[An unusual case of clear-cell carcinoma of the pancreas]. / Une observation exceptionnelle d'un carcinome pancréatique à cellules claires.

This case of clear-cell carcinoma of the pancreas was a rare for three reasons: a) discovery: the investigation was indicated after sudden digestive hemorrhage revealed by melena and anaemia; b) morphology: the tumour began in the head with a spheric tumoural bud and a pediculated extension into the duodenum; c) pathology a clear-cell tumour similar to the type seen in renal localizations. Only one other case of such a primitive tumour was found reported in the literature.

Hand metastases from urothelial tumor.

Metastases to the hand are rare, particularly those of soft tissues. As a rule they arise in lung, breast, or kidney but other primary sites such as the bladder, have been described. We report a silent primary malignant tumor of the bladder, which came to light as soft tissue hand metastases.

[Local tumefaction of the gallbladder wall due to pancreatic heterotopia]. / Epaississement localisé de la paroi vésiculaire dû à une hétérotopie pancréatique.

A 38-year-old woman was examined because of vague abdominal symptoms. Cholecystography and US studies demonstrated a lobulated tumor, 14 mm in length, with a homogeneous structure, sharp limits, adjacent to the posterior wall of the gallbladder and producing no acoustic shadow. Pathological examination demonstrated subserosal pancreatic heteropia. More than 22 different kinds of focal lesions affecting the gallbladder wall have been described. Unfortunately, no clinical or US criteria allow a definite diagnosis. Only the size makes a difference: more than 94% of the adenomas measuring less than 10 mm are benign whereas 88% of the malignant lesions are over 10 mm. Considering the absence of specific criteria, surgical removal is therefore indicated for lesions over 10 mm.

Intravascular bronchioloalveolar tumour.

We report the clinical and histological characteristics of a case of intravascular bronchioloalveolar tumour, a rare multicentric pulmonary neoplasm of endothelial origin. This tumour affects predominantly women under 40 years of age and causes initially few symptoms. The disease may be found incidentally on a routine chest X ray. This tumour has a low metastasizing capacity and survival rate is quite high.

[Immunohistochemical study in 16 cases of primary lymphoma of the central nervous system (author's transl)]. / Etude immunohistochimique de 16 lymphomes primitifs du système nerveux central.

Sixteen primary lymphomas of the central nervous system (CNS) have been studied with an immunoperoxidase technique (PAP) for the demonstration of intracytoplasmic immunoglobulins. The material was obtained by biopsy (10 cases) and at autopsy (6 cases). For comparison, ten other tumors (glial tumors and secondary lymphomas involving the nervous tissue) were simultaneously investigated. In the 16 primary lymphomas, 14 contained intracellular immunoglobulins that were considered "monoclonal" in 9 cases, "probably monoclonal" in 4 cases but "uninterpretable" in the last one. According to the Kiel classification, the 13 malignant lymphomas with intracellular immunoglobulins were classified, morphologically, as immunoblastic sarcomas (9 cases) or immunocytomas (4 cases). No immunoglobulins were detected in 2 cases: 1 lymphoblastic lymphoma and 1 centrocytic lymphoma. Various amounts of intracytoplasmic immunoglobulins were detected in inflammatory cells and glial cells (either reactive or tumoral) but the pattern of staining was consistent with current concepts of polyclonality. Therefore, a diagnosis based on the Kiel classification of lymphomas and the PAP technique will allow a more accurate prognosis on the evolution of primary lymphomas of the CNS with aspect of "high grade" and "low grade" malignancy.

Insulin, prostaglandin E2 and glucagon release by human tissue incubated in vitro. Influence of indomethacin.

In view of reports that prostaglandins influence insulin and glucagon secretion, we have studied PGE2, insulin and glucagon release from fragments (15-20 mg) of human insulinoma tissue incubated in vitro in the absence or presence of indomethacin (100 mumol/liter) an inhibitor of prostaglandin synthesis. Acid-ethanol extraction of this tissue showed the following hormonal contents : insulin : 7.17 U and glucagon 84.4 ng per g of tissue (wet weight). In the absence of indomethacin, the mean release of PGE2, insulin and glucagon into the incubation medium was 3.65 +/- 1.3 pmol, 10.5 +/- 1.2 mU and 708.4 +/- 141.8 pg in two hours (mean of 5 vials containing 2 fragments of 15-20 mg of tissue). PGE2 release was significantly inhibited in the presence of indomethacin (0.89 +/- 0.23 pmol). This effect was associated with a significantly higher insulin (16.8 +/- 1.9 mU/2 hours) and lower glucagon (176 +/- 19.7 pg/2 hours) release. These results support the view that insular tissue possesses a prostaglandin synthesis system which positively modulates glucagon secretion whereas it negatively influences insulin release.

[Encephalitis and ornithosis]. / Encéphalite et ornithose

Neuropathology of ornithosis encephalitis in an adult man is reported. Lesions were widespread with severe vascular congestion, hyaline thrombi, intense perivascular infiltration by mononucleated cells and microglial reaction in the parenchyma. No specific lesion of the neurons was found.