Biomedical subjects
Publications and source records attributed to J F Michiels.
The authors report a case of abdominopelvic actinomycosis, a rare bacterial infection. This case is exceptional for its clinical tumoral expression with fistulization through the skin, and for its rapid diagnosis by ultrasonically-guided needle biopsy. The clinical, bacteriological, histological and therapeutic aspects of actinomycosis are detailed.
Two cases occurred of granulocytic sarcoma with cerebrospinal fluid involvement but no associated leukemia on presentation. Both cases were difficult to identify by histology and were initially misdiagnosed as malignant lymphoma. The characteristic cerebrospinal fluid cytologic picture allowed the diagnosis. These cases underscore the value of cytologic examination of tumor imprints and the use of myeloid markers in panels for immunophenotyping lymphomas.
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The authors report on 3 cases of malignant lymphoma associated with well-defined lytic lesions of the skull and limbs that were identical to lesions observed in patients with multiple myeloma. In two patients, subcutaneous nodules were found opposite the site of bone lysis. Histologic examination diagnosed centrofollicular cell malignant lymphoma in all 3 cases. The exceptional nature of such lesions in patients with malignant lymphoma is discussed in connection with literature data. The suggested physiopathologic mechanism is secretion of an "osteoclast activation factor" (OAF) by malignant lymphoid B cells.
Clinico-pathological data in a typical case are compared with those of 54 published reports of systemic angioendotheliomatosis. In this rare disease the lesions, characterized by clusters of abnormal cells in the small vessels, usually have multivisceral localizations, with chiefly cutaneous and encephalic manifestations and a rapidly fatal course. However cases are known with lesions restricted to the skin and a protracted if not regressive course; about half of these cases are associated with an endocarditis. In the case reported, the results of ultrastructural and histo-immunological studies (f. VIII, lysozyme, anti-protease, Ig) are in favour of the endothelial origin of the abnormal cells, a now widely accepted hypothesis.
After a surgical operation on the biliary tract, stenoses can occur, most of the time due to fibrotic lesions, and more rarely due to granulomas or traumatic neuromas. The latter generally develop on the cystic stump after a cholecystectomy. The occurrence of a traumatic neuroma on the common bile duct is much more rarely described. We report the case of a 64 year-old man presenting, four years after a surgical removal of the gallbladder, with a cholangitis, due to neuroma located on the choledochus. He was treated by surgical resection of the common bile-duct at the site of the stenotic zone, and choledocojejunal anastomosis; post-operative course was satisfactory.