[Report of two cases of gastro-intestinal fibrous inflammatory polyps. Review of the literature (author's transl)].
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Biomedical subjects
Publications and source records attributed to J Briere.
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Most of the blood serotonin is bound to platelets. However, some authors described plasma "free" serotonin; which is normally very low, and might be increased during some diseases. Usual spectrofluorimetric methods and paired by statistical evaluation "extra-platelet" serotonin (not bound to platelets) in the blood of healthy volunteers and patients with myeloproliferative disorders was studied. In these conditions, we cannot be sure of the existence of "extra-platelets" serotonin in the blood of controls and some patients; in others it was present. "Extra-platelet" serotonin is always present in the blood of untreated patients with primary thrombocytosis.
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One hundred and seventy seven pieces of normal or pathologic thyroid tissue from 17 patients were assayed for rRNA, tRNA and DNA content. The tRNA/DNA and rRNA/DNA ratios in pathologic tissue were statistically compared with the same ratios in normal tissue. In toxic adenoma (5 cases) and anoplastic cancer (2 cases), both ratios were increased. In cold nodules (9 cases), there was in increase of the tRNA/DNA ratio only in 1 case, of the rRNA/DNA ratio only in 4 cases, and of both ratios in 3 cases. In one case of a cold nodule in a Basedow's disease gland, there was no modification of these ratios. In Basedow's disease (3 cases), there was an increase of rRNA/DNA ratio only in one case.
The authors report 5 cases and study the thoracic and abdominal lesions of actinomycosis. This is a rare bacterial disease but not exceptional, discovered usually by chance on operative specimen on autopsy. The clinical and bacteriological diagnosis is very difficult although the lesions are characteristic. Thus it is always necessary to carry out biopsy and seek sulphur granules in the actinomycotic follicle. The differential diagnosis is usually easy with granulomycoses, but it is sometimes more difficult to distinguish the disease from nocardioses.
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The authors reported 12 cases of patients with cutaneous involvment associated with the presence of Sezary cells in the peripheral blood and specific lymph node involvment. They classify these cases as partial, early segmentary types, advanced types and diffuse types. either leukemic or sarcomatous. This study, once again, suggests the possibility that the Sezary syndrome and mycosis fu ngoïdes are different expressions, either predominantly leukemic, or predominantly sarcomatous, of the same chronic malignant hemopathy of "T" lymphocytes.
The study of the evolution of 168 cases of idiopathic myeloid splenomegaly allowed to point out the prognostic value of the clinical hematologic, isotopic and radiological parameters. The correlation of these data with the histological type of the osteomedullary lesions at the time of the diagnosis, allows to confirm the long survival of the hyperplastic formes (type I) and the more reserved prognosis in advanced myelofibrosis (type II and III together). Indeed, median survival is of 82 months for type I, and 60 months for type II and type III together. It seems advice to gather the two last types and so, to compare two anatomoclinical entities : one is characterized by hyperplastic marrow with reticulinic fibrosis, usually associated with enlarged spleen and sometimes even with increase red blood cells volume but without radiological bone lesions; the other one is characterized by a marrow of middle importance or marked marrow depletion, fibrosis, with or not osteosclerosis, and shows moderate or marked radiological lesions (respectively 16,9% of the cases) and, often, pancytopenia.
The diagnosis of myelofibrosis depends on three fundamental criteria. Myeloid metaplasia of the liver and spleen, absence of Philadelphia chromosome and a variable degree of myelofibrosis. It is thus necessary to have available bone and marrow biopsies to make the diagnosis. The analysis of elementary lesions, together with their grouping, was at the origin of various pathological classifications, including those of Hickling and Jacquillat, Chom and Ripault. The latter, adopted by most authors, distinguishes three histological types, depending on the degree of myelofibrosis and bony sclerosis. They are usually considered as successive stages of the disease.
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The simultaneous detection of multiple myeloma and acute myeloblastic leukaemia is reported in two patients who had not undergone chemotherapy. Histological examinations confirmed the infiltration by both myeloblasts and plasma cells. Only the latter contained monoclonal immunoglobulin chains at immunofluorescent studies. The possible relation between the two distinct proliferative processes is briefly discussed.
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