Morphological and ultrastructural methods for Pneumocystis.

Pneumocystis is a eukaryotic unicellular microorganism with marked fungal affinities. All known life cycle stages of this parasite were observed in the lung of mammals. The cystic forms of this microorganism may be observed microscopically by using stains with affinity for the components of their relatively thick cell wall. However, about 100 years ago they were observed for the first time thanks to panoptic stains which do not stain their cell wall. Methanol-Giemsa technique as well as Giemsa-like rapid stainings are often used to reveal vegetative or cystic forms of this parasite on air dried smears of clinical or experimental samples. For many years, hypotheses on its life cycle, which remains unknown, were based on transmission electron microscopy (TEM) studies. However, only for the last years progresses in the quality of fixation for TEM led to a better understanding of the Pneumocystis cell structure. In this chapter, strategies to reveal Pneumocystis organisms in clinical or experimental specimens by using light microscopy, as well as techniques allowing a good preparation of parasitic samples for TEM, are given and shortly discussed.

[Thyroid autonomous nodule. Surgical treatment and postoperative outcome, retrospective study of 102 cases (author's transl)]. / Le nodule thyroïdien hyperfixant et extinctif. Traitement chirurgical et devenir post-opératoire. Etude rétrospective de 102 observations.

Follow-up of 102 patients operated upon for autonomous thyroid nodules is reported. Retrospective study of operative findings and aftermath of surgery clearly demonstrates that the patho-physiological concept of autonomous nodule does not snugly fit practical problems experienced with the management of such patients. The autonomous nodule can be a malignancy. Ipsilateral thyroid lobectomy seems more suitable than nodulectomy. Gross appearance of the thyroid remnant makes sometimes post-operative hormonotherapy unexpectedly advisable. From a theoretical point of view, post-operative thyroid scan, TSH assay and TRH test are mandatory, to assess recovery.

[A gonadoblastoma in a true hermaphrodite. A case history (author's transl)]. / Gonadoblastome et hermaphrodisme vrai. A propos d'une observation.

The gonadoblastoma has been found in patients with gonadodysgenesis of a pure or mixed variety or who have male pseudo-hermaphroditism. This gonadic tumour is rarely found in true hermaphroditism. This case history would seem to be the first that has been reported in France. The patient had been followed since birth because of having an intersex state with doubtful external genital organs and male internal genital organs consisting of a testis on the left side and feminine ones consisting of an ovary on the right. The caryotype was 46 XY. The gonadoblastoma was discovered at the age of 18 following a hysterectomy with castration which had become necessary because of pyometra and a tubal abscess. The discovery was a chance one, as there had been no clinical sign suggestive of it. Since a gonadablastoma is potentially malignant this finding highlights the problem of management of the gonads in such patients when the caryotype includes the Y chromosome.