[Osseous metastasis of bladder cancer. Apropos of 15 cases].
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Biomedical subjects
Publications and source records attributed to M Grossin.
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We report three cases of inflammatory fibroid polyp of the stomach (Helwig's pseudo-tumour) and record 127 patients in the literature. The anatomo-clinical features of such a disease are analysed and the larger outline of eosinophilic infiltrations of the gastro intestinal tract are described. Most of the authors class the gastric nodular eosinophilic granuloma as the Helwig's pseudo-tumour, but they are not so unanimous for the exact relationship between inflammatory fibroid polyp and the eosinophilic gastroenteritis. For Helwig, they are two distinct conditions, but for others, they belong to the same anatomo-clinical entity, with a broad diversity of morphological features.
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The authors report here two observations of leiomyosarcomas arising from peripheral blood vessels. The first case occurred in the pedious vein and infiltrated into tarsal bones. The second case was localized into leg muscles' tendons, near the knee. The topographical and histological characteristics of peripheral vascular leiomyosarcomas are noted, and compared, according to the review of literature, with those of the great central blood vessels, and of other classical leiomyosarcomas.
The pathogenesis of Stewart-Treves syndrome remains controversial: angiosarcoma or epithelial cell metastases from a mammary carcinoma? The case reported here, with clinical signs of Stewart-Treves syndrome on one side and mastectomy for carcinoma on the other side of the body, revives the debate. Case-history. The patient was an 89-year old woman whose left breast had been removed in June, 1981 for carcinoma with lymph node involvement. One year after the operation, multiple lymphadenopathy developed in her right armpit and subclavian region. In December, 1984, her right arm became swollen by lymphoedema, while Kaposi-like and nodular skin lesions appeared on her right upper chest and upper back and on her right shoulder and arm. Radiography of the chest showed right pleural effusion, bronchial lymph node enlargement and a reticulate image in the right lung. In spite of chemotherapy, the patient died in April, 1985. Pathology. Pathological examinations included standard histology (HPS, PAS and Gordon-Sweet staining), immunohistochemistry, using anti-factor VIII, anti-keratin KL1 and anti-EMA antisera, and electron microscopy. Results. Irrespective of the skin area biopsied, the histological images were always the same, showing carcinomatous lymphangitis with a varying degree of invasion of the surrounding dermis. Staining of the reticulum enhanced the vascular basal membranes but did not mark the intraluminal tumoral cell population. Post-mortem examination confirmed that the malignant lymphangitis extended to the lung tissue, the oesophageal wall and the adrenal glands, and that the axillary and subclavian lymph nodes were invaded by metastases.(ABSTRACT TRUNCATED AT 250 WORDS)
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A case of primary localized amyloidosis of the bladder in a 60 years old male is described. The initial symptom was hematuria. Cystoscopy revealed a redish angioma-like lesion on the trigone, and the diagnosis was pointed out with biopsy, complementary data, and a close follow-up during two years. In the literature we found 47 cases of primary localized amyloidosis of the bladder and 10 others cases of amyloidosis of the bladder which were part of generalized amyloid disease. The interest of the Wright's special staining method is underlined specifying, on light microscopic study, the AA or AL type of the amyloid disease.
A rare case of leiomyomatosis Peritonealis Disseminata (L.P.D.) associated with an Endometriosis is reported. A 40 years old non-gravid patient had a laparotomy for uterine fibromas. Multiple sub peritoneal nodules were found and a total hysterectomy with annexectomy was done with the diagnosis of peritoneal metastatic disease. The light and electron microscopy showed a benign multicentric proliferation of myofibroblasts and smooth muscles cells. The association with endometriosis suggests that L.P.D. must have a metaplastic origin, from subcoelomic mesenchymal cells, as speculated by previous authors.
The results of 20 puncture-biopsies and 43 needle-biopsies performed under local anaesthesia and guided towards a localized bone lesion under a fluoroscopic TV screen are reported. Malignancy was confirmed in 31 out of 36 cancerous bone lesions (83%). Metastases were demonstrated in 24/25 cases (96%) and malignant lymphocytic or plasmocytic lesions in 6/6 cases. There were no false-positive results with benign lesions. However, an accurate aetiological diagnosis was supplied by puncture- or needle-biopsy in only 1/5 cases of primary malignant tumour and in 1/6 cases of benign tumour. Guided puncture- or needle-biopsy seems to be particularly useful to distinguish between benign and malignant lesions, notably when bone metastasis is suspected. The technique can then be applied to those cases where puncture-biopsy of the posterior iliac crest is negative or even as first choice procedure if the bone lesion is not readily accessible.
The authors report one case of Mycobacterium marinum of the deep structures of the hand and review the literature on the subject. The symptoms are not specific: biopsy and culture are essential for diagnosis. As chemotherapy does not seem to be of help, wide surgical incision is the appropriate treatment.
Diffuse inflammatory angiitis is seen in extremely varied aetiological and nosological situations. In some cases, the vascular disease represents the only sign of systemic disease. In other cases, it mays be associated with or complicated by diffuse systemic inflammatory conditions. This study analysed 100 cases of inflammatory angiitis with systemic manifestations seen over a period of 7 years in a rheumatology department. Patients with scleroderma, erythema nodosa, Behçet's syndrome and angiitis associated with microbial infectious diseases were excluded from this study. 24 cases in which the angiitis was clinically certain, but in which the vascular lesion was not confirmed histologically were also excluded. The type of histological lesion and the nosological distribution of these 100 cases are described in detail. The results of this analysis confirm the very great variety of the clinical and histological presentations. A number of rare syndromes were observed. Classical periarteritis nodosa only represented 14 per cent of the whole series and only 3 of the 14 cases had a demonstrable aetiology (2 HBs, 1: desensitisation to Candidin). The authors stress the histological diversity of inflammatory angiitis associated with rheumatoid arthritis and systemic lupus erythematosus. All sizes of vessels may be involved and all types of lesions can be observed in these two diseases. The authors also emphasise the lesser known clinical and histological features (stenosing endarteritis of the great vessels in systemic lupus erythematosus) and previously unreported cases (valvular lesions in 2 cases of Mac Duffie's syndrome, progression of 2 cases of delayed urticaria to pressure towards a clinical lupus with unusual laboratory findings).(ABSTRACT TRUNCATED AT 250 WORDS)
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Authors present the case of a 59 years old man in whom an intra abdominal mass was discovered fortuitly. A surgical intervention permitted to remove a retroperitoneal mass. The macroscopic features were similar to those of multicystic mesothelioma. A review of literature of the 31 cases published permits to present the characteristics of cystic mesothelioma. This entity was confound during a long time with cystic lymphangioma, from which it was distinguished in 1979 with the use of electron microscopy. Interest of studies in immunochemistry, already unpublished, is demonstrated here for Factor VIII and cytokeratin.
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