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M E Ribet

Publications and source records attributed to M E Ribet.

At least 19 recordsLinked to original sources
PubMed1996

Plasma cell granuloma of the lung: difficulties in diagnosis and prognosis.

BACKGROUND: The nature of plasma cell granuloma of the lung is still not well defined. Its diagnosis can be difficult, and its long-term prognosis is uncertain. METHODS: Four patients, aged 4 1/2 to 45 years, had resection of a circumscribed plasma cell granuloma. In 1 of them, it was associated with a carcinoma. The fifth patient was treated by irradiation for an invasive form of plasma cell granuloma, which was diagnosed as malignant lymphoma 1 year later. The plasma cell granulomas had a similar polymorphic pattern and were polyclonal at immunohistochemistry. RESULTS: The 3 patients treated by lobectomy, including the patient with an associated carcinoma, were alive and well at 12, 12, and 11 years postoperatively. The patient treated by pneumonectomy had recurrence 9 years later and died 11 years after operation: irradiation was not effective. The patient with lymphoma was treated by chemotherapy and was alive and in remission 5 years later. CONCLUSIONS: An accurate preoperative diagnosis is difficult. The results of biopsy can be inconclusive, and an associated malignancy can be missed. Complete resection remains the best treatment. The long-term prognosis is unpredictable, and late and fatal recurrences are possible.

Adolescent↗
PubMed1996

Bronchogenic cysts of the lung.

BACKGROUND: The clinical presentation of lung bronchogenic cysts (BC) is variable, from respiratory distress at birth to late appearance of symptoms. METHODS: This study of BC was based on a retrospective review of 41 cases: 21 infants and children and 20 adults, aged 1 day to 68 years. The diagnosis was antenatal in 4 cases. Three infants required mechanical ventilation, and 2 had their cyst drained before resection. Twenty infants and children and 17 adults underwent operations. RESULTS: Compression was the most important complication in infants and children. Cough, infection, and hemoptysis occurred later in life; 80% of the total population was symptomatic. Seven cysts were infected. There were no deaths after resection, and there was no recurrence of symptoms during the follow-up period (13 months to 21 years). CONCLUSIONS: Bronchogenic cysts originate from the foregut. Differentiation from other acquired or congenital lesions can be difficult. It is uncertain what proportion of BC remain asymptomatic. More than half of patients are diagnosed after the age of 15 years, and complications may appear late. Clinical findings and plain chest radiograms are often sufficient for diagnosis. Lobectomy is the standard treatment, whereas drainage is a temporary, palliative, and risky procedure in cases of life-threatening compression. We conclude that a symptomatic BC is an indication for resection and that the long-term prognosis of an asymptomatic BC is unpredictable. Thus, there is a role for preventive operations.

Adolescent↗
PubMed1996

Postresection irradiation for T2 N0 M0 non-small cell carcinoma: a prospective, randomized study.

BACKGROUND: Stage I nonirradiated T2 N0 non-small cell lung carcinoma has a postoperative prognosis not very different from stage II irradiated T1 N1 carcinoma. The hypothesis was that more locoregional malignant sites are overlooked in T2 N0 M0 than in T1 N0 M0 tumors, considering the better prognosis of this last group, and that T2 N0 cancer might benefit from postresection irradiation. METHODS: From 1985 to 1991, 163 non-small cell lung carcinomas were classified T2 N0 M0 and randomized for irradiation or nonirradiation after operation. After revision of all the cases, 132 were included in this study: 60 were irradiated and 72 were not irradiated. All were followed up. The study was closed in October 1995. Statistical analysis was then performed considering volume, location, cell type, survival, and recurrence in the two groups. RESULTS: One hundred thirteen patients were followed up during a minimum of 5 years: the survival was 44.2%. There was no significant difference considering cell type or irradiation. There was no recurrence-free survivor beyond 5 years with a tumor invading the visceral pleura. At the close of the study (follow up, 4 years 3 months to 10 years 1 month), 49 of 132 patients were alive. The median survival was 3 years 11 months. Fifty-nine patients had died of local (21) or distant (40) recurrences (2 patients had both local and distant recurrence). There was again no significant difference considering cell type or irradiation, either in the survival or in the mode of recurrence. CONCLUSIONS: Stage I T2 N0 M0 non-small cell lung carcinoma tends to manifest distant metastasis. Prospective studies of stratified systemic adjuvant therapy should improve the present moderate result of radical resection in this group of tumors.

Adult↗
PubMed1995

Bronchioloalveolar carcinoma and congenital cystic adenomatoid malformation.

We report on a 42-year-old woman in whom was discovered a symptomless peripheral radiologic excavated lesion of the lung, which actually existed 3 years before. All investigations were negative. A segmentectomy was performed. Histopathologic examination proved a bronchioloalveolar carcinoma in contact with a type I congenital cystic malformation of the lung. Such a malformation can be diagnosed late in adult life. The epithelial cells of the malformation might predispose to slow proliferation and malignancy, enhanced by smoking habits.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1995

Bronchogenic cysts of the mediastinum.

During a 25-year period 69 patients whose ages ranged from 1 day to 64 years were treated for bronchogenic cyst of the mediastinum. The male-to-female sex ratio was 1:0.76. The cysts were symptomatic in 63.7%, compressive in 43.4%, and life threatening in 2.8% of cases. Symptoms and signs of compression were more frequent in infants and children than in adults. Such symptoms and signs were more dependent on the location of the cyst than on its volume. The preoperative diagnosis was wrong in 16% of cases. The cysts were approached through thoracotomy in 67 cases, including one conversion from thoracoscopy, and through cervicotomy and mediastinoscopy in one case each. The cysts opened into the respiratory tract in five cases. No communication with the esophageal lumen was observed. The cystic contents were apparently infected in three cases, but samples remained sterile at culture. There was one hospital death caused by a centrally located compressive cyst that was undiagnosed at thoracotomy. The postoperative morbidity rate was 13.4%. There were no further symptoms after operation in children, but five adults reported continuing pain or dyspnea. Resection of bronchogenic cysts is recommended because of uncertainties in diagnosis and in evolution.

Adolescent↗
PubMed1994

Neurogenic tumors of the thorax.

We have conducted a retrospective review of 134 cases of neurogenic tumors of the thorax, including 66 in infants and children and 68 in adults. Nerve cell tumors were the majority in infants and children (84.8%) and were mostly malignant (67.2%). Nerve sheath tumors were more frequent in adults (73.5%). Nerve cell tumors were the most frequent tumors in males and nerve sheath tumors in females. Nineteen tumors were associated with von Recklinghausen's disease. The tumors were symptomatic in 76.4% of children and 36.7% of adults. Spinal cord compression was observed in 8 infants and children and in 2 adults. Neo-adjuvant treatment was administrated to 3 patients. Resection was complete for 80 benign tumors out of 86 (93%) and for 26 malignant tumors out of 48 (54%). Postoperative chemo- or radiotherapy (or both) was administrated to 17 children and 8 adults. The mean followup periods were 11 years for the infants and children and 8 years, 6 months for the adults. There was one postoperative death. There were no late deaths related to benign tumor. The prognosis of spinal cord compression depended on the malignancy and staging of the tumors. At 5 years postoperatively, 21 children out of 28 with neuroblastomas and 8 out of 9 with ganglioneuroblastomas were alive. The possibility of maturation of neuroblastomas and survival with hepatic metastases was confirmed. The prognosis in cases of chemodectoma depended on the extension. Patients with malignant schwannomas had very poor prognoses, especially when associated with von Recklinghausen's disease.

Adolescent↗
PubMed1992

Reflux esophagitis and carcinoma.

Early detection of a malignancy in reflux esophagitis should permit an effective surgical action if a causal time relation between reflux, esophagitis and carcinoma exists. In the medical literature on tumors of the esophagus associated with reflux esophagitis, it has been reported that they are adenocarcinomas in most instances. Squamous carcinomas are seldom mentioned. In a population of patients with five squamous carcinomas and 13 adenocarcinomas associated with reflux, three squamous carcinomas had developed on stage III or on a stenotic esophagitis and two squamous carcinomas were at the upper limit of a Barrett's esophagus. The 13 adenocarcinomas were associated with a Barrett's esophagus. No carcinoma was found to be associated with a low grade esophagitis. During the same time period, 224 patients were operated upon for a serious documented esophagitis (stage III, stenotic, Barrett's esophagus), including the 18 patients with carcinoma. Five hundred and thirty-four patients were operated upon for a lower grade esophagitis, with no associated carcinoma and 592 patients were operated upon for carcinoma of the esophagus. The five squamous carcinomas associated with reflux were resected and classified T1 N0. The 13 adenocarcinomas associated with reflux were resected and classified T1 N0 M0 (two patients), T2 N0 M0 (two), T3 N0 M0 (five), T3 N1 M0 (one patient), T3 N2 M0 (one) and T3 N3 M0 (two patients). Four patients with squamous carcinomas were alive after two, six, nine and 15 years. Eight patients with adenocarcinomas were alive after two years (one patient), three years (two patients), four years (three), five years (one patient) and seven years (one). Three carcinomas were diagnosed by routine endoscopy. The mean age of the patients with carcinoma associated with reflux was older than in the general carcinoma series, the relative number of females was higher and the use of alcohol and tobacco was not as frequent, but the differences were not significant. In squamous and columnar carcinomas, a long history was significant (p less than 0.001); in Barrett's esophagus, loss of weight (p less than 0.01), intestinal epithelium (p less than 0.001) and dysplasia (p less than 0.01) were also significant. In one patient, carcinoma was discovered during the follow-up evaluation of an antireflux procedure for Barrett's esophagus.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenocarcinoma↗
PubMed1991

Thymoma.

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Combined Modality Therapy↗