[Post-herpetic pseudolymphoma in chronic lymphoid leukemia].
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Biomedical subjects
Publications and source records attributed to M Grossin.
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An immunohistochemical study of 40 primary and secondary malignant melanomas in 27 patients, with routinely-used monoclonal antibodies, demonstrated the antigenic pattern exhibited by these tumors, as well as the frequency of aberrant positivities for epithelial cell markers. The following results were found: 95% of melanomas stained positively for S100 protein and vimentin, which is the characteristic immunohistochemical pattern in melanomas. In most cases, the primary tumor and its metastases in a given patient had the same antigenic phenotype. As for epithelial markers, 10% of melanomas stained positively for KL1 and 27.5% for EMA. Despite this relatively high frequency of KL1 and EMA positivities, in practice, simultaneous positivity for S100 protein and vimentin, confronted with the patient's history and with histologic features, firmly establishes the diagnosis of malignant melanoma in virtually all cases.
Four cases of neuroendocrine carcinoma following Bowen's disease are presented. An immunohistochemical study was performed. The four patients, 3 men and a woman, ranging from seventy to eighty-seven years of age, developed a nodular tumor on a preexisting cutaneous lesion. In one of those cases the diagnosis of Bowen's disease was confirmed histologically before the apparition of the nodular tumor. The tumors were localized on the scalp, thorax, dorsum of the hand, and the scrotum. The four tumors were immunohistologically typical of neuro-endocrine carcinoma: there was a positivity for neurofilaments, cytokeratins and neurone-specific enolase. The clinico-pathological characteristics of those 4 neuro-endocrine carcinomas associated with a Bowen's disease, when compared with the 15 similar described in the literature, are identical to the isolated neuroendocrine carcinoma, from a clinical, morphological and evolutional point of view. The majority are seen in patients older than 60 years old and one third of the cases described survived at least 5 years. The coexistence of Bowen's disease and neuroendocrine carcinoma, the association of neuroendocrine and epidermoid cells in other cutaneous tumors, reactivate the controversy concerning the histogenesis of the so-called Merkel cell carcinoma. In fact, the histogenesis of the tumor is still not fully understood.
We report three cases of typical macular atrophy which appeared during, or was noticed shortly after varicella. The three patients were children. These cases were particular in that anetoderma lesions occurred independently of the scarring varicella lesions and followed a prolonged course of their own afterwards. We were unable to classify these cases in the primary or secondary type of macular atrophy. The various dermatoses associated with macular atrophy and the numerous physiopathological hypotheses put forward concerning this entity are enumerated.
Recently, applications of immunohistochemical techniques for the cytoplasmic localization of intermediate filaments has produced advances in tumor diagnosis and characterization. We report a 58-year-old white male with a clinically and histologically typical metastatic malignant melanoma. This case was peculiar because the same neoplastic cells stained for both S-100 protein and keratin on paraffin embedded tissue. These facts illustrate how cautiously we must interpret the positivity of immunohistochemical technics. We thus insist on the importance of the clinical and basic histologic data for the diagnosis, in order to avoid errors.
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The authors report an association of an adenocarcinoma and an osteosarcoma of the prostate in a 78-year-old man. He died within 18 months according to the bad prognosis encountered in the seven cases of prostatic primary osteosarcoma published in the literature.
Sacroiliac joint (SIJ) involvement has been reported in up to 9.7 percent of patients with skeletal tuberculosis. Lack of awareness of this now uncommon form of infection often leads to diagnostic delay and increased morbidity. Eleven consecutive cases of SIJ tuberculosis are reported; clinical and radiologic features, diagnosis, treatment, and outcome are discussed. Buttock pain was the presenting complaint in all patients. However, radicular pain in the lower back (seven patients) or lower limb (10 patients) was common and in one patient precipitated an unnecessary surgical intervention. SIJ tuberculosis is frequently an isolated phenomenon. Therefore, direct sampling of the SIJ is necessary to establish the diagnosis. The recently described technique of closed needle biopsy of the SIJ was employed in all 11 patients and established the diagnosis in nine of the 11.
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The prognostic value of bone marrow biopsy was established in 31 patients suffering from stage IIA and IIIA myeloma (Durie and Salmon classification). Data obtained from quantitative marrow cytology permit to differentiate 3 sub-groups of cells: plasmocytes, plasmoblasts, plasmocytes/plasmoblasts of which the incidence on the prognosis and the response to treatment was studied. There is a correlation between the response to MP and the nature of various cells populations and, on the other hand, the type of infiltration. A sub-group of patients, resisting to MP, was identified: diffuse plasmoblastic myelomas of poor prognosis. Induction poly-chemotherapy seems far superior over the MP combination, which was always a controverted issue.