Diagnosis of orthostatic hypotension.
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Biomedical subjects
Publications and source records attributed to J Boddaert.
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The clinico-pathological, immunohistochemical and ultrastructural features of eight cases of sinus histiocytosis with massive lymphadenopathy (SHML) recorded in Rwanda from 1975 to 1980 are reported. The main histopathological features were a massive enlargement of the lymph node sinuses which were filled with large histiocytes, a great number of which phagocytosed blood cells, especially lymphocytes, and an important proliferation of plasma cells in the medullary cords. The pathogenesis of this syndrome is discussed, particularly the role of immunological disorders challenged by a chronic, but non-specific, infectious state. The ultrastructural study revealed no micro-organisms and no Langerhans' granules. Immunohistochemical staining revealed two interesting features: the presence of immunoglobulins in the cytoplasm of the histiocytes indicating the presence of an immune phagocytosis and the absence of lysozyme and alpha 1-antichymotrypsin (alpha 1-AC) from the histiocytes. The significance of the latter phenomenon is still unknown.
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The authors present a rare case, unique in the literature, of an osseous desmoid fibroma in which the histological diagnosis was made at the age of fifteen months. The signs were of a slight swelling with complete trismus of the mandible. After excision of the tumour, with a resultant defect in the superior ramus of the mandible, the trismus disappeared spontaneously after two weeks.
We have observed a secreting tumor of the testis classified as an intermediate malignant teratoma type A. This hormone secreting tumor was associated to bilateral gynecomasty. Surgery with radiotherapy were followed by disappearance of all symptoms for two years. Hormone levels, that were abnormal, returned to normal. Next to seminomas, testis teratomas are grouped in different types according to their differentiation, from well organized tissues to totally anaplastic cells. Clinical manifestations of these lesions are essentially dependent on their secretory capacity. Gynecomasty secondary to oestrogenic production of chorionic gonadotrophins or pituitary hormones, is the usual symptom; one may encounter hyperthyroidism or hypercortisolism. Generally, resection of the tumor is followed by a return to normal hormone values; recurrence of pathological values is often a sign of metastatic evolution. The treatment is orchidectomy with radiotherapy or eventually with chemotherapy.
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