[AL amyloidosis]. / Amylöidose AL.

AL amyloidosis is a systemic disease caused by the deposition of fibrillar proteins in organs and tissues. These deposits are responsible for organic dysfunctions and may be rapidly lethal. Current therapy is unsatisfactory. We describe three clinical cases of multisystemic AL amyloidosis but with different initial presentation: nephrotic syndrome, cardiac failure and hepatic insufficiency. We review the literature about the clinical features, diagnostic methods and treatment of the disease.

Nuclear DNA content, proliferation index and nuclear size determination in normal and tumoral adrenal tissues, pheochromocytomas and metastases.

The diagnostic values of nuclear size, proliferation index and ploidy level were investigated in a series of 58 samples from adrenal glands, including 9 samples from normal adrenal glands, 18 adenomas, 3 carcinomas, 16 pheochromocytomas and 12 metastases. Nuclear assessments were computed on Feulgen-stained nuclei by means of a cell image processor. Ploidy level was assessed by means of both the DNA index and DNA histogram type. The results show that nuclear size and proliferation index do not allow any discrimination between these various histopathologic subgroups. The measurement of ploidy level made it possible to obtain helpful information about these various histopathologic groups. Indeed, all the normal cases (except one from a malignant kidney tissue) and all adenomas (except one) were diploid, while most (but not all) of the remaining cases, including carcinomas, pheochromocytomas and metastases, were aneuploid. Furthermore, with this measurement we were able to show that some tendencies appear across these histopathologic groups. Indeed, the metastases contained a high proportion of aneuploid cases, whereas pheochromocytomas were frequently tetraploid. The results also show that the assessment of ploidy level by means of the DNA histogram type is more accurate than with measurement of the DNA index.

Carcinomas of the thyroid with unusual presentation. About two cases.

Two cases of thyroid carcinoma with unusual presentation are reported. In the first case, a follicular carcinoma was associated with hyperthyroidism from a hot nodule located in the same lobe. This condition is not so infrequent as indicated by the literature and should warrant pathological examination at the time of excision of the hot nodule. In the second case, both anaplastic and follicular carcinomas were coexisting in the same tumour of a young adult. This occurrence is rather exceptional in the early period of life and is usually the fact of elderly people with long-standing goiters. The favourable outcome of this patient is also contrasting with the bad prognosis associated with anaplastic carcinoma of the thyroid. Another interesting feature is the existence of an anaplastic carcinoma of the thyroid in a family member of this second case.

DNA histogram typing in human seminomas.

Characterization of the nuclear DNA content (DNA index and DNA histogram type) was carried out in 9 normal testicular tissues and 21 seminomas. Proliferative activity was further determined in the seminomas. Nuclear DNA content was assessed by means of a cell image processor computing the integrated optical density on Feulgen-stained nuclei from formalin-fixed paraffin-embedded materials. The results indicated that the so-called normal testicular tissues exhibited DNA histograms where three cell nuclei populations emerged in varying proportions. These three cell nuclei populations corresponded to haploid, diploid and tetraploid cell nuclei respectively. In contrast, most of the seminomas exhibited monomorphic DNA histogram patterns with a predominance of GO-G1 cell nuclei in the range of the 3c-4c nuclear DNA content. Further studies will be necessary in order to determine whether the DNA histogram has a predictive prognostic value or could be considered as a grading index.

Cyst of the gallbladder.

A cyst of the gallbladder is a very rare lesion. The possible causes of such an anomaly are reviewed. It may be acquired or congenital. The latter is particularly exceptional. A case of congenital cyst is reported and illustrated by various imaging techniques.

[Value of echography and fine needle biopsy for diagnosis of thyroid nodules]. / Intérêt de l'échographie et de la ponction à l'aiguille fine dans la mise au point des nodules de la thyroïde.

Value of ultrasonography and fine needle biopsy for the diagnosis of thyroid nodules. From 1/1/1986 to 31/7/1987, thirty patients with a nodular disease of the thyroid (14 solitary nodules, 9 multiple nodules, 5 colloid cysts, 2 carcinomas) were included in a controlled prospective study using clinical examination, scintigraphy, sonography and fine needle biopsy of the gland. All the patients were operated on and the specimens were submitted to pathological examination. It is shown that palpation is not able to provide an accurate evaluation of the consistancy and number of nodules. The images derived from the scintiscans were not very helpful for discerning a possible malignancy. Sonography was revealed as a fiable method of investigation (21 nodules discovered on a total of 25) allowing to find discrete lesions of 0.5 cm diameter, and also fluid collections with a high resolution rate. Needle biopsy is very useful in diagnostic studies specially for screening of remote malignant lesions with an excellent accuracy approaching 95%. Although considerable progress has been made through these methods of study, a final diagnosis about a solitary solid nodule will always need a surgical exploration to be sure to exclude the risks of an occult carcinoma of the thyroid.

Intra-abdominal cystic lymphangioma in a newborn infant. Case report and review of the literature.

We report a newborn infant presenting with an intra-abdominal cystic lymphangioma, in which necrosis and infection led to an unusual combination of solid and liquid areas observed by ultrasonography.

Prenatal diagnosis of a pulmonary cyst by ultrasonography.

We report a patient in whom a prenatal diagnosis of an intrapulmonary cyst was made by ultrasonography. To our knowledge, no such case has been reported before and prenatal diagnosis permitted prompt management of an asymptomatic neonate.

[A case of mesenteric venous thrombosis. Review of the literature]. / A propos d'un cas de thrombose veineuse mésentérique (TVM). Revue de la littérature.

A case is presented in which a venous mesenteric thrombosis necessitated an extended small bowel resection. The postoperative follow-up with its complications is presented. Review of the literature.

Chronic neutrophilic leukaemia with enlarged lymph nodes and lysozyme deficiency.

A further case of chronic neutrophilic leukaemia is reported and compared to fourteen previously reported cases. The presence of enlarged lymph nodes as the first clinical sign and the existence of a relative lysozyme deficiency of the granulocytes were striking features.

Treatment with steroids of a giant cell granuloma of the maxilla.

This case report of giant cell granuloma involving the maxilla is of particular interest for two reasons: the locally aggressive clinical course contrasting with the diagnosis of a benign disease and the spectacular, although transient, response under steroid treatment. Corticotherapy should be further tested in cases of invasive or recurring giant cell granuloma.