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Biomedical subjects

J Wechsler

Publications and source records attributed to J Wechsler.

At least 127 records · Page 7Linked to original sources
PubMed1995

Primary cutaneous medium and large cell lymphomas other than mycosis fungoides. An immunohistological and follow-up study on 54 cases. French Study Group for Cutaneous Lymphomas.

Primary cutaneous medium and large cell lymphomas (MLCL) other than mycosis fungoides (MF) are rare, and their prognosis and treatment are controversial. The clinical, immunohistological and follow-up data of 54 well-documented cases of primary cutaneous MLCL other than MF, seen in our institutions over a 14-year period, were retrospectively reviewed, in order to determine the prognostic factors related to these lymphomas, and to analyse the results obtained with different treatment regimens. Forty-six patients presented with a solitary tumour or with localized lesions, and eight had disseminated cutaneous lesions. According to the updated Kiel classification, 45 cases (83%) corresponded to B-cell lymphomas: centroblastic lymphomas, 32 cases; centroblastic-centrocytic lymphomas, 11 cases; immunoblastic lymphomas, two cases. Nine cases (17%) were classified as T-cell lymphomas: pleomorphic medium and large cell lymphomas, eight cases; anaplastic large cell lymphoma, one case. Four of eight patients with disseminated skin lesions had a T-cell lymphoma, whereas 41 of 46 patients with a solitary tumour had a B-cell lymphoma. Patients with disseminated skin lesions and elevated serum lactate dehydrogenase (LDH) levels had a poor prognosis. Comparison of patients' overall survival, depending on immunohistological subtype, showed that the median survival of patients with pleomorphic T-cell lymphoma was 2.5 years, whereas it was not reached at 12 years for patients with centroblastic-centrocytic and centroblastic lymphoma. The eight patients with disseminated skin lesions were treated with polychemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Pachydermodactyly and atrophia maculosa varioliformis cutis.

Pachydermodactyly is a rare form of superficial digital fibromatosis characterized by progressive asymptomatic thickening of the back and sides of the proximal interphalangeal joints of the fingers. Atrophia maculosa varioliformis cutis is an acquired dermal atrophy, localized on the cheeks. Only a few cases of each pathology have been published. We find it interesting to report the case of a patient with both conditions as these two connective-tissue diseases are very rare. The association is probably fortuitous.

Adult↗
PubMed1995

Gene analysis in 18 cases of cutaneous lymphoid infiltrates of uncertain significance.

BACKGROUND AND DESIGN: Patients with cutaneous lymphoid infiltrates that appear reactive histologically and immunophenotypically may develop clinically overt cutaneous lymphoma, suggesting the possibility of misdiagnosis by classical methods. We investigated DNA rearrangement in such cases of lymphoid infiltrates of uncertain significance to determine whether this more sensitive method could detect an occult monoclonal lymphoid proliferation. METHODS AND PATIENTS: Skin biopsy specimens were taken from 18 cutaneous lymphoid infiltrates diagnosed as reactive on the basis of clinical, histopathological, and immunohistochemical criteria. Specimens included 12 cases with mixed lymphoid infiltrates rich in polytypic B cells and inconstant follicle formation and 6 cases with exclusive T-lymphoid infiltrates. Southern blot analysis for immunoglobulin and T-cell-receptor beta-chain gene rearrangements was performed in all cases. RESULTS: No specimen showed T-cell-receptor beta-chain gene rearrangement. Clonal immunoglobulin gene rearrangement was demonstrated in one case with polytypic B cells, but no clinical malignancy has appeared 19 years after disease onset duration and 7 years after detection of the B-cell clone. CONCLUSIONS: In the present series, the results suggest that histological and immunohistological criteria are appropriate to establish the diagnosis of most cases of cutaneous lymphoid infiltrates. The detection of a B-cell clone is remarkable by absence of clinical malignancy, suggesting that such a discovery does not necessarily mean an aggressive evolution. Nevertheless, there is presently no way to predict the prognosis of a clonal lymphoid proliferation, indicating that a long-term follow-up is necessary.

Adult↗
PubMed1995

Peritonitis biliaris: some aspects of its origin.

As a cause of septic shock, peritonitis biliaris is a very serious condition. We stress the risks of its development and necessity of postoperative drainage in laparoscopic cholecystectomy. The risks include a cholascos which may develop after some radical procedures of a "non-operative" nature on the liver parenchyma and bile passages (transperietal or endoscopic procedures).

Biliary Tract Diseases↗
PubMed1995

[Hypersensitivity syndrome caused by dapsone. Transient circulating clone T].

INTRODUCTION: Hypersensitivity is a rare side-effect of dapsone. The most complete clinical presentation associates papulous exanthema, lymph node enlargement, liver cell failure and an increase in mononuclear and eosinophil counts. CASE REPORT: A 45-year-old woman developed hypersensitivity to dapsone when this drug was used to treat corticoid-dependent asthma. A transient circulating clone T was demonstrated by Southern blot during the acute phase. The clinical manifestations and laboratory findings returned to normal under systemic corticosteroid treatment. When corticoids were tapered off, hypersensitivity reactions began to progress again. DISCUSSION: Transient circulating clone T, as observed here, emphasizes the importance of close surveillance and long-term follow-up in drug-induced hypersensitivity syndromes.

Anti-Asthmatic Agents↗
PubMed1995

[Exclusive nodular plexiform neurofibroma. An unusual case of neurofibromatosis type 1].

INTRODUCTION: Type 1 neurofibromatous tumours (NF) are benign skin tumours which include cutaneous, subcutaneous and plexiform neurofibromas. Plexiform neurofibromas are either diffuse or nodular, the latter form being much more frequent. CASE REPORT: We observed a particular form of neurofibroma in an 18-year-old patient who developed large deep subcutaneous which histology examination revealed to be exclusively nodular plexiform neurofibromas. The patient also had 6 café au lait spots leading to the diagnosis of sporadic NF 1. He did not have acoustic neuronoma, schwannoma or posterior cataract, eliminating NF 2. COMMENTS: In NF 1, subcutaneous neurofibromas develop in 5 p. 100 of the patients. These lesions are termed nodular plexiform neurofibromas when they form long formations along nerve branches. The exclusive nature of the nodular plexiform neurofibromas in our case was exceptional. It could be hypothesized that the particular phenotype in our patient might correspond to a particular anomaly of the NF 1 gene.

Adolescent↗
PubMed1994

Hyperplastic pacinian corpuscles: an uncommonly encountered lesion of the hand.

The occurrence of hyperplastic pacinian corpuscles in the hand is rare, with only 13 cases reported in the literature. We describe such a case in a 70-year-old male who had worked as a locksmith for many years. A grape-like cluster of firm, rice-sized nodules was discovered in the subcutaneous tissue of the finger following a glass-induced injury. Histopathological findings revealed pacinian corpuscles to be increased in size and number. Individual corpuscles consisted of a central nerve fiber surrounded by 35 to 60 concentric lamellae (normal controls from other specimens: 13-15 lamellae). The external corpuscular diameter ranged from 1.8 to 3.2 mm (normal controls from other specimens: 1.6 mm). Immunohistochemistry showed positive staining with Leu 7 antibody and antiglial fibrillary acidic protein in the small nerves situated in the vicinity of the pacinian corpuscles, but not in the corpuscles themselves. The lesion reported here clearly differed from both neurofibroma with occasional pacinian differentiation and the so-called pacinian neurofibroma. There was no evidence of neurofibromatosis.

Aged↗
PubMed1994

[Non-bacterial thrombotic endocarditis complicating metastatic melanoma].

INTRODUCTION: Non-bacterial thrombotic endocarditis is defined by the presence of cardiac aseptic valvular vegetations made of fibrin and platelets. We report a case diagnosed ante mortem that occurred in a patient with metastatic melanoma. CASE REPORT: M. S., presented with a metastatic melanoma associated with an acute neurological deficit. Cerebral computerized tomographies and nuclear magnetic resonance showed occipital ischaemic lesions in the territory of the posterior cerebral artery. Cardiac echography showed large vegetations of the mitral valve. Bacterial endocarditis was eliminated. The diagnosis of non-bacterial thrombotic endocarditis was made, confirmed by post mortem examination. DISCUSSION: Non-bacterial thrombotic endocarditis is the second cause of neurological manifestations in patients with cancer. The presentation of our case was unusual because of an audible heart murmur and vegetations visible on echography.

Adult↗
PubMed1994

[From Murphy's button to Valtrac].

The author gives an account of the history of methods of mechanical compression viscerosynthesis without using sewing material and presents a report of the first clinical application of Valtrac on the territory of former Czechoslovakia.

Aged↗
PubMed1994

Nonepidermotropic cutaneous lymphomas. A histopathological and immunohistological study of 52 cases.

We report the detailed histological and immunohistological findings in 52 cases of nonepidermotropic cutaneous lymphoma, as revealed by cutaneous lesions. The patients presented mainly with cutaneous nodules and, more rarely, with infiltrated plaques, annular erythema, or erythroderma. The staging procedure following the diagnosis revealed lymph node and/or bone marrow involvement in half of the cases. Nearly 60% of the nonepidermotropic cutaneous lymphomas were of the large-cell type. The reticular dermis was involved in all of the cases, and the papillary dermis was involved in only 11 of them. Nonepidermotropic cutaneous lymphomas were of the B-cell, T-cell, and non-B-, non-T-cell type in 38, 13, and 1 case(s), respectively. A monotypic immunoglobulin light chain expression was detected in 33 of 35 tested cases of the B-cell lymphomas, and a loss of one or several pan-T-cell antigens was observed in all of the cases of the T-cell lymphomas. In seven cases (13%), the diagnosis of malignancy was based only on these immunohistological criteria. This study shows that nonepidermotropic cutaneous lymphomas are B-cell lymphomas in 75% of the cases, most often of the large-cell type. It also emphasizes the value of immunohistochemistry to firmly establish malignancy when routine light microscopical findings are questionable.

Adolescent↗