIDS-related complex. Immunohistochemistry and electron microscopy demonstrated, respectively, an excess of cytotoxic-suppressor lymphocytes with a decreased CD4/CD8 ratio in the germinal centers and viral particles of the human immunodeficiency virus. The immunohistochemical and ultrastructural studies were more helpful than light microscopy in presenting histopathologic arguments in favor of the human immunodeficiency virus infection.
[Survey of changes in the lymph nodes and spleen in HIV infection--significance for the early diagnosis of AIDS].
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[Pseudomycetomatous subcutaneous phaeohyphomycosis].
The authors report the first Nigerian case of cutaneous and sub-cutaneous phaeohyphomycosis. It was characterized by its original macroscopy: the lesion was pseudo-tumoral and provided with fistulae. So it looked like a mycetoma. The diagnosis was finally made by histology: it showed the typically pigmented mycelium. Cultures have not been made. Etiological agents of phaeohyphomycosis being opportunistic, this disease occurs often among immunosuppressed patients. The knowledge of unusual clinical forms may allow to suspect the diagnosis and to cultivate the exudate: this provides the only specific mycologic diagnosis.
[From the detection to the prevention of cancer of the cervix uteri. A 22-year appraisal].
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