[Calcified ovarian fibroma. Apropos of 1 case].
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Biomedical subjects
Publications and source records attributed to K Dellagi.
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The authors report on 19 cases of Inverted Papilloma collected over ten years at the Institut Gustave-Roussy. The Inverted Papillomas are rare tumors affecting predominantly adult males. This slow progressing tumor is usually revealed by unilateral nasal obstruction (68%). Its loco-regional extension is best appreciated by radiologic and tomodensitometric scanning. After limited surgical resection, the tumor may either recur (11 out of 19 cases) or show malignant evolution (9 out of 19 cases). Histopathologic criterias of this latter possibility are discussed. A radical surgical treatment such as paralateronasal rhinotomy may prevent the malignant transformation of this benign tumor.
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One case of abdominal actinomycosis is reported which was detected in a diabetic patient three years after surgery for duodenal peptic ulcer. Gastric actinomycosis is very rare and is usually discovered during surgery for gastric mass. The role of surgery as a predisposing condition to infection is discussed. The diagnosis rely on the characterization of the bacteria in cultures from a discharging wall fistula and on histopathologic examination which reveals the characteristic actinomycotic granules.
The authors report the first two cases of Echinococcus multilocularis observed in Tunisia, in two patients from the North-West of the country, who never travelled abroad. The diagnosis was reached by histopathologic examination of a partial hepatectomy section. The appearance of this disease in this geographic area where unilocularis hydatic cyst is endemically present needs further epidemiologic study.
Lymphocyte markers were studied on fresh cells from 30 patients with Burkitt (L3) leukaemia and cell lines derived from endemic and non-endemic Burkitt's lymphoma (BL) patients. We observed day-to-day variations of lymphocyte marker expression by cultured lines and, occasionally, differences between fresh and cultured cells. In L3 leukaemia, a wide range of phenotypes, including pre-B cell and mature monoclonal IgM + IgD positive B-cell phenotypes, was observed. Most often, the cells expressed high-density monoclonal surface IgM without IgD and lacked IgG Fc, complement and Epstein-Barr virus receptors. Blast cells from rare patients featured monoclonal IgG or IgA instead of IgM. Cases with light chains of the lambda type were more frequent than those with kappa chains. Monoclonal immunoglobulins were found in serum or urine from eight of 20 patients studied. These results are compared with data from the literature on endemic and non-endemic BL and discussed with respect to the maturation stage reached by the cells. In the study of both fresh and cultured cells, we demonstrated a correlation between variant chromosomal translocations and light-chain types, the cells from patients with a t(2;8) translocation expressing kappa and those with a t(8;22) expressing lambda chains, with one exception Vimentin expression was absent or weak in most BLs studied (lines or fresh cells) and in cells from patients with Langer-Giedion syndrome, in contrast to most other lymphomas and leukaemias and normal lymphoblastoid cell lines.
Since vimentin intermediate filament (IF) expression in hemopoietic cells varies with the cell lineage as well as the state of differentiation of the cells, we studied the vimentin cytoskeleton by direct immunofluorescence and electron microscopy in 50 cases of acute nonlymphocytic leukemias. We found that malignant cells tend to reproduce the vimentin organization characteristic of their normal cellular counterpart. Thus, in M2 and M3 leukemias (French-American-British classification), vimentin was often reduced to a juxtanuclear bundle of filaments contrasting with the rich filamentous network expressed by M4 or M5 leukemias. In erythroblastic leukemias (M6) and megakaryoblastic leukemias, both identified by the expression of lineage-specific antigens, the absence of vimentin IFs could be correlated with the level of differentiation reached by the blasts. M1 leukemias displayed an abnormal pattern of vimentin organization with aggregated filaments giving a ring-like structure. However, no abnormality of the vimentin polypeptide could be detected by two-dimensional electrophoresis. These results show that the expression of the vimentin IF cytoskeleton may be a useful marker of differentiation in the study of leukemic cells.
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A patient with a nasal chondroma and Ollier's disease treated at the Institut Gustave-Roussy, Villejuif, had a long past medical history of over 10 years, starting with a nasal lesion diagnosed as a myxoma. Follow up clinical and radiologic examinations failed to detect recurrences. The discovery, ten years after excision of tumor, of multiple skeletal enchondromas raised the hypothesis of Ollier's disease, this being responsible for the myxoid chondroma of the nasal cavities. A past medical history of surgery to the left lower limb presenting a valgus deformity, and of a left suborbital angioma treated by curietherapy confirmed the diagnosis of Ollier's disease and suggested that of a Maffuci syndrome. Prognosis of the disease is dominated by the risk of onset of chondrosarcoma.
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In two patients with Waldenström's macroglobulinaemia complicated with peripheral neuropathy, purified monoclonal immunoglobulin M showed antibody activity specifically directed against vimentin, a major polypeptide of mesenchymal cell cytoskeleton and therefore in Schwann's cell. The neuropathy was of the sensory-motor type. It was improved in one case by plasma exchanges combined with chemotherapy. The relevance of this original antibody activity to the pathogenesis of neuropathy is discussed.
We evaluated the prevalence and specificity of smooth-muscle autoantibodies in 20 serum samples obtained from patients with angioimmunoblastic lymphadenopathy. Smooth-muscle antibodies in high titers were detected in 75 per cent of the samples. No such antibodies were found in 30 normal control serum samples or in 10 samples from patients with non-Hodgkin's lymphoma and 1 of 12 from patients with other types of polyclonal hypergammaglobulinemia were positive. The antibodies were polyclonal and belonged to the IgM, IgG, and IgA classes. They reacted with vimentin, the major polypeptide of the intermediate-filament cytoskeleton of mesenchymal cells. The pattern of tissue reactivity and absorption experiments both show that these antibodies recognize special antigenic determinants of the vimentin polypeptide that are shared by vimentin and other classes of intermediate-filament proteins - namely, keratin and desmin. The frequency of this unusual autoantibody activity in angioimmunoblastic lymphadenopathy suggests that, like hypergammaglobulinemia and a positive Coombs' test, it may represent a useful serologic marker for the disease.
We have studied the alterations of vimentin intermediate filaments in uninduced or differentiated HL60 and U937 human leukemic cell lines. Whereas uninduced lines exhibited only a discrete reseau of vimentin, TPA treated cells acquire a very rich vimentin network similar to that of normal monocytes. On the other hand, DMSO treated HL60 cells differentiate to polymorphonuclears without modification of the IF network. These findings indicate that leukemic cells retain the expression of vimentin and exhibit an IF network similar to that of their normal counterpart.
The expression of vimentin, the major polypeptide of the intermediate filament (IFM) cytoskeleton of lymphoid cells, was studied in normal and malignant human lymphoid cell lines. Cells from 24 of 27 Burkitt's lymphoma cell lines (BLCL) were found to have an absent (16 lines) or decreased (8 lines) expression of vimentin IFM. In contrast, non-Burkitt's malignant lymphoid cell lines (5 lines) and lymphoblastoid cell lines (LCL) derived from normal B-cells (45 lines) exhibited a well-developed vimentin IFM network. However, low expression of vimentin was also found in 3 LCL derived from patients with the Langer-Giedion syndrome, which is characterized by a deletion of the distal end of chromosome 8. Treatment of vimentin-negative BLCL and Langer-Giedion LCL with azacytidine led to a transient reexpression of vimentin.
A fatal case of eosinophilic meningitis associated with a large cell bronchogenic carcinoma is reported. Neither a cerebral parasitic disease nor metastatic localizations were found at necropsy. It is the first reported case of an eosinophilic meningitis linked to a bronchogenic carcinoma as a paraneoplasic syndrome.
We describe the alterations of vimentin intermediate filament (IF) expression in human hemopoietic committed precursors as they differentiate into mature cells of the erythroid, granulomonocytic, megacaryocytic and lymphoid lineages. A double labelling fluorescence procedure was used to identify hemopoietic cells expressing lineage-specific antigens and to decorate the vimentin IF network. Whereas very early progenitors from each lineage expressed vimentin, the density and organization of the network differed strikingly as the cells matured on a given pathway. T lymphocytes, monocytes and granulocytes retained vimentin expression at all stages of maturation. In contrast, megakaryoblasts lose vimentin expression at a very early stage of differentiation, erythroblasts at variable steps between the committed erythroid cell and the red cell. Finally, B lymphocytes tend to lose vimentin expression later when they mature into plasma cells.