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Biomedical subjects

M Patey

Publications and source records attributed to M Patey.

At least 19 recordsLinked to original sources
PubMed2006

[How to interprete hypercalcitoninemia?].

PURPOSE: Today, calcitonin assay is used for the diagnosis of thyroid medullary cancer in the context of nodular thyroid disease. Calcitonin is an excellent marker of thyroid medullary cancer but some hypercalcitoninemia can also be related to other diseases, such as renal failure, endocrine tumors other than thyroid medullary cancer and sometimes to C cell hyperplasia, which is a not well-defined situation. Recent studies contributed to define calcitoninemia thresholds, which guide decision and avoid excessive invasive treatment. CURRENT KNOWLEDGE AND KEY POINTS: After a brief reminder of physiological role of calcitonin and assays, the difficulties encountered in interpreting hypercalcitoninemia and its potential causes other than thyroid medullary cancer are addressed. Recent studies, on large series, now allow a better knowledge of specificity and sensitivity of calcitonin measurement in patients with nodular thyroid disease and a well-argued management. FUTURE PROSPECTS AND PROJECTS: In the future, calcitonin dosage will be ordered even more frequently, as some authors recommend it for the diagnosis of thyroid nodule. It is up to us to know how to use this remarkable marker, by considering all possible situations of benign hypercalcitoninemia and reserving aggressive treatments for patients who really need them.

Adult↗
PubMed2001

[Paraneoplastic acquired ichthyosis revealing non-Hodgkin's lymphoma].

BACKGROUND: Paraneoplastic ichthyosis is a rare affection generally associated with malignant hemopathy. CASE REPORT: A 61 year-old man was seen with a generalized ichthyosis associated with a palmoplantar hyperkeratosis developed over the last 2 years, and an axillary lymph node. Histology of the lymph node revealed a large cell anaplastic lymphoma. Both ichthyosis and palmoplantar keratosis totally disappeared three weeks after adenectomy, without any other treatment. DISCUSSION: This rapid and complete regression of ichthyosis, after the sole ablation of the involved lymph node confirmed the paraneoplastic nature of the disorders of the keratinization (ichtyosis, palmoplantar keratodermia). The review of the literature showed only one case characterized by a rapid disappearance of ichthyosis after surgical treatment of the malignant lymphoma.

Humans↗
PubMed2000

Surgical anatomy and embryology of the adrenal glands.

Gross anatomy explains the different surgical approaches to adrenalectomy and the difficulties encountered by surgeons during this procedure. Development of the adrenal glands explains the location of the ectopic sites and excess hormone production by adrenal tumors. The choice of a surgical approach is sometimes difficult and is dependent on (1) the morphology of the body; (2) the volume of the tumor, which necessitates immediate vascular control; and (3) the type of disease, which may necessitate a complete exploration of the abdominal cavity.

Adrenal Gland Diseases↗
PubMed1999

Medullary thyroid microcarcinoma: a clinicopathologic retrospective study of 38 patients with no prior familial disease.

Thirty-eight patients (25 women, 13 men; mean age, 57.8 [32 to 91]) showing one or more medullary thyroid microcarcinomas (ie, < 1 cm), with no prior MEN II or medullary thyroid carcinoma history in their family, were reviewed. Follow-up was available for 29 patients (mean, 53.6 months [1 to 147]). 21 patients (72.4%) are alive and free of disease, four patients (13.8%) died during follow-up without disease, 2 patients are alive with disease (local recurrence and persistent hypercalcitoninemia) after 80 and 99 months, respectively, and 2 patients died of disease after 24 and 46 months. Most tumors were incidental pathological findings (19 of 38) or were discovered by systematic blood calcitonin measurement for a nodular thyroid disease (15 of 38). Only the four patients who had an unfavorable outcome were symptomatic cases (palpable micro-MTC, diarrhea, cervical lymph node metastasis and pulmonary metastatic disease). The two patients with metastatic disease at diagnosis died during follow-up. In univariate analysis, a symptomatic medullary thyroid carcinoma was a strong predictor of an unfavourable outcome (p < .00008), as were the preoperative calcitonin level (P = .007) and an elevated postoperative calcitonin level (P = .004). Among 30 histopathological criteria, only the presence of amyloid correlated with an unfavorable outcome (P = .018).

Adult↗
PubMed1999

Immunohistochemical study of thrombospondin and its receptors alpha root of beta 3 and CD36 in normal thyroid and in thyroid tumours.

AIM: To describe the pattern of distribution of thrombospondin (TSP1) and its receptors, alpha root of beta 3 integrin and CD36, in normal human thyroid tissue and to compare their expression in different benign and malignant thyroid conditions. METHODS: Immunohistochemistry was used to study TSP1 and its receptors in 40 surgical thyroidectomy specimens (normal parenchyma, 7; follicular adenoma, 4; multinodular goitre, 13; papillary carcinoma, 6; follicular carcinoma, 8; anaplastic carcinoma, 2). RESULTS: In the normal thyroid parenchyma, there was weak expression of TSP1 limited to the vessels with no staining of the extracellular matrix. In goitres, the expression of TSP1 was more pronounced in areas of fibrosis, with staining of alpha root of beta 3 on thyrocytes located in the vicinity. In thyroid adenomas, expression of TSP1 was slightly enhanced compared with normal tissue, located in the basement membrane of vessels. In papillary carcinomas, TSP1 was abundant in the desmoplastic stroma with a cytoplasmic distribution of alpha root of beta 3 integrin in thyrocytes. In follicular carcinomas, TSP1 was less abundant in the extracellular matrix, limited to the vessels of the stroma with a weaker expression of alpha root of beta 3 on thyrocytes than in papillary carcinomas. In anaplastic carcinomas, TSP1 was only present in the numerous capillaries of the stroma, with a marked positivity for alpha root of beta 3 in one case. No immunostaining of thyrocytes is observed with CD36. CONCLUSIONS: These results suggest the importance of the interaction between alpha root of beta 3 integrin and TSP1 during remodelling of the matrix in fibrous goitres with areas of early sclerosis comparable with wound healing. In papillary carcinomas, the overexpression of TSP1 restricted to the stroma suggests protective effects against tumour progression.

CD36 Antigens↗
PubMed1999

[How to optimize lymph node dissection in colorectal cancers. A technique for simple and efficacious clarification].

Studies relating to the prognosis of colorectal carcinomas insist on the quality of mesocolic examination and on the frequency of metastases in minute lymph nodes. The aim of our study was to evaluate an easy, rapid and new clearance method recently described by Koren et al. Twenty-one surgical specimens for colorectal carcinomas have been investigated. After lymph node examination with the traditional method, the mesocolic fat was immersed in a clearing solution. After 6 hours, lymph nodes stood out as white chalky nodules, and were dissected. By the traditional method 182 lymph nodes were detected and 89 additional lymph nodes after clearing. In one case, the detection of a metastasis in lymph node after clearing allowed to upstage the tumour from Dukes B (N0) to Dukes C (N+). This easy and inexpensive method allows the detection of minute lymph nodes and helps to establish a more accurate staging.

Colorectal Neoplasms↗
PubMed1999

[112 cases of sporadic and genetically determined pheochromocytoma: a comparative pathologic study].

The aim of this study was to compare 64 genetically determined pheochromocytomas (PH) (49 MEN IIa, 3 MEN IIb, 6 Von Recklinghausen diseases, 1 von Hippel-Lindau disease, 5 familial pheochromocytomas) and 48 sporadic PH. Genetically determined PH were more often observed among men and more frequently bilateral and multicentric than sporadic PH. Sporadic tumors had more often adrenal capsular invasion, necrosis and pseudocysts. Genetically determined PH were more differentiated with an insular pattern, hyaline globules and a higher percentage of polyhedric cells. Sporadic tumors were less differentiated with more frequently a diffuse pattern and small cells. Adrenal medullar hyperplasia was significantly associated with genetically determined PH. Adrenal cortical hyperplasia was not associated with a particular type of PH. The PS100 and chromogranin immunodetection was equivalent in both groups.

Adrenal Cortex↗
PubMed1998

Medullary thyroid carcinoma: search for histological predictors of survival (109 proband cases analysis).

A group of 13 pathologists belonging to the French Calcitonin Tumor Study Group (GETC: Groupe d'Etude des Tumeurs à Calcitonine) examined the histological slides and medical records of 109 proband cases of medullary thyroid carcinoma (MTC) diagnosed on clinical features. The cases belonged to the various forms of the disease (80 sporadic and 29 familial MTC). The aim of the study was to detect histological predictors for survival by comparing morphological data from patients killed by the disease versus the others. Twenty-seven histological parameters were considered, including cellular heterogeneity, shape of the cells, and cytoplasmic characteristics. Other parameters such as sex, age, and phenotype of the disease were also studied. First, predictive parameters of interest on survival function were selected by univariate analysis (Mantel-Cox test). Then, the extracted parameters were tested in a multifactorial analysis using the Cox's forward stepping proportional hazard model. Five parameters were significantly associated with a lower survival function: presence of necrosis in the tumor (P = .001), squamous pattern (P = .002), age over 45 years (P = .004), presence of oxyphil cells in the tumor and absence of cells with intermediate cytoplasm (P = .025), less than 50% of calcitonin immunoreactive cells in the tumor (P = .04).

Adolescent↗
PubMed1998

[Anatomo-clinical prognostic factors of papillary carcinoma of the thyroid. Multivariate analysis: report of a series of 52 cases].

A retrospective study about 52 cases of papillary thyroid carcinomas was carried out with emphasis on histopathological features. The mean follow up period was 10 years. The survival curves were estimated using the Kaplan-Meier method and compared using the log rank test. The multivariate analysis was performed using the Cox's regression model. In univariate analysis, age, Tp (histopathological extension of the tumor), histological differentiation, VAN score (Vascular invasion nuclear Atypia tumor Necrosis) of Akslen and the LeuM1 expression were significant prognostic factors. In multivariate analysis, the Tp and histological differentiation were associated with high risks of poor outcome.

Adult↗
PubMed1998

[Oxyphilic cell and clear cell carcinoma of the thyroid].

Oxyphilic cell (Hürthle cell) carcinomas of the thyroid gland, variant of follicular carcinoma, are more malignant than follicular non oxyphilic cell carcinomas with a similar size and degree of invasiveness. Gross features, microscopic features of oxyphilic, clear and bicolored cells carcinomas and diagnostic techniques are related with a differential diagnosis with papillary oxyphilic cell carcinoma.

Adenocarcinoma, Clear Cell↗
PubMed1997

Evaluation of the monoclonal antibody antithyroperoxidase MoAb47 in the diagnostic decision of cold thyroid nodules by fine-needle aspiration.

Fine needle aspiration (FNA) of cold thyroid nodules has become the first line diagnostic decision for electing which patients need surgery. In order to improve FNA accuracy, the monoclonal antithyroperoxidase (TPO) antibody (MoAb47) was tested. A total of 554 patients were included in this study and among them, 208 were referred to surgery. The results of FNA compared to the final histological diagnosis revealed a sensitivity and a specificity of 94 and 55% respectively, while the sensitivity and specificity of TPO immunodetection on the same cases reached 98 and 83% respectively. By combining the two methods, the 3 false-negative of FNA and 60% of suspicious cytology corresponding to histological benign lesions were correctly identified by immunocytochemistry. With better results than FNA alone, TPO immunodetection with MoAb47 represents a useful adjunct to conventional cytology for selecting patients for surgery.

Adenocarcinoma, Follicular↗
PubMed1996

Ret and trk proto-oncogene activation in thyroid papillary carcinomas in French patients from the Champagne-Ardenne region.

OBJECTIVES: To investigate the presence of ret and trk proto-oncogene rearrangements in thyroid tumors. DESIGN AND METHODS: High-molecular-weight DNA was extracted from 36 thyroid tumors (1 multinodular goiter, 14 follicular adenomas, 16 papillary carcinomas, 1 lymph node metastasis of a papillary carcinoma, 1 follicular carcinoma, and 3 medullary carcinomas) and 22 adjacent tissues. Southern blot analysis was performed after digestion with EcoR1 or BamH1, using specific probes for ret and trk. RESULTS: Only 2 ret rearrangements were found in 2 papillary carcinomas (overall frequency: 6%; papillary carcinoma frequency: 13%). All normal or tumor samples were negative for the presence of a trk rearrangement. CONCLUSIONS: The previous data from the literature are highly conflicting, ranging from 0 to 30% of activation. Our results could be, therefore, classified as medium between these extreme values. It seems, therefore, that genetic and/or geographical factors could play a role in ret and trk proto-oncogene activation.

Adult↗
PubMed1996

Immunohistochemical study of 100 pancreatic tumors in 28 patients with multiple endocrine neoplasia, type I.

One hundred pancreatic tumors ranging in size from 0.3 to 7 cm were studied in 28 patients (17 male and 11 female patients; mean age 35 years) with multiple endocrine neoplasia, type I. An immunohistochemical study was performed on deparaffinized sections using the following antibodies: neuron-specific enolase, chromogranin A or synaptophysin, insulin, glucagon, somatostatin, pancreatic polypeptide (PP), vasoactive intestinal peptide (VIP), gastrin, adrenocorticotropic hormone, alpha-subunit of human chorionic gonadotropin, gonadotropin-releasing factor, serotonin, and calcitonin. Among the 100 tumors (all multiple), seven were unclassified, 10 were plurihormonal, and 83 produced a predominant hormonal secretion (with 50-90% of the same cell type), including 37 "A-cell tumors" (glucagon), 27 "B-cell tumors" (insulin), 11 PP-cell tumors, one G-cell tumor (gastrin) and one vasoactive intestinal peptide (VIP)-cell tumor. These multiple tumors had a different predominant hormonal secretion in the same patient in 23 of the 28 cases. There was a preferential association of A-cell tumor and B-cell tumor. Hyperplasia of the islets of Langerhans was not detected in adjacent pancreas. Nesidioblastosis was observed in 30% of cases.

Adolescent↗
PubMed1996

Quantitative cytology and thyroperoxidase immunochemistry: new tools in evaluating thyroid nodules by fine-needle aspiration.

Fine-needle aspiration (FNA) of cold thyroid nodules is proposed to be the most useful diagnostic test for deciding which patients need surgery. A retrospective study of standard cytology (SC) performed in 776 patients who had been operated on, showed a sensitivity of 94% and a specificity of 80%. Quantitative cytology (QC) was carried out with a cell image analyzer, which classified the cases as benign or not benign. In 87 cases, sensitivity and specificity of QC alone were 100 and 76%. When SC and QC were combined, there were no false negative reports. A new monoclonal antithyroperoxidase (TPO) antibody (MoAb47) was tested. The sensitivity and specificity of TPO alone were 97 and 81%. When SC and TPO were combined, specificity rose 90%. As adjuncts to SC, QC and TPO represent useful tools for selecting patients for surgery.

Biopsy, Needle↗
PubMed1996

Quantitative analysis of cellular proliferative activity in 35 T-cell non-Hodgkin's lymphomas. Use of proliferating cell nuclear antigen and Ki-67 (MIB-1) antibodies and nucleolar organizer regions.

OBJECTIVE: To analyze-cellular proliferation in non-Hodgkin's lymphoma (NHL) of T-cell origin using three variables available on histologic paraffin, dewaxed sections. STUDY DESIGN: The study group consisted of 35 T NHLs (22 low and 13 high grade). Two immunohistochemical methods established the percentage of cells expressing proliferating cellular nuclear antigen (PCNA), or PCNA index, and the Ki-67 antigen, or MIB-1 index. The third method quantified nucleolar organizer regions (NORs) with an image analyzer, giving the NOR area and number of NORs; an internal reference on lymphocytes was used. RESULTS: For the PCNA index, each subtype of low grade NHL demonstrated a difference as compared with high grade NHL except for angioimmunoblastic type NHL (AILD). The difference between the two grades became significant after including AILD-type NHL within high grade NHL (P = .02). The MIB-1 index gave similar results. The PCNA index and MIB-1 correlated (r = .55, P = .008). The relative NOR area and number of NORs differed significantly between the two grades (P < 10(-4) and P < 10(-2); the absolute NOR area differed to a lesser degree (P = .02), and no difference was observed for the absolute number of NORs (P = .07), stressing the importance of an internal reference. NOR areas and numbers correlated highly (r = .90 for relative and .78 for absolute variables, P < 10(-4)). No relation was found between PCNA and MIB-1 indexes. CONCLUSION: Correlations between these variables and grades of malignancy, between the two indices with each other and between the AgNOR variables with each other, including referring to internal lymphocytes, were reported for these T NHL-like tumors in studies on B NHL. The proliferative character of the AILD-type T NHL was in accordance with their worse prognosis. The absence of a correlation between PCNA or MIB-1 indices and NOR variables may reflect a biologic difference between B and T NHLs in a shorter cell cycle or more important functional activity in T NHL.

Cell Division↗
PubMed1995

[Leiomyosarcoma of the inferior vena cava. Apropos of a new case].

A leiomyosarcoma was diagnosed in the mid portion of the inter-renal inferior vena cava. Survival was long (6 years) but required 14 reoperations to remove metastases. During the first operation, vascular integrity was reestablished with a cava-cava prosthesis after exeresis of the upstream cava without removal of the left renal vein ostium. The right renal vein was sectioned and directly implanted onto the prosthesis. The pathology report confirmed the diagnosis of leiomyosarcoma with multiple metastases presenting cytonuclear anomalies which worsened with time.

Blood Vessel Prosthesis↗
PubMed1992

Modification of the amounts of G proteins and of the activity of adenylyl cyclase in human benign thyroid tumours.

The possibility that a TSH post-receptor-binding defect is responsible for the pathogenesis of benign thyroid tumours was studied. Thus, we attempted to determine in hyperfunctioning (hot) nodules and non-functioning (cold) nodules whether the functional activity or the amount of G proteins were modified in comparison with surrounding normal tissues. The adenylyl cyclase response to agonists that bypass the TSH-receptor complex (forskolin, guanosine 5'- (beta.gamma-imido)triphosphate (Gpp(NH)p) or [AIF4]-) was studied on membranes from tumorous and adjacent normal thyroid tissues. We also examined the ability of G proteins to be ADP-ribosylated by cholera toxin (CT) or pertussis toxin (PT), and quantified G proteins by Western blot analysis with specific antisera directed against Gs alpha and Gi alpha subunits. Basal adenylyl cyclase activity was unchanged in hot tumours compared with normal tissue whereas the stimulation of adenylyl cyclase by Gpp(NH)p or [A1F4]- (which act directly on Gs) as well as by forskolin (which acts on the catalyst) was significantly (P less than 0.05) decreased in five of seven nodules studied. Two types of response were found in cold nodules, depending upon whether they were microfollicular or macrofollicular tumours. Basal as well as stimulated adenylyl cyclase activity was increased (0.02 less than P less than 0.05) in microfollicular tumours. In contrast, in macrofollicular tumours basal adenylyl cyclase was unchanged whereas stimulated adenylyl cyclase activity was decreased (0.02 less than P less than 0.05). The ability of Gs or Gi to be ADP-ribosylated by CT or PT respectively was maintained in tumorous tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗