[Interdigitating reticulum cell hyperplasia simulating histiocytosis X of the lymph nodes].
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Aged↗
Biomedical subjects
J Audouin
Publications and source records attributed to J Audouin.
[Centroblastic and centrocytic centroblastic malignant lymphomas, predominantly splenic (or primary of the spleen). Anatomo-clinical study of 17 cases].
Seventeen cases of splenic centroblastic-centrocytic or centroblastic lymphoma are reported. A large splenomegaly is discovered in all these cases as the prominent symptom. For this reason, all these cases can be considered as primary lymphoma of the spleen. Splenectomy is done in 7 cases for diagnosis a period of 2 to 8 months after the discovery of the splenomegaly. In these patients, no bone marrow biopsy was performed before splenectomy. In 8 other cases, the diagnosis of follicular lymphoma is proposed on a bone marrow biopsy performed with the aim to disclose an etiology for the splenomegaly. In 3 of these cases, a lymph node (2 cases) or a tonsil biopsy (1 case) discover a tumoral localization before the splenectomy. In the 2 last cases, the diagnosis is recognized on a lymph node biopsy. The most important clinical and biological data are compared for these 17 patients. The anatomopathological data are described. In 15 cases, a multimicronodular pattern is recognized on the spleen section. The 2 other cases express a multimacronodular pattern. The weight of the spleen is comprised between 450 and 3,350 g, with only 6 spleens weighing less than 1,000 g. The spleens with multimicronodular pattern correspond to a follicular centroblastic centrocytic lymphoma of low grade of malignancy in the Kiel-Lennert classification. The 2 multimacronodular spleens exhibit the histological aspect of a polymorphous centroblastic lymphoma of a high grade of malignancy. The equivalent of these histological types are given in the Working Formulation. The diagnosis with others diseases of the spleen is discussed. For fourteen patients, the follow-up is available. Six patients are alive, with an evolution of many years. Because of the few number of cases, it is not possible to correlate the histological subtypes according to Kiel or to the WF, and the clinical stage with the evolution. To perform such correlation, a multicentric study should be organized.
Adult↗
[Cryptosporidiosis in grafting of allogeneic bone marrow].
Cryptosporidiosis may cause diarrhea after a conditioning regimen for allogeneic bone marrow transplantation. The case reported here suggests resurgence of latent cryptosporidiosis in early post-graft period, since other causes of immunosuppression such as graft-versus-host disease or transfusional LAV/HTLV III retroviral infection, were absent. The diagnosis was confirmed by rectal biopsy and ultrastructural analysis. Good response to spiramycin was obtained.
Adolescent↗
[Identification of C or D virus-type particles in the germinal centers of lymph nodes sampled at the lymphadenopathy stage of the acquired immunodeficiency syndrome].
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Acquired Immunodeficiency Syndrome↗
LAV-like viral particles in lymph node germinal centers in patients with the persistent lymphadenopathy syndrome and the acquired immunodeficiency syndrome-related complex: an ultrastructural study of 30 cases.
The detection of LAV- or HTLV III-type viral particles in lymph node germinal centers from patients with the persistent lymphadenopathy syndrome (LAS) or the acquired immunodeficiency syndrome (AIDS)-related complex (ARC) is an important diagnostic factor in the prodromal stages of AIDS. These particles, the morphology of which is defined, are situated solely in the extracellular spaces delimited by cytoplasmic extensions of the dendritic reticular cells. Often few in number, they were found in 26 of the 30 lymph nodes studied, selected uniquely on the basis of light microscopic criteria (predominantly follicular lymphoid hyperplasia). The four negative nodes contained no, or fewer than two, germinal centers in the samples taken for ultrastructural study. The diagnosis of the LAS or the ARC was always confirmed clinically and biologically. Thus, lymph node biopsy and the corresponding ultrastructural study are important steps in the diagnosis of AIDS.
AIDS-Related Complex↗
Non epidermotropic cutaneous lymphoma ending in leukemia. A case of adult T cell lymphoma (ATL) in France?
A case of uncommon non Hodgkin malignant lymphoma with initial skin involvement is reported. The pathological pattern does not come under standard classifications. An aspect of non epidermotropic diffuse pleomorphic lymphoma is observed. In an immunological cell membrane study, the T-cell lineage of the malignant proliferation exhibited a very unusual pattern including the presence of the E rosette receptor and the expression of HLA-DR monomorphic determinant. This type of T cell malignant lymphoma can probably be included in the group of adult T cell leukemia/lymphoma (ATL) which is endemic in South Western Japan and occasionally observed in Western countries. The emergence of such cases in these countries raises important epidemiological questions.
Adult↗
[Immunopathologic study of the persistent lymphadenopathies related to LAV-HTLV III infection].
The authors describe the immunopathological findings in the different histopathological types. In type IA, the most important findings are disruption of the network of the intrafollicular dendritic cells, progressive atrophy of the mantle zone as shown with anti-delta antibody, the progressive diminution of the number of CD4 cells first in the germinative centres then in the extrafollicular areas, the progressive increase of CD8 cells first in the germinative centres, the presence of a severe B cells hyperplasia which is polytypic. In type II, the most important findings are the global decrease of T cells predominantly of CD4 cells. These alterations of the repartition of B and T cells is highly suggestive in type IA for LAV infection. These findings have some interest for the understanding of the physiopathology of the disease.
AIDS-Related Complex↗
[Histological changes in the lymph nodes during immune stimulation reactions].
The stimulation of the cellular and humoral immune reactions is described, as well as the different cellular types implicated (B and T lymphocytes, their subsets and derived cells, and mononuclear cells of the phagocytic system). The classification of these various cells, using immunolabeling the "back-up" cells and the so-called immune-accessory cells (dendritic and interdigital reticular cells) is also shown. The aspects of lymphatic circulation and intralymphatic blood circulation are then discussed. Findly, the various elementary modifications which appear during these immune reactions are studied: some result from the action of the humoral immunity (follicular hyperplasia, immunoblastic hyperplasia and plasmocytosis), and others from the stimulation of cellular immunity (hyperplasia of the deep cortex). These modifications may be variably associated with plasmacytoid cell hyperplasia, various sinusal reactions (chronic catarrh, macrophagic histiocytosis - some-times erythrophagocytic, and B-lymphocytosis), and histiocytic, epithelioid, tuberculoid or abscessed granulomatous reactions. the diagnosis and classification of these elementary lesions allow the definition of the histopathological type, thus permitting the orientation towards a certain etiology.
Acquired Immunodeficiency Syndrome↗
[Histopathologic aspects of adenopathies in the persistent adenopathy syndrome and AIDS-related syndromes].
The histopathological modifications of the lymph nodes are studied in patients at risk for AIDS, LAV positive, with the lymphadenopathy syndrome (LAS) or the ARC. Three different types are described: type IA, with predominantly a severe follicular hyperplasia, type IB with angiofollicular hyperplasia or Castleman disease like lesions, type II with angioimmunoblastic like lesions. In type IA, the modifications of the follicles are the most important histological modification (atrophy of the mantle zone, germinative centres lymphoid infiltrate). These lesions are non specific. But associated to modifications of the deep cortical area and the sinuses they are highly suggestive of the diagnosis of LAV infection. A correlation is shown between evolution and histopathological lesions. The lymph node biopsy in patients at risk for AIDS is useful for the diagnosis and also the prognosis.
AIDS-Related Complex↗
[Transformation of malignant non-Hodgkin's lymphomas from low- to high-grade malignancy].
Clinical and histological findings of six patients with low grade non-Hodgkin lymphoma (NHL) which transformed to high grade tumours are reported: 5 out of the 6 cases showed transformation from the centroblastic-centrocytic type to the centroblastic-polymorphic type (Kiel classification). Clinical aggressivity, large tumour mass, high frequency of extranodal sites of disease, systemic symptoms and resistance to treatment were observed. This type of transformation is not rare, estimated to be about 20 p. 100 of cases in the literature, and is more common than Richter's syndrome in chronic lymphocytic leukaemia.
Aged↗
[Ultrastructural study of the lymph nodes in patients at risk for AIDS].
The identification of viral particles in the lymph node germinative centers from patients at risk for AIDS is an important diagnostic factor in the prodromal stages of this illness. Those particles are solely seen between the cytoplasmic extensions of the dendritic reticular cells. They have the same morphology than LAV-HTLV III virus, incriminated retrovirus in the etiology of the disease. They were found in 26 of the 30 lymph nodes studied.
AIDS-Related Complex↗
Herpes simplex virus lymphadenitis mimicking tumoral relapse in a patient with Hodgkin's disease in remission.
A patient treated for Hodgkin's disease and presenting 12 years later with a left inguinal lymphadenopathy mimicking a relapse is reported. Histopathological study disclosed large histiocytic granulomas in the sinuses. Some of these granulomas showed necrotic areas with numerous neutrophils. At the edge of the necrotic zones, cells of undetermined origin exhibited intra-nuclear inclusions typical of Herpes simplex virus. The diagnosis was confirmed by immunolabelling, revealing Herpes simplex viral antigens in frozen and paraffin sections, and by ultrastructural studies. The diagnostic value of the histological methodology and pathological changes and the significance of the disease, appearing in a patient treated for Hodgkin's disease are discussed.
Adult↗
Lymph node modification in patients with the acquired immunodeficiency syndrome (AIDS) or with AIDS related complex (ARC). A histological, immuno-histopathological and ultrastructural study of 45 cases.
The authors present the results of a histopathological study on the lymph-nodes taken from 45 subjects suffering from either an AIDS or from a chronic adenopathy corresponding to the definition of AIDS related complex (ARC). The various aspects observed were classed as type I to type IV. The lymph-node modifications observed in the 29 patients with an ARC could be divided into three principle groups: an extensive follicular hyperplasia associated with other elementary lesions or type IA (25 lymph-nodes from 23 patients); changes resembling a multicentric Castleman syndrome or type IB (1 case); angioimmunoblastic-like (AIL) lesions or type II (2 cases) and an association of lesions of type II (7 lymph-nodes from 6 patients). During AIDS, the adenopathy usually disappears, and the small lymph-nodes removed, especially on autopsy, show an extensive lymphoid depletion (type III) with systematic sclerosis (15 lymph-nodes from 14 patients). When adenopathy persists, it is due to infections complications (tuberculosis, cryptococcosis, avian mycobacteriosis and Whipple's disease like lesions). Of the 10 patients in whom a Kaposi's sarcoma was observed, only 6 showed lymph-node involvement, or type IV. The different histopathological lesions seem to appear according to an evolving succession, proven by certain association of lesions and by successive biopsies. In our series, 17% of subjects with an ARC evolved to AIDS. Lymph-node biopsy allows a possible ARC to be implicated on the association of the following simple lesions: follicular hyperplasia with partial or total destruction of the perifollicular lymphocytic cisterna, infiltration of the germinative centres by streams of small lymphocytes, evolving to an aspect of a "burst" germinative centre and various sinusal reactions with, in particular, the presence of neutrophilic polynuclear cells. The biopsy also allows the forms with bad prognosis to be recognized: those with AIL-like aspect or multicentric Castleman-like syndrome, which seems to represent a particular evolutive form. Finally, it also detects, in certain cases, the localization of a Kaposi syndrome, signalling the passage to AIDS. The immunopathological studies present a double interest. Firstly, they offer arguments in favour of the diagnosis: increase in the number of T8 lymphocytes in the germinative centres with the formation of small clusters and disruption of the network of dendritic reticular cells, and the inversion of the T4/T8 ratio in the extra-follicular cortical regions, by either a decrease in T4 lymphocytes or by an increase in T8 lymphocytes.(ABSTRACT TRUNCATED AT 400 WORDS)
Acquired Immunodeficiency Syndrome↗
Pulmonary polymorphic centroblastic type malignant lymphoma in a patient with lymphomatoid granulomatosis, Sjögren syndrome and other manifestations of a dysimmune state.
A case of lymphomatoid granulomatosis arising in a patient with a long history of dysimmunity is reported. The autopsy reviewed the final evolution into a high grade malignant lymphoma with IgM K immunoglobulin production and discovered in deep lymph nodes modifications similar to angio-immunoblastic lymphadenopathy.
Adult↗
Human follicular dendritic cells express CR1, CR2, and CR3 complement receptor antigens.
The expression of complement receptors by human follicular dendritic cells (FDC) was investigated by immunohistochemical techniques by using polyclonal and monoclonal antibodies to antigenic determinants of CR1, CR2, and CR3. Upon optical immunohistochemical examination of frozen sections from human reactive lymph nodes and tonsils by a three-step immunoperoxidase technique, a strong staining of cell bodies and cytoplasmic extensions of FDC was observed in germinal centers with anti-CR1 and anti-CR2 antibodies. Staining for these antigens was also found on cytoplasmic extensions of FDC in the mantle zone and on the plasma membrane of B cells in the entire follicles. Staining of FDC with anti-CR2 antibody was more intense than that of B lymphocytes. Monoclonal antibodies directed against epitopes of the alpha-chain of CR3 weakly stained FDC in follicles in a similar pattern to that which was observed on adjacent sections with mouse monoclonal antibody KIM4 that only recognizes FDC in human lymph nodes. Immunoelectron-microscopy was performed on frozen sections of a lymph node involved with a centroblastic centrocytic B malignant lymphoma and a reactive tonsil with the use of rabbit F(ab')2 anti-CR1 antibodies and mouse monoclonal anti-CR2 antibody. All the plasma membrane of the cell body and cytoplasmic extensions of FDC in germinal centers and in the mantle zones homogeneously stained for CR1 and CR2 antigens. Fibroblastic reticulum cells were negative. The plasma membrane of tumoral B lymphocytes strongly stained with anti-CR1 and weakly stained with anti-CR2 antibodies. The presence of CR1, CR2, and CR3 on FDC is a unique surface characteristic of these cells that should optimally allow the cells to bind antigen/antibody complexes bearing any type of C3 fragment.
Antibodies, Monoclonal↗
[Viral type particles in the germinal centers during a lymphadenopathic syndrome related to AIDS].
The identification of virus-like particles in the germinal centers of an AIDS-related lymph node with histological findings of group IA is reported. A 23 year-old man, intravenous drug user, presents an inversion of T helper/T suppressor cell ratio and a peripheral generalized lymphadenopathy, suggesting a diagnosis of ARC. Lymph node biopsy shows follicular hyperplasia and features consistent with group IA of AIDS-related lymphadenopathy. Immunohistochemical study reveals an increase of intrafollicular T8+ lymphocytes. Electronmicroscopic examination of follicles demonstrates the presence of particles showing features of viral nucleocapsids; these particles are seen between the cytoplasmic processes of follicular dendritic cells. Pathologic findings associated with lymphoid follicular hyperplasia in AIDS prodromal period are examined. The importance of lymph node biopsy with histological, immunohistochemical and ultrastructural studies, in patients at high risk for AIDS, is demonstrated. The detection of type D viral particles suggestive of retrovirus is in accordance with results of virologic studies which indicate the involvement of a retrovirus (called LAV or HTLV III) in the etiology of the disease.
Acquired Immunodeficiency Syndrome↗
[New cases of hydatidosis in Niger].
New cases of hydatidosis in the Republic of Niger. Five cases of hydatidosis diagnosed in the Republic of Niger are reported. All localisations are extra-hepatic: spleen: 2, lungs: 1, mediastinum: 1, parotid gland: 1. West african hydatidosis is uncommon and remarkable for the predominance of extra-hepatic localizations.
Adolescent↗
[Direct immunofluorescence study of 33 cases of malignant centroblastic and immunoblastic lymphoma].
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Fluorescent Antibody Technique↗