[Stromal tumors in the digestive tract. A case of duodenal localization]. / Les tumeurs stromales du tube digestif. Un cas localisé au duodénum.

BACKGROUND: Stromal tumors of the digestive tract are undifferentiated connective tissue tumors which are difficult to characterize even with immunohistochemistry. CASE REPORT: A stromal tumor of the duodenum (the most frequently encountered location) was resected entirely. Histochemistry was unable to provide a precise identification of the histological nature. The tumor was considered to be low grade due to the low mitosis index despite its large size and the presence of necrosis. Careful surveillance was indicated. DISCUSSION: The risk of these tumors is uncertain and may be assessed on the basis of histological prognosis factors such as tumor size, mitosis index and ploidy. Echoendoscopy can be particularly useful for diagnostic purposes providing information on location in the duodenal musculosa.

[Pancreatic metastasis of a renal adenocarcinoma. Apropos of 2 cases]. / Métastase pancréatique d'un adénocarcinome rénal. A propos de 2 cas.

The pancreas is an uncommon site of metastasis for renal cell carcinoma. We report 2 cases of patients who underwent total and subtotal pancreatectomy 13 and 10 years after resection of the primary tumor. One of the patients already had liver and cerebellum metastasis, the second one had a solitary metastasis to the pancreas. In both cases, tumoral proliferation invaded the lumen of the Wirsung, and in one case was prominent through the papillae.

Light chain deposition disease presenting with hepatomegaly: an association with amyloid-like fibrils.

We report an unusual case of lambda light chain deposits without overt plasma cell dyscrasia. The clinical presentation was hepatomegaly without biochemical sign of renal involvement. Portal hypertension, spontaneous rupture of the spleen and fracture of the 12th thoracic vertebra occurred during the course of the disease. Ultrastructural studies showed that lambda light chain deposits were associated with amyloid-like deposits. This case suggests that light chain deposition disease and amyloidosis could be two expressions of the same disease.

[Dilatation of the common bile duct without visible obstruction at endoscopic retrograde cholangiography. Description and development]. / Dilatation de la voie biliaire principale sans obstacle visible à la cholangiographie rétrograde endoscopique. Description et évolution.

The aim of this study was to specify the signs and course of patients with a dilated common bile duct without obstruction. We included patients with a dilated common bile duct of more than 12 mm on endoscopic retrograde cholangiography, and we excluded patients with stones, tumor or other visible obstruction. Two hundred and seven patients (8.4 p. 100 of endoscopic retrograde cholangiography) were included. One hundred and nineteen (57.5 p. 100) had undergone cholecystectomy. Sixty-five p. 100 of patients had signs suggesting biliary tract disease, and 78 p. 100 had biological signs of cholestasis. The size of the common bile duct was not different whether the patient had been cholecystectomized (16.2 +/- 0.3 mm.M +/- SEM) or not (16.2 +/- 0.4 mm). Forty-one patients in the non cholecystectomized group had gallbladder stones. Thus, 47 of our 207 patients (23 p. 100) had neither gallbladder stones nor previous cholecystectomy. Endoscopic retrograde cholangiography was completed by endoscopic sphincterotomy in 130 patients, either in the intent of not missing obstruction, or for therapeutic purposes. Follow-up more than one month after endoscopic retrograde cholangiography was available for 159 patients (77 p. 100). The median survival was 73 months. One hundred and ten patients (69 p. 100) were asymptomatic, 36 (23 p. 100) had atypical abdominal pain while 13 (8 p. 100) patients had episodes of biliary colic and/or fever and/or jaundice. During follow-up, an initially unrecognized obstacle was discovered in 8 patients: 5 common bile duct stones, 2 ampullary tumors and one pancreatic tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

Ultrasonography, angiography, computed tomography and magnetic resonance in nodular regenerative hyperplasia of the liver: report of a pseudo-tumoral case.

Ultrasonographic, computed tomographic, and angiographic abnormalities of nodular regenerative hyperplasia have been described in very few cases. We report here the case of a 50-year-old man with round, well-limited hypoechogenic lesions involving the two lobes of the liver, and hypervascular, poorly delineated angiographic lesions. Computed tomography and magnetic resonance of the liver were normal. Histological examination of large liver specimens provided by intraoperative biopsy allowed the diagnosis of nodular regenerative hyperplasia. Such a pseudo-tumoral ultrasonographic and angiographic pattern must be recognized in order to avoid diagnostic and therapeutic mistakes, especially since percutaneous liver biopsy usually fails to diagnose this disease.

[Pulmonary metastasis of a hemangiopericytoma of the tongue disclosed by pneumothorax]. / Métastase pulmonaire d'un hémangiopéricytome de la langue révélée par un pneumothorax.

The authors report a case of recurrent haemangiopericytoma of the tongue complicated with a single pulmonary metastasis revealed by a spontaneous pneumothorax.

[Arterial recanalization using the laser. A technic for the future?]. / Désobstruction artérielle par laser. Une technique d'avenir?

On the basis of two years' experience, a technique for the use of percutaneous endoluminal continuous emission Nd-YAG laser has been developed for arterial recanalisation. The effectiveness of this type of laser has been demonstrated in a large number of clots and atheromatous plaques, including calcified plaques. A balloon catheter gives a coaxial position of the fiber in center of the artery. Infusion of a blood solution containing 3 g of haemoglobin/100 ml at a rate of 20 ml/minute limits the thermal parietal lesions, improves the conditions of laser treatment and eliminates any risk of arterial perforation. No embolic debris is collected down-stream. Recanalisation of long arterial segments in amputated legs was performed prior to the human application. Ten patients have been treated with no mortality and virtually no morbidity. The narrowness of the reformed arterial lumina resulted in early re-thrombosis in the first 5 cases, requiring balloon modelling to ensure patency with a follow-up of 1 to 3 months in the 5 following patients.

Comparative study of the effects of argon and neodymium YAG laser beams on the normal fundic wall in the beagle dog.

A study was performed to compare the lesions induced by argon and neodymium YAG laser beams in the normal fundic wall of the same beagle dogs and to follow their healing over a 21-day period. The total energy per application was 21 joules for the argon laser and 53 joules for the neodymium YAG laser. Both laser beams were emitted from the same distance, directed at right angles to the tissue surface, and with the same flow rate of coaxial gas. Thirty-nine shots were performed with each type of laser. Differences between the two lasers were observed in the appearance of the impacts, the volume of tissue affected, and the rate of healing, but all the lesions healed without any perforation. The differences observed were probably due to differences between the two lasers in the radial distribution of luminous energy and its absorption and transformation within the tissue into heat. It was concluded, however, that under the experimental conditions chosen, both kinds of laser could be used to penetrate the mucosal and submucosal tissue without risk of damage either to the longitudinal or to the serosal layers of the fundic wall.