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Biomedical subjects

M D Diebold

Publications and source records attributed to M D Diebold.

At least 37 records · Page 2Linked to original sources

[Lymphocytic ascites revealing systemic mastocytosis].

Systemic mastocytosis is a chronic disease with proliferation of mastocytes in organs separate from skin. We report the case of a systemic mastocytosis revealed by a lymphocytic ascites in the absence of cutaneous involvement. The diagnosis was established by the ultrastructural examination of the bone marrow. Identification of few mastocytes in ascites suggested a mast cell infiltration of the peritoneum. A treatment by alpha-2b interferon was unsuccessful, and death rapidly occurred.

Ascites↗

[Colorectal lesions predisposing to cancer].

Precursors of colorectal carcinoma are adenomatous polyps, sporadic or arising in familial adenomatous polyposis and Lynch syndrome and chronic inflammatory lesions related to ulcerative colitis and Crohn's disease. The adenoma-carcinoma sequence is well established and early detection and removal of colorectal adenomas is thought to prevent colorectal cancer in high risk asymptomatic persons, i.e. subjects over 45 years, with personal or familial history of adenomas and colorectal cancers. The precancerous potential of adenomatous polyps varies according to tissue type, with increased risk with the extent of the villous component, high grade of dysplasia, large size greater than 1 cm and multiple adenomas. The development of de novo colorectal cancer from normal mucosa with flat adenomas has been recently emphasized. The risk of colonic cancer in patients with ulcerative colitis and Crohn's disease is controversed.

Aged↗

[Bronchial epidermoid carcinoma with unusual disclosure].

Dissemination has often occurred before the diagnosis of bronchopulmonary cancer. Pancreatic metastases are exceptional and are very rarely the revealing manifestation. The authors report a case of a tumour of the pancreas which led to the discover of an bronchogenic epidermoid carcinoma. The relationship between these two tumours lead to the proposed hypothesis of pancreatic metastasis of a bronchogenic carcinoma. Although this situation is rare, the preoperative work-up for bronchogenic carcinoma should include computed tomography of the pancreas if the abdominal echography does not allow complete visualization of the pancreas in cases with suggestive digestive disorders. If a tumour is observed in the pancreas, scan-guided needle biopsy should be performed to enable the histological examination.

Carcinoma, Bronchogenic↗

[Reproducibility of histological criteria of dysplasia in Barrett mucosa].

Barrett's mucosa is a precancerous condition. The goal of endoscopic surveillance for patients with Barrett's esophagus is to grade dysplasia. The diagnosis of dysplasia is difficult. The aim of this study was to determine the observer variation in diagnosis of dysplasia. Thirty-seven biopsies selected from Barrett's mucosa reported as having dysplasia between 1987 and 1988 were reviewed by 4 pathologists. The biopsies were classified according to the method of Riddell, as no dysplasia, indefinite for dysplasia, low-grade dysplasia and high-grade dysplasia. Each pathologist reviewed the biopsies alone and then together. There was a total agreement between the 4 pathologists in 20 out of 37 biopsies (54%). The pair-wise agreement varied between 65 and 84%. It was 84% when the pathologists belonged to the same institution. Of 222 double reviews made by 6 pairs of pathologists (37 biopsies x 6 pairs of pathologists), there were 58 disagreements: 19 low grade/high grade dysplasia, 2 high grade/indefinite for dysplasia, 1 high grade/no dysplasia, 18 low grade/indefinite for dysplasia, 2 low grade/no dysplasia, 16 indefinite for dysplasia/no dysplasia. At the second review when the pathologists evaluated the biopsies together, the agreement was 92%; there were 3 biopsies on which there was total disagreement: twice between high grade and low grade dysplasia, once between low grade dysplasia, indefinite for dysplasia and no dysplasia. This retrospective study has shown that disagreement between pathologists was rarely found on the biopsies diagnosed as having high grade dysplasia, more often on those diagnosed as having low grade dysplasia or indefinite for dysplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Barrett Esophagus↗

[Ultrasound-guided fine-needle punctures of abdominal masses: cytology or histology? Comparative prospective study].

The aim of this study has been for one part to assess the obtaining of cytological and histological material from the same patients with the minimum amount of injections using a fine needle (diameter less than 1 mm) and also to evaluate the histological and cytological supply, individually and jointly in the diagnosis of abdominal tumors. Seventy lesions of which 58 hepatic have been punctured with fine needles of 20 (0.9 mm) to 22 G (0.7 mm). Material has been obtained in 98.6 per cent of cases for cytology and 54 per cent of cases for histology. Their respective sensitivity in the diagnosis of malignant tumors was 96.8 per cent and 86.8 per cent and was not improved by adjoint analysis. The specificity was 1 for cytology. The differential diagnosis in malignant hepatic tumors between hepatocarcinoma and metastasis was existent in 94.3 per cent of cases for cytology and 90 per cent for histology with no benefit coming from the association of two. In the group having hepatic metastasis without known primary cancer having found histological confirmation of the primary lesion, the cellular type has been revealed in exactitude in 94.4 per cent of cases with cytology and in 63.6 per cent with histology. No complications have been observed. The fine needle cytological aspiration ponction gives very satisfying results, comparable with regard to the diagnosis contribution to results of published studies, obtained with the use of coarse needle biopies. We suggest that fine needle ponction should be used preferentially and that coarse needle biopsy should be restricted to the few cases in which the former does not yield sufficient information.

Abdominal Neoplasms↗

[Value of the nucleolar organizers (AgNOR) in brain gliomas].

The aim of the study was to evaluate the feasibility and possible contribution of silver stained nucleolar organizer regions (AgNORs) to prognostic considerations, in a series of 55 supratentorial gliomas: eight grade II astrocytomas, twelve grade III astrocytomas, thirty grade IV astrocytomas, two glioblastomas, one anaplastic oligodendroglioma, one oligodendroglioma and one ependymoma. Silver NORs (AgNORs) were demonstrated according to the method of Crocker et al. A difference between AgNOR sizes in peritumor and tumor tissue is noted. The mean NOR numbers in the tumor areas range from 0.871 to 2.677, without overlap between peritumor gliosis and glial tumors. A comparative analysis reveals significant correlations between the mean NOR number per nucleus and histological grading. This technique can play a practical role in the diagnosis and grading of tumors sampled by stereotactic biopsies: a count higher than 0.8 is highly suggestive of malignancy. In addition, the distribution of NORs may be important: intratumoral heterogeneity expresses various degrees of transcriptional activity between different glial tumors of the same grade. This technique provides information about the biological behaviour of glial tumors supplementary to that obtained from growth fraction analysis.

Evaluation Studies as Topic↗

[Cardiac metastasis secondary to digestive adenocarcinoma. A case report].

The authors report a case of cardiac metastasis revealing a malignant tumor of the biliopancreatic junction. This observation raises the problem of the diagnosis of revealing metastases. Immunohistochemical and ultrastructural studies may help to diagnose and identify primary tumors. This identification plays a major role predicting the prognosis and determining an optimal treatment.

Adenocarcinoma↗

[Intramural pseudo-diverticulosis of the esophagus or cystic esophagitis? Study of an unusual surgical case].

The authors report an unusual case of oesophageal pseudo-diverticulosis. A 63-year-old male patient presented with dysphagia. A preoperative diagnosis of oesophageal intramural tumour was made on radiological and endoscopic abnormalities. The histopathological study of the involved oesophagus showed a pseudocystic dilatation of glandular ducts in the submucosa with a lymphocytic infiltrate. The authors review the relevant literature on oesophageal intramural pseudodiverticulosis and suggest a possible pathogenesis for this rare and benign entity.

Diverticulum, Esophageal↗

[Familial forms of endocrine tumors of the pancreas. Apropos of 4 cases in the same family].

Four cases of endocrine tumors of the pancreas and, more generally, of the diffuse endocrine system, are presented here. Included are all the data relative to the inherited character of the disease covering two generations. Two brothers had Zollinger-Ellison syndrome--one of them probably, the other one proven (first case recorded in France). Both patient's only sons are currently treated for endocrine tumor of the pancreas and Zollinger-Ellison syndrome, respectively.

Adult↗

[Occult adenocarcinoma of the parotid. Apropos of 2 cases].

The authors present two cases of parotid gland adenocarcinomas, without clinical swelling: revealed differently: one by facial paralysis; the other by mandibular extent signs, but setting altogether, some problems to explain their histogenesis; primitive or metastatic adenocarcinoma in the first observation; primary gland tumor, or transformation of a pleomorphic adenoma in the second one. The authors insist on the facial paralysis value, to guide the surgical approach.

Adenocarcinoma↗

[Metastatic cancers of the thyroid gland. Diagnostic difficulties].

Metastatic carcinoma of the thyroid is uncommon in surgical pathology and may masquerade as primary thyroid cancer. We studied 6 cases of biopsied and/or surgically resected metastatic carcinoma of the thyroid and their corresponding primary carcinoma, with emphasis on the differential diagnosis. There were 4 men and 2 women patients aged 44 to 77. The primary carcinoma was a breast infiltrating duct carcinoma (3 cases), a colorectal adenocarcinoma (2 cases) and a bronchial oat-cell carcinoma (1 case). The interval between primary carcinoma and secondary thyroid carcinoma was 2 to 9 years in 4 cases; 2 other cases showed simultaneous occurrence. Five patients died with widespread metastases 1 to 14 months following the diagnosis of secondary carcinoma of the thyroid; 1 patient was alive after 24 months. The histological differentiation of secondary from primary thyroid cancer may be difficult in the following situations: clear-cell, Hürthle-cell and signet ring cell changes; positivity of mucins stains; production of melanin; epidermoid differentiation; very rare miscellaneous tumours ("columnar cell carcinoma" and primary thymoma of the thyroid). Immunoperoxidase methods and mucin histochemistry may help.

Adenocarcinoma↗

Metastatic calcification in the thyroid gland demonstrated on bone scan in a patient with primary hyperparathyroidism.

Bone scanning agents are known to accumulate in extraskeletal sites. We report the case of a patient with primary hyperparathyroidism whose bone scan performed with [99mTc]HMDP revealed not only the classic pattern described in hyperparathyroidism, but also a striking visceral uptake in the lungs, heart, stomach, and thyroid gland. Metastatic calcification was found on histologic examination of the thyroid.

Aged↗