[Benign tumors and pseudo-tumors of the jaws].
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Adolescent↗
Biomedical subjects
M Auriol
Publications and source records attributed to M Auriol.
[Undifferentiated carcinomas of the thyroid corpus. Apropos of 10 cases].
Ten undifferentiated thyroid carcinomas detected between 1976 and 1991, were reviewed by means of immunohistochemical techniques. These tumors were highly aggressive with a mean survival rate of three months after the histological diagnosis. They were predominant in women and always occurred in old people (mean age 63.1 years). Four tumours were composed of differentiated trabecular areas. Another one was included in a microvesicular adenoma and a sixth one occurred as a recurrence of a papillary carcinoma surgically treated four months previously. Six tumours were cytokeratin-positive and two of them showed a cytokeratin-vimentin coexpression. These results, like those of an electron microscopic analysis of 1 case, confirm the epithelial origin of these tumours. Undifferentiated carcinomas must be distinguished from poorly differentiated carcinomas and from malignant non Hodgkin lymphomas which have a better prognosis and a different therapeutic approach. The immunohistochemistry and the electron microscopy are useful to identify undifferentiated thyroid carcinomas.
Adult↗
[The value of biopsy of the accessory labial salivary glands for the diagnosis of amylosis].
Diagnosis of amyloidosis depends on the demonstration of amyloid deposits in biopsies using specific stains. Recently, in addition to classical biopsies (kidney, liver, gum, skin, rectal mucosa), labial salivary gland biopsy has been recommended as safe diagnostic method. In our recruitment, it allowed the fortuitous discovery of amyloidosis in three patients suffering from rheumatoid polyarthritis or spondylarthritis. In five other patients (2 cases of familial amyloidosis, 1 dysglobulinemia, 2 primary cardiac amyloidosis), biopsy was performed for systematic search of amyloidosis. In five of these eight cases, a sicca syndrome was associated with the salivary deposits. These deposits were stained with congo red viewed in polarized light and with T thioflavine. Besides, Wright's method allowed to know the AL or AA type of amyloidosis and thus to guide the treatment. On the whole, labial salivary gland biopsy is a highly sensitive method for diagnosis of primary and secondary amyloidosis.
Adult↗
[Heart-lung transplantation. A necropsy study of thirty-seven patients].
Between 1987 and 1992, thirty-seven heart-lung transplant recipients had a postmortem examination at the Pitié-Salpêtrière Teaching Hospital in Paris, France. Except for three patients who survived 2 months, 4 months and 16 months after transplantation, respectively, most patients died in the early postoperative period (mean survival time = 34.6 days). Autopsy disclosed minor acute heart rejection in four patients and minor acute lung rejection in three patients. Five patients had obliterating bronchiolitis that was the cause of death in two cases. Main causes of death included perioperative pleural bleeding, respiratory infection with or without septicemia, diffuse alveolar lesions (adult respiratory distress syndrome and/or pulmonary edema undergoing organization) and multiple organ failure. Hemodynamic and respiratory complications responsible for multiple organ failure in the perioperative period, as well as pre-existing morbid conditions such as cirrhosis of the liver induced by heart failure, may have a major bearing on the outcome of heart-lung transplantations.
Adolescent↗
[A malignant salivary lymphoepithelial lesion with a poorly differentiated epidermoid carcinoma. Apropos a case].
A case of malignant lymphoepithelial lesion of the submandibular gland is reported in a 71-years-old woman. The carcinoma showed a poorly differentiated pattern and its epidermoid nature was obvious after immunohistochemistry and electron microscopy. The epithelial nests were lying in an abundant lymphoid stroma consisting of small lymphocytes. A recurrence occurred ten months after surgical treatment. This observation is compared with those already related in the literature.
Aged↗
Basaloid carcinoma of salivary glands, a variety of undifferentiated adenocarcinoma. Immunohistochemical study of intermediate filament proteins in 24 cases.
Among adenoid cystic carcinomas of salivary glands (ACCs), the solid basaloid type has a poor prognosis similar to that of undifferentiated adenocarcinomas. We studied 24 cases in immunohistochemistry using antibodies reactive with keratins of various molecular weights, vimentin, S-100 protein, and its A and B subunits. Our findings were correlated with the histological pattern and with the variable degree of differentiation of these carcinomas. In comparison with other types of ACC, intermediate filament proteins in this group were weakly expressed. The co-expression of cytokeratin and vimentin was noted in some cases. Additional features noted were the presence of cribriform cavities associated with solid lobules and areas of necrosis giving a comedocarcinomatous pattern. In these two variants, cells characterized by the dual expression of cytokeratin and S-100 protein were seen. In the highly malignant anaplastic variety, only a few cells were weakly positive with antisera to cytokeratin and vimentin. This group shows similarities to undifferentiated adenocarcinomas of salivary glands. Such similarities could be explained by the common origin of these tumours from intercalated ducts.
Carcinoma, Transitional Cell↗
A pathologic analysis of the outcome following heart-lung transplantation: an autopsy study of 22 recipients.
Between 1987 and 1989, twenty-two patients who received combined heart-lung transplantation were autopsied at La Pitie Salpetriere Hospital in Paris. With the exception of two recipients who survived for 2 months and 4 months, respectively, the majority of the patients died in the early postoperative period (the mean survival was 20.1 days). At autopsy, five patients showed acute cardiac rejection of a minor grade. Perivascular and peribronchiolar mononuclear cell infiltrates suggesting acute pulmonary rejection were seen in three patients. Obliterating bronchiolitis, which might be indicative of chronic rejection, was observed in four patients who had longer survival rates, and one of these four had died of obliterating bronchiolitis. Rather than allograft rejection, the major causes of death were (1) perioperative hemorrhage, (2) infections (mainly respiratory infections and occasionally mediastinitis), (3) diffuse alveolar damage (the so-called adult respiratory distress syndrome and/or pulmonary organizing edema), and (4) multiple organ failure. The present study suggested some of the reasons why the survival rate following heart-lung transplantation is much poorer than after isolated heart transplantation. Hemodynamic or respiratory problems causing perioperative multiple organ failure as well as pre-existing complications of the recipients, such as "cardiac cirrhosis," may play an important role in the prognosis of heart-lung transplantation.
Adolescent↗
An immunohistochemical study of the distribution of lysozyme, lactoferrin, alpha 1-antitrypsin and alpha 1-antichymotrypsin in salivary adenoid cystic carcinoma.
The immunohistochemical expression of lysozyme (Ly), lactoferrin (La), alpha 1-antitrypsin (alpha 1-AT), and alpha 1-antichymotrypsin (alpha 1-Ach) was described, and their distributions were compared to each other in 28 cases of adenoid cystic carcinoma (ACC) of the salivary glands. ACC materials were obtained from the parotid gland (7), the submandibular gland (4), the sublingual gland (8), and minor oral salivary glands (9). Histopathologically, ACC was classified into cribriform (14), tubular (3), and basaloid or solid patterns (11). Positive staining for Ly was found in 1 case of solid ACC in the sublingual gland; La was found in 4 cases (2 cribriform, 1 tubular, 1 basaloid) in the sublinguals (3) and parotid glands (1); alpha 1-AT was found in 6 cases and alpha 1-Ach in 17 cases. The immunohistochemical localization of Ly and La was usually confined to luminal tumor cells of tubulo-ductal structures, irrespective of the pathologic types. Positive staining for alpha 1-AT and alpha 1-Ach appeared in tumor cells of cribriform, tubular and solid ACC. Tumor cells with positive La staining coincided with a positive reaction to alpha 1-AT and alpha 1-Ach, and tumor cells with alpha 1-AT positive deposition were also positive for alpha 1-Ach. The contents of pseudocysts in the cribriform pattern showed a positive reaction to La, alpha 1-AT, and alpha 1-Ach. Of the 28 cases of ACC, positive expressions for Ly, La, alpha 1-AT and alpha 1-Ach were found with a high frequency of alpha 1-Ach staining (17 in 28 cases were positive). In sublingual ACC (8), 7 cases were positive for immunohistochemical reactions. Co-expression or simultaneous expression for Ly, La, alpha 1-AT, and alpha 1-Ach in ACC suggest that tumor cells are protected from proteolysis or degradation.
Carcinoma, Adenoid Cystic↗
Immunohistochemical localization of MAM-3 and MAM-6 antigens in adenoid cystic carcinoma.
MAM-3 and MAM-6 antigens were detected immunohistochemically in 34 cases of adenoid cystic carcinomas (ACC) of the salivary glands and these patterns were compared to these of epithelial membrane antigen (EMA) and laminin. ACC was histologically divided into three types; the cribriform pattern, the tubular and trabecular pattern, and the solid cluster pattern. Immunostaining of EMA and MAM-6 antigen had a similar distributions in the luminal borders of luminal tumor cells, whereas the MAM-3 antigen was slight or negative in luminal borders. Myoepithelial derived tumor cells of ACC accompanying hyaline stroma demonstrated positive staining for the MAM-6 antigen (whole cell positive type), and luminal tumor cells of microcysts showed strong staining for the MAM-3 antigen. Laminin staining was confined to the basement membrane and surface borders in pseudocyst cavities. In salivary gland ACC, laminin staining can be used as a marker of pseudocyst surfaces and immunostaining of EMA and the MAM-6 antigen as a marker of luminal borders of cyst. These two histochemical markers were useful for discriminating pseudocyst and cyst.
Antigens, Neoplasm↗
[Epithelial-myoepithelial carcinoma of the salivary glands. Study of 15 cases and review of the literature].
Epithelial-myoepithelial carcinoma initially described by Donath in 1972 represents about 0.5% of salivary gland tumors. Total number of reported cases brings to at least 56 cases; we add 15 personal cases. These 71 cases included 46 women and 25 men. The ages range from 23 to 91 years with peak incidence from the 6th to the 8th decades. The majority of tumors (58) arose in the parotid gland. Of the 71 patients local recurrences occurred in 20, cervical lymph node metastasis in 6 and 2 patients died of their disease. Epithelial-myoepithelial carcinoma typically have a multinodular growth pattern with islands of tumors separated by dense fibrous connective tissue. These tumor masses were composed of well-defined tubules lined by two layers of cells: outer cells are large clear with variable amount of glycogen, inner cells are small, cuboidal and eosinophilic. Perineural invasion and necrosis were occasionally seen. In some cases, this biphasic pattern was less apparent with solid masses of clear cells. Electron microscopic and immunohistochemical studies confirmed the epithelial and myoepithelial differentiation. The differential diagnosis included all clear cells tumors of salivary glands (mucoepidermoid carcinoma, acinic cell carcinoma, sebaceous carcinoma) and also metastatic renal carcinoma. Epithelial-myoepithelial carcinoma is a tumor of low-grade malignancy of duct origin which should be differentiated from salivary duct carcinoma.
Adult↗
Heterogeneity and co-expression of intermediate filament proteins in adenoid cystic carcinoma of salivary glands.
Among a series of 76 adenoid cystic carcinomas (ACC), 51 cases with cibriform or trabecular patterns were selected for an immunohistochemical study. These tumors were composed of three types of cells: basaloid, myoepithelial and ductal luminal acinous or tubular cells with a variable amount of each cell type from one case to another. Monoclonal antibodies (MoAb) against keratins (PKK1, KL1, K8.12, K8.13, K4.62 anti-cytokeratins antibodies) and against vimentin were used. Tubular cells were characteristically marked by anti-cytokeratins MoAb, but with a great heterogeneity of keratin distribution. In myoepithelial cells, keratin was absent or slightly positive and vimentin was present, with co-expression of the two types of filaments in some cells. Like myoepithelial cells, basaloid cells were positive to anti-vimentin antibody and negative or slightly positive to anti-keratin antibodies, with sometimes a co-expression of vimentin and keratin filaments in the same cell. Histogenesis of adenoid cystic carcinomas was discussed. Progenitor intercalated duct reserve cells may change into ductal luminal and myoepithelial tumor cells. Otherwise, basaloid cells, arising also from intercalated duct reserve cells, are able to acquire some secretory organites.
Antibodies, Monoclonal↗
[An unusual form of primary epithelioma of the mandible: odontogenic clear cell carcinoma. Clinical and morphologic study].
One case of aggressive intramandibular epithelial tumor is presented. This tumor demonstrated an unusual pattern with areas of follicular ameloblastoma together with undifferentiated trabeculae or lobules composed of basophilic cells and of clear glycogenic-rich cells. The odontogenic nature of this tumour and its analogies with common ameloblastoma were demonstrated by electron microscopy, immunohistoenzymology and immunohistochemistry. The signification of such a neoplasm is discussed.
Adenocarcinoma↗
Acinic cell carcinomas of salivary glands histoprognosis. Value of NORs stained with AgNOR technique and examined with semi-automatic image analysis.
Twenty one patients surgically treated for acinar cell salivary gland carcinomas were studied retrospectively. Four cases were excluded from the results because of an inadequate follow-up time (less than 5 years). The rest was classified into two groups: eleven patients with a favorable outcome were still alive without any recurrence after a mean follow-up period greater than 10 years; in six other patients, recurrences and metastases occurred followed by death in four cases. Previously for such tumors a high degree of histological undifferentiation usually gave rise to a poor prognosis, although some exceptions were noted. Thus, in an attempt to find a more reliable prognosis criterion, we evaluated by semi-quantitative image analysis nucleolar organizer regions by means of AgNOR count and mean area in all these cases. Our results significantly correlated with the clinical prognosis: a high count (more than 3) and a small mean area were always found in tumors with an unfavorable outcome whereas lower counts and larger mean areas were found in tumors with a favourable clinical course. Thus, this method showed promise as establishing the prognosis of acinar cell tumours.
Adult↗
[Metastases of malignant tumor in the jaw. Analysis of 30 case reports].
30 metastases of malignant tumors in jaws were retrospectively studied. They occurred more often in women than in men (17 F/13 H). In 21 cases, the primitive cancer was known and had been treated 1 to 4 years before. In the other cases (9), the bone metastasis led to the discovery of a latent tumor. Clinical signs and symptoms included swelling, pain, loosening of teeth, labio-mental anaesthesia and rarely pathologic fracture. Radiologically, all but two patients had radiolucent lesion. These metastases almost always involved the mandible (95% of cases) and in that bone, most often molar area and angle. Histologically, the majority of lesions were adenocarcinomas from breast (33%) and alimentary canal (stomach, colon). Epidermoid bronchial carcinomas were seen in 5 cases and malignant melanomas in 2 cases. Only one sarcoma of this series was arising from a liposarcoma of the thigh. In all but one patients, evolution was quickly lethal.
Adult↗
[The effect of CO2 laser radiation on the morphological changes of mucocutaneous wound healing in oral surgery. A histo-enzymologic and ultrastructural study].
The tissular effects of CO2 laser were compared with those of conventional surgery on cutaneo-mucous biopsies performed during stomatologic surgery. Two hours after the incision, a cellular necrosis was seen and vessels were obliterated by a turgescent endothelium, explaining the bloodless character of wounds with laser. After 24 hours, though vasculo-exsudative end inflammatory reaction were weak, an intense functional stimulation of fibroblasts was obvious (turgescent cells with numerous organelles). At the 4th day, this fibroblastic hyperactivity was always persistant with an abundant microfibrillar secretion. Myofibroblasts, usually present during cicatrization after scalpel, were lacking in our material; this constatation should explain the relative slowness of cicatrization after CO2 laser.
Alkaline Phosphatase↗
[Cardiomyocyte in valvular cardiopathies. Comparative morphometry of myofibrils and mitochondria. Functional correlations].
Twenty-four endomyocardial biopsies performed during surgical correction of valvulopathies were compared with ventricular function. Patients were divided into three groups: group I without anomalies of ventricular function, group II with a slight decrease of the ventricular ejection fraction, group III with a low ventricular ejection fraction. Morphometric analysis was carried out using electron microscopic photographs and an image analyser. The results were correlated with those of functional studies. In patients of the second group, the small number of mitochondria with respect to the increased myofibrillary area seemed to indicate mitochondrial dysfunction. In patients of the third group, alterations of myocontractility expressed a myofibrillary deficiency unable to be corrected by the multiplication and the increased exchange areas of mitochondria.
Heart Valve Diseases↗
[Contribution to the study of NORs in acinic cell tumors of the salivary glands. Morphometric comparative analysis by optic and electronic microscopy].
Quantification of number and mean area of NORs was retrospectively studied in six acinic cell tumors with a well-known follow-up by means of electron microscopy without any silver staining. The results were compared with those obtained using silver staining and optical quantification. Mean areas were inversely correlated with the number of NORs. Positive correlations were found between these results and the clinical course: tumors with good outcome were characterized by a low NOR count (less than 2) and by large mean areas (greater than 600 microns 2); on the contrary, tumors with recurrences or metastases always had high NOR counts with small mean areas.
Carcinoma↗