[Breast chondrosarcoma: a case report and review]. / Chondrosarcome du sein: à propos d'un cas.

Sarcomas of the breast are relatively rare and account for 1% of all primary malignant tumors of the breast. Only 4 cases of pure chondrosarcoma of the breast have been published. We report an additional case in a fifty-seven-year-old woman. Histological and immunohistological characteristics were similar to those described in other localizations. Differential diagnosis involves cystosarcoma phyllodes and breast metaplastic carcinoma with chondroid differentiation. The prognosis is likely to be the same as in other chondrosarcomas.

Expression of platelet-activating factor receptor in human carotid atherosclerotic plaques: relevance to progression of atherosclerosis.

BACKGROUND: Human monocyte-derived macrophages synthesize numerous proinflammatory and prothrombotic substances, including lipid mediators, such as platelet-activating factor (PAF), which may play a major role in the onset and perpetuation of atherosclerotic lesions. In addition, both monocytes and macrophages express PAF receptors (PAF-R). The expression of PAF-R is transcriptionally downregulated by oxidized LDL in in vitro primary cultures of monocyte/macrophages. In this study, we evaluated the expression of PAF-R in human carotid plaque tissue, in foam cells isolated from human carotid plaques, and in primary cultures of umbilical smooth muscle cells (SMCs). METHODS AND RESULTS: We show that PAF-R was expressed at low levels in foam cells compared with monocyte/macrophages in plaques, as assessed by immunohistochemical staining and in situ hybridization. In addition, low levels of mRNA were also detected by RT-PCR in isolated human carotid foam cells. A prominent finding of our study was the demonstration that contractile SMCs were positive for PAF-R, and its mRNA was extracted from primary cultures of umbilical SMCs. CONCLUSIONS: As macrophages loose their inflammatory phenotype on transformation into foam cells, they may equally loose their capacity of defense against aggression. We postulate that the diminished expression of PAF-R may be deleterious in the context of plaque formation and progression. The observation that arterial SMCs of contractile phenotype express PAF-R opens new avenues concerning the migration of these cells from media to intima and atherosclerotic plaque formation.

Impact of human immunodeficiency virus infection on the histological features of chronic hepatitis C: a case-control study. The MULTIVIRC group.

Hepatitis C virus (HCV) is frequently encountered in human immunodeficiency virus (HIV)-infected patients because of common routes of transmission. Previous studies suggested that HIV infection impaired the natural course of chronic hepatitis C, with a more rapid progression to cirrhosis. However, these studies did not assess the HIV infection impact on chronic hepatitis C by taking into account the risk factors for liver fibrosis progression: alcohol, sex, age at the contamination, and duration of HCV infection. We studied liver biopsy specimens of 2 groups of 58 patients that were infected by both HCV and HIV or by HCV alone. The 2 groups were matched according those risk factors, and liver biopsy responses were evaluated with the METAVIR items. The METAVIR activity was higher in HIV-positive than HIV-negative patients. Cirrhosis was more frequent: (1) in HIV-positive patients with CD4 < or = 200 cells/microL (45%) than in HIV-negative patients (10%) (P = .003), (2) in HIV-positive patients with CD4 < or = 200 cells/microL (45%) than in HIV-positive patients with CD4 > 200 cells/microL (17%) (P = .04). These differences, which were linked to HIV status, might be related to the enhanced HCV replication during HIV infection or other immune mechanisms that need further studies.

Preservation of midbrain catecholaminergic neurons in very old human subjects.

Parkinson's disease is characterized by a progressive degeneration of dopaminergic neurons in the midbrain, yet the cause of this neuronal loss is still unknown. It has been hypothesized that Parkinson's disease could be the consequence of accelerated ageing. In order to reveal a possible common process during ageing and Parkinson's disease neurodegeneration, catecholaminergic neurons of five anatomical regions of the brainstem (substantia nigra, central grey substance, ventral tegmental area, peri- and retrorubral area, and locus coeruleus) have been quantified using immunohistochemical staining for tyrosine hydroxylase (TH) on regularly spaced sections, between the rostral and caudal poles of the mesencephalon and in the rostral pole of the pons, in post-mortem samples of 21 control subjects who died at ages 44-110 years. No statistically significant loss of TH positive neurons was observed in the older subjects, either in the substantia nigra or in the other midbrain regions that are known to degenerate to a lesser degree in Parkinson's disease. Furthermore, in the later regions no neuronal loss was observed from age 44 to 80 years, indicating that this result is not dependent on the inclusion of 'supernormal' very old people. These results suggest that from age 44 to 110 years, ageing in control adults is not, or is scarcely, accompanied by catecholaminergic cell loss in the midbrain and hence Parkinson's disease is probably not caused by an acceleration of a degenerative process during ageing.

Low hepatic iron concentration: evaluation of two complementary methods, colorimetric assay and iron histological scoring.

AIMS: To validate a method of assessment of low hepatic iron concentration based on a biochemical colorimetric assay plus histological scoring. METHODS: The within-day and day to day precision of the iron colorimetric assay was determined on frozen rat liver. The coefficient of variation (CV) of iron measurement in two separate samples from the same liver was determined for 21 deparaffinised human biopsies. The intra- and interlaboratory variability of the colorimetric assay and histological scoring were assessed on 38 deparaffinised liver biopsies. RESULTS: For the within-day test, the CV was 11% (5.1 (0.6) mumol/g dry weight (dw), mean (SD) iron concentration). For the day to day test, the CV was 19.5% (8.2 (1.6) mumol/g dw). The CV was 14.7% for iron concentration determined in two separate samples from the same liver. By correlation and kappa concordance tests, the intra- and interlaboratory variability of the hepatic iron colorimetric assay and iron histological scoring was slight. Absence of stainable iron corresponded to a liver iron concentration < or = 20 mumol/g dw. CONCLUSIONS: A combination of two complementary methods, colorimetric measurement and histological scoring, is an accurate and reliable way of determining low iron concentrations in deparaffinised human liver biopsies. In secondary haemosiderosis, such methods would be essential for investigating the role of low iron overload in fibrogenesis and during the response to antiviral treatment in chronic viral hepatitis.

Repair of UVA-induced elastic fiber and collagen damage by 0.05% retinaldehyde cream in an ex vivo human skin model.

BACKGROUND: Cellular effects of UV exposure are implicated in cutaneous aging. UV radiations induce structural and cellular changes in all the compartments of skin. AIM: To study the antiaging efficacy of a cream containing 0.05% retinaldehyde with an ex vivo technique using human skin in order to approximate in vivo metabolic conditions. METHODS: Human skin explants were maintained alive in organ culture for 18 days and subjected to UVA exposure, thus simulating skin photoaging. Retinaldehyde cream was then applied to the surface of the epidermis for 2 weeks and the results were compared with those of nontreated skin explants. Dermal repair was analyzed histologically with quantification of collagen and elastic fibers, and biochemically by the measure of newly synthesized collagen as shown by adding tritiated proline to the culture medium. RESULTS: UVA exposure induced significant alterations of collagen and elastic fibers as shown by morphometric analysis. In all UVA-exposed and then retinaldehyde-treated skin specimens, collagen and elastic fibers were restored to the level of nonexposed skin. UVA exposure induced a decrease in collagen synthesis, whereas in retinaldehyde-treated UVA-exposed skin the synthesis was similar to that of unexposed skin. CONCLUSION: It has been shown that retinaldehyde has many of the properties of tretinoin in its biological and beneficial effects on photoaging. We have verified some of these previous observations, especially on dermal connective tissue, by obtaining significant repair of elastic fibers and collagen alteration induced by UVA exposure.

Neurogenic modifications induced by substance P in an organ culture of human skin.

Neurogenic inflammation of the skin observed after topical application of an irritant substance or environmental stimulation induces vascular changes and the production of inflammatory mediators. Substance P (SP) is one of the main neuropeptides which trigger an inflammatory response in the skin. So, with the aim to develop an alternative method to study neurogenic inflammation of the skin, we used an organ culture of human skin. SP was added onto epidermis or directly to culture medium in an attempt to reproduce ex vivo the effects described in vivo. Even disconnected from systemic blood circulation, in skin fragments in culture, we observed dose-dependent edema, vasodilation and extravasation of lymphocytes and mast cells through the microvascular wall. Moreover, the release of proinflammatory mediators interleukin 1alpha and tumor necrosis factor alpha was evidenced.

Isolated retroperitoneal intradiaphragmatic bronchogenic cyst. A case report.

Isolated retroperitoneal bronchogenic cysts are extremely rare. We report a case which was intradiaphragmatic intimately associated with the musculature of the left crus diaphragmatic and unconnected with any other structures. Ultrasound and computed tomography findings were consistent with a pancreatic or an adrenal mass. Pathology confirmed a bronchogenic cyst. The outcome is favourable and the overall prognosis is good.

Evaluation of combinations of titanium, zirconia, and alumina implants with 2 bone fillers in the dog.

The quality of the tissue-implant interface was evaluated using light and scanning electron microscopy with morphometric analysis. Nine dogs were implanted with 3 types of dental implants (titanium, zirconia, or alumina). A total of 24 dental implants was placed in mandibular bone previously filled with coral carbonate calcium (corail) or hydroxyapatite. The study results in breaking the concept of osseointegration into 2 phases: "osseocoaptation," which concerns only the interface (physical contact between the implants and the bone without interpenetration process), and "osseocoalescence," which relies on an interpenetration of the bioactive material, which almost entirely disappears, being substituted by newly formed bone. There was no significant statistical difference between the 3 types of implants. Both fillings showed good ossecoalescence properties. However, hydroxyapatite led to fibrous encystment, preventing osseocoaptation of implants. In contrast with calcium carbonate filling.

[Apparently isolated case of African Burkitt lymphoma localized in the breast]. / Lymphome de Burkitt africain à localisation mammaire apparemment isolée.

We report a case of unilateral primary Burkitt lymphoma of the breast. It occurred in a young woman with a history of recent abortion, as a painful mass confused with an abscess. The diagnostic was suggested after fine needle aspiration. Biopsy allowed confirmation, by revealing a B-phenotype lymphoma with intranuclear Epstein-virus small RNA (EBER) in all cells. Additional investigations (clinical and radiographic) were negative (no lymphadenopathy). Chemotherapy induced rapid and complete remission. Patient is in good health (no local recurrence) 5 years later.

[Endometrial stromal tumor associated with rhabdoid phenotype and and zones of "sex cord-like" differentiation]. / Tumeur stromale de l'endomètre associant un phénotype rhabdoïde et des zones de différenciation "sex cord-like".

An unusual endometrial stromal sarcoma is described in a 50-year-old patient. The distinctive feature of this case is the focal occurrence of sex cord-like pattern and rhabdoid appearance of tumor cells. Rhabdoid cells have an eosinophilic cytoplasm and a vesicular nucleus with a prominent nucleolus. Immunohistochemistry showed positive cytoplasmic staining for both cytokeratin and vimentin, and ultrastructural examination identified tumor cells with abundant cytoplasmic intermediate filaments. To our knowledge, only one case of endometrial stromal sarcoma with this unusual morphological association has been reported in the literature.

Long-term effects of interferon-alpha in five HIV-positive patients with chronic hepatitis B.

Chronic hepatitis B viral infection is common in human immunodeficiency virus (HIV) carriers, but the effectiveness of interferon therapy is still unknown. We report the results of a long-term pilot study of five patients, who were infected with HIV and chronic hepatitis B, treated by interferon. Five males co-infected with HIV and hepatitis B virus (HBV) (mean age 27 years) were given a 6-month course of interferon (IFN)-alpha 2b 5 million units (MU) three times weekly. On initiating the treatment, their CD4 lymphocyte count was 340-553 mm-3, their CDC stage was IIa-III; all had histologically proven chronic hepatitis, with Knodell's score ranging from 6-10, and active HBV replication (HBV DNA and hepatitis B e antigen (HBeAg) were detectable). There was no associated hepatitis delta virus (H delta V) or hepatitis C virus (HCV) infection. Follow-up was for 53 months on average (24-74 months). After the treatment, hepatitis B e antibody (HBeAb) and hepatitis B s antibody (HBsAb) seroconversion was observed in one patient, HBeAb seroconversion alone in two patients, HBV DNA was absent from serum in three patients, and HBV DNA significantly decreased in one patient. The serum alanine aminotransferase (ALT) activity was normal in four patients. Histological improvement was obtained in four patients. The HIV stage remained unchanged in all patients during the whole follow-up. These preliminary results suggest that interferon can be successfully used in immunocompetent HIV carriers with chronic hepatitis B as well as in HIV-negative patients.

Liver dysfunction in allogeneic bone marrow transplantation recipients.

Liver dysfunction is common in allogeneic bone marrow graft recipients, but no systematic studies of pre- and posttransplantation liver biopsies have been performed to identify and compare hepatic lesions. This study involved 25 consecutive patients who had undergone serial viral screening tests, liver tests, and pre- and posttransplantation liver biopsy. The aims were to ascertain the origin of liver disorders prior to bone marrow transplantation, to determine the mechanism and severity of liver dysfunction occurring early after transplantation, and to identify a possible relationship between pre-existing liver lesions and the frequency and nature of early liver dysfunction after transplantation. Pretransplantation biochemical liver tests were abnormal in 72% of patients, despite the absence of clinical liver disease. Eleven patients had chronic viral hepatitis B or C. Mild or moderate histological lesions were present in all the patients, with bile duct abnormalities in 48%, central vein abnormalities in 24%, sinusoidal fibrosis in 52%, portal fibrosis in 88%, portal necrosis in 52%, and parenchymal siderosis in 76%. After transplantation, fatal veno-occlusive disease occurred in two patients and biochemical abnormalities occurred in 24. Coded review of needle biopsy specimens failed to provide a single diagnosis. Histological lesions differed between pre- and posttransplantation biopsy specimens only by increased iron overload (96%, P<0.01). We conclude that pretransplant liver lesions contribute to hepatic dysfunction early after bone marrow transplantation, being very similar in nature and degree to lesions observed posttransplantation.

[Paradental cyst]. / Le kyste paradentaire.

The paradental cyst is an odontogenic inflammatory cyst (WHO classification, 1992). It has been rarely described in the french literature and includes: The inflammatory paradental cyst which occurs on the buccal or distal aspects of an erupted third mandibular molar or of a canine (first description by Main in 1970); the mandibular infected buccal cyst which occurs on the buccal surface of the mandibular second or first molar in children around 6-8 years of age with an associated history of inflammatory signs (Stoneman and North, 1993). The histological features are the same as those of the radicular cyst. Prognosis is excellent after enucleation. This paper present an additional case report of a paradental cyst located on a second mandibular molar.

[Neuroendocrine carcinoma of the larynx with secretion of calcitonin: primary tumor or metastasis of the medullary thyroid carcinoma?]. / Carcinome neuroendocrine laryngé avec sécrétion de calcitonine: cancer primitif ou métastase d'un cancer médullaire de la thyroïde?

Neuroendocrine carcinomas of the larynx are rare and their links with thyroid neoplastic lesions are not specified in most reported cases. We report such a case secondary to medullary thyroid carcinoma. In a 63-year-old man, a supra glottic laryngeal carcinoma confirmed by biopsy was initially treated by chemotherapy. A second biopsy of the laryngeal lesion after incomplete remission displayed a neuroendocrine carcinoma with calcitonin in neoplastic cells. Laryngectomy, cervical bilateral neck dissection and thyroid isthmic adenoma dissection were performed. Numerous neoplastic cells from these tissues contained calcitonin revealed by immunohistochemical method. Calcitoninemia was highly increased and multiple bone metastases were discovered. Secondary total thyroidectomy was not possible and the patient died 6 months after. In this case the neuroendocrine laryngeal carcinoma was probably secondary to a latent medullary thyroid carcinoma. Medullary thyroid carcinoma is most often unknown in similar previously reported cases of neuroendocrine laryngeal carcinoma. Thus a neuroendocrine tumour of the larynx should require search for extra thyroid and over all thyroid neuroendocrine carcinoma, even limited to a small and latent lesion.