[Presentation of a case of spastic paraplegia treated with chemical rhizotomy].
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Biomedical subjects
Publications and source records attributed to V Masson.
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Between January 1980 and January 1990, a tumour of the testis in 12 of our patients was found to be a non-Hodgkin's malignant lymphoma (NHL). Age varied from 16 to 83 years, with 9 of them aged over 50. In 7 cases the pretherapeutic evaluation disclosed one or more other visceral sites of the tumour, and in 6 cases the tumoral diameter reached or exceeded 10 cm. Staging according to the Ann Arbor classification was: IE: 3 cases; IIE: 1 case and IV: 8 cases. The histological type assessed according to the international classification was: lymphoblastic (2 cases), small cell non cleaved of Burkitt's type (1 case), immunoblastic (2 cases), large cell diffuse (3 cases), mixed diffuse (3 cases), small lymphocyte diffuse (1 case) and unclassifiable (1 case). Seven patients underwent orchiectomy which, in 3 of them, was not followed by any other treatment. Nine patients were put on polychemotherapy which was intensive in 6 cases. Median survival was 30 months. Four patients, all treated intensively, are now in persistent complete first remission. This study confirms that NHL of the testis is rare and its malignancy in almost every case is either high or intermediate grade NHL. It occurs predominantly in elderly men. Advance prognostic factors are often present at diagnosis. However, the advent of intensive polychemotherapy seems to have transformed the course of the disease as well as that of other aggressive NHL's in more common sites.
The plasminogen/plasmin system plays a key role in cancer progression, presumably via mediating extracellular matrix degradation and tumour cell migration. High levels of components of the plasminogen activation system, and paradoxically also its inhibitor, plasminogen activator inhibitor 1 (PAI-1), have been correlated with a poor prognosis for patients with cancers of different types. Recent findings clearly suggest that PAI-1 is essential for capillary sprouting during tumour angiogenesis. Moreover, there is accumulating evidence that both the urokinase receptor and PAI-1 are multifunctional proteins involved not only in extracellular matrix proteolysis but also in cellular adhesion and migration through their binding site for vitronectin. The understanding of whether PAI-1 plays a regulatory role in angiogenesis by tightly controlling proteolytic activity or by influencing cell migration could allow a new anti-angiogenic approach for tumour therapy.
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