ABSTRACT
UNLABELLED: Thymic hyperplasia in response to stress is a well known phenomenon. Thymic hyperplasia has also been described after chemotherapeutic treatment for malignancies in children. CASE REPORT: A three-year-old girl was followed up from the age of 18 months for a left kidney nephroblastoma treated by combination of chemotherapy (vincristin, actinomycin and adriamycin) and surgery. Assessment at the end of treatment was normal. Four months after the end of treatment, pulmonary radiography showed mediastinal enlargement, which was shown to originate in the thymus at thoracic CT scan. A recurrence of the disease was suspected. Biopsy showed thymic hyperplasia without evidence of tumor cells. Mediastinal enlargement then disappeared spontaneously 2 months later. CONCLUSION: Thymic hyperplasia occurring during remission of a cancer treated by chemotherapy is a diagnostic dilemma as it suggests mediastinal reccurence of the disease. Needle aspiration cytology is an appropriate investigation in thymic hyperplasia. No steroid therapy should be used before histologic diagnosis of thymic hyperplasia.
Subject(s)
Kidney Neoplasms/therapy , Thymus Hyperplasia/diagnosis , Wilms Tumor/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Child, Preschool , Diagnosis, Differential , Female , Humans , Neoplasm Recurrence, Local/diagnosis , NephrectomyABSTRACT
OBJECTIVE: To compare flow cytometric data (ploidy and proliferative activity or percentage SG2M-phase cells) to cytologic and histologic data of the bladder carcinomas. MATERIALS AND METHODS: Cytologic and flow cytometric analysis of DNA content were performed on 48 bladder washings: 28 bladder washings from patients being followed for urothelial carcinomas and 20 control washings from individuals undergoing cytoscopy for other reasons. RESULTS: Cytological sensitivity and specificity of bladder washing were 75% and 91% respectively. Specificity was increased to 94% using flow cytometric DNA analysis whereas sensibility was moderately decreased to 68%. Combination of flow cytometry and cytology increased the diagnostic yield to 100%. The study of the patient group showed an increased abnormalities (aneuploidy and/or proliferate activity SG2M > 10%) according to the tumor grading and tumor staging. A cytometric test was positive in 80% for G3 tumours and in 68% for G2 tumours. The staging tumor was positive in 46%, 89% and 100% of the pTa-pT1, pT2 and pT4 tumours respectively. Otherwise the comparison of control group with patients showed a statistical correlation between cytometric test, staging tumour and tumoral grading as showed in the following groups: control/G1-G2 (p < 0.05), control/G3 (p < 0.001), control/pTa-pT (p < 0.05), control/pT2-pT4 (p < 0.001). CONCLUSION: We confirmed through this study the interest of the flow cytometric DNA analysis in the diagnosis and prognosis of bladder carcinomas, and we showed the importance of the histogram classification in order to facilitate their interpretation and to avoid the trap of false aneuploidy.
