[Malignant Leydig cell tumor]. / Tumeur maligne à cellules de Leydig.

A case of malignant Leydig cell tumor is reported. The best feature of malignancy of this rare tumor is the presence of vascular invasion. An immunohistochemical study is presented and the differential diagnosis is discussed.

[Late flexor synovitis induced by the use of a fabric lace]. / Synovite des fléchisseurs induite à distance de l'utilisation d'un lac textile.

A thirty year old woman underwent trigger finger release of her left middle finger after two injections failed to give relief. Several months later, she developed an area of nodular tenosynovitis localized to the operative site. Her finger had recovered full function, her general health was good, and routine lab work was normal. Because of the persistent mass, flexor tenosynovectomy was performed. Histologic examination revealed synovial hyperplasia associated with a filamentous birefringent foreign material. The bluish color of the foreign material indicated that it came from a fabric retraction loop used during the original operation. She made an uneventful recovery, and three years later her hand remained normal. As a result of this unusual complication, we recommended the use of retraction loops made of plastic rather than fabric. Whenever a micro-foreign body remains in the flexor tendon shealth, there is risk of aseptic tenosynovitis.

[Neuroendocrine cancers of the prostate]. / Les cancers neuro-endocrines de la prostate.

This article is a transcription of several papers on neuroendocrine cancers of the prostate presented to the Uropathology Club in Angers in 1990. It consists of three parts: Firstly, a study of neuroendocrine cells in various organs of the human body, followed by the demonstration of these cells in the normal and pathological prostate. The second part reports 3 cases of neuroendocrine cancers as they are observed in routine practice. A total of 66 cases of pure neuroendocrine cancers have been reported to date in the English language literature. This type of cancer is characterised by a rapid, hormone-resistant course with the development of multiple metastases, frequently visceral. Periods of remission in response to chemotherapy may be observed in some cases. The third part concerns the systematic demonstration of neuroendocrine cells in prostatic adenocarcinoma. The percentage of neuroendocrine cells demonstrated by various histological techniques is directly correlated to an increasingly severe prognosis of the cancer.

[Bellini duct carcinoma or kidney collecting duct carcinoma]. / Carcinome des tubes de Bellini ou carcinome des tubes collecteurs rénaux.

The authors report a case of renal collecting duct carcinoma or Bellini duct carcinoma. This rare variety of renal carcinoma, which usually has a poor prognosis, is situated in the renal medulla and pyramid. It is composed of large cells similar to collecting duct cells and can be seen at a distance from the tumor. These cells are arranged in highly suggestive tubular, microcystic and papillary structures. These morphological data are compared with those reported in the literature.

[Pleural mesothelioma: morphology, histochemistry, difficulties in diagnosis and nosologic problems (author's transl)]. / Les mésothéliomes pleuraux: morphologie, histocytochimie, difficultés diagnostiques et problèmes nosologiques.

Using the material of the French Register, these authors define the epithelial aspects and the histological forms of diffuse pleural mesothelioma. Histochemistry studies, on pleural cytology and on tissues, are of the utmost importance in distinguishing mestothelioma from carcinoma. Hyaluronic acid is almost always showed in the epithelial mesothelioma, being otherwise only noticed in some very flourishing forms of mesothelial cell hyperplasia nad in rare mucus-secreting carcinoma. Cytoenzymology studies are very useful on pleural fluid material, making it possible to show the difference between macrophages and mesothelial cells. Difficulties encountered by pathologists are analysed with reference to the materials examined: cytology, needle biopsy, guided biopsies, surgical material and documents from autopsies. After a critical study of the structures seen in other pleural tumors mesothelioma is defined as a localized or diffuse tumor of the pleura, positively originating from mesothelial cells which manifest either epithelial structures of a double epithelial and mesenchymal composition.

[Evolutive patterns of diffuse pleural mesothelioma (author's transl)]. / Aspects évolutifs des mésothéliomes pleuraux diffus.

The clinical beginning of diffuse pleural mesothelioma is a pleurisy. Initially pleura may be normal at X-ray examination, then either a pachypleuritis or a tumorous pleura appears. Thery serious since there is in the literature no cured case. The average survival time from diagnosis to death is 15 months. At terminal stage mesothelioma does not invade the other coelomic cavities. It may remain limited to the hemithorax where it has started, invading then the organs by contiguity. Metastasis may occur but their frequency is very variable, from 30 to 70% according the literature. On a therapeutic point of view all was tried: Surgery is rarely curative but may reduce temporarily effusion pain and dyspnea. Radiotherapy at high doses produces a partial effect in some series, but results are variable. Chemotherapy: adriamycin could be the most promising agent. At present time according to many authors no treatment seems to change the course of the disease.

[Isoenzyme distribution of creatine kinase in various human organs. Interest in human pathology (author's transl)]. / Répartition isozymique de la créatine kinase dans différents organes humains. Intérêt en pathologie humaine.

The isoenzyme content of creatine kinase was determined in various human organs after autopsy. The results found were on the whole in agreement with the literature. Their analysis dictates the choice of a method of separation of the MB fraction: chromatography or electrophoresis. It permits better interpretation of the results of estimation of the MB fraction in the serum.

[Topographical variations of pulmonary and pleural asbestos fiber concentrations in variously exposed subjects]. / Variations topographiques des concentrations pulmonaires et pleurales en fibres d'amiante chez des sujets diversement exposés

The authors study three groups of subjects with different exposures to asbestos dust. The lung content in asbestos fibres is measured by optical and electron microscopy, the latter technique revealing preferential concentration of asbestos fibres in the peripheral zones of the lung, in particular in individuals subject to a moderate degree of professional exposure.

[Asbestosis with sarcoid-like pulmonary lesions. A propos of one anatomoclinical case report]. / Asbestose avec lésions pulmonaires "sarcoïd-like". A propos d'une observation anatomo-clinique

A report of a clinico-pathological case of asbestosis with special histological lesions. The latter had a granulomatous appearance, progressing to fibrosis with Schaumann bodies organised around bodies with a ferruginous covering, apparently due to asbestosis. The histogenesis of the lesions is discussed, together with the need to take a precise professional history. The usefulness of certain simple methods of analysis is mentioned.

Topographic distribution of asbestos fibres in human lung in relation to occupational and non-occupational exposure.

A topographic study of asbestos fibre content of lung and pleura of diversely exposed cases has been carried out. For heavily exposed cases with lung fibrosis, this study has stressed the distinctive behaviour of the peripheral lower lobe in the retention of asbestos fibres in the lung. In these areas were found the smallest asbestos concentrations but the largest fibres. For cases without lung fibrosis, the results clearly demonstrated an accumulation of asbestos fibres, especially of chrysotile type, in peripheral areas. These findings are to be related to the incidence of pleural mesothelioma associated with moderate or low exposure. The small variation of fibre concentration in the pleural plaques of diversely exposed subjects is pointed out.

[An unusual case of talco-asbestosis]. / A propos d'une observation inhabituelle de talco-asbestose

The authors present an unusual case of asbestosis. The latter had very diffuse macrophagic and giant cell granulomatous lesions. The morphological findings and the history enabled one to relate the appearance observed to the conjoined handling of asbestos and talc. A primary adenocarcinoma developed on these lesions.

Asbestos bodies and fibers in lung tissues.

It is suggested that the ratio of asbestos bodies observable by light microscopy to asbestos fibers counted by electron microscopy be examined in a series of cases of asbestosis of varying severity. If the ratio is reasonably constant an estimate of fiber content could be made from the more easily conducted count of asbestos bodies by light microscopy.