Identification and localization of netrin-4 and neogenin in human first trimester and term placenta.

We describe here for the first time the characterization of family member of netrins, netrin-4 and its receptor neogenin, during the development of the placenta. By using western blots and RT-PCR, we demonstrated the presence of netrin-4 and its receptor neogenin protein as well as their transcripts. Using immunohistochemistry, we studied the distribution of netrin-4 and neogenin in both the first trimester and term placenta. We observed staining of netrin-4 in villous and extravillous cytotrophoblasts, syncytiotrophoblast, and endothelial cells whereas staining in stromal cells was faint. In decidua, we observed netrin-4 labelling in glandular epithelial cells, perivascular decidualized cells, and endothelial cells. However, neogenin was absent in villous and extravillous cytotrophoblasts and was expressed only on syncytiotrophoblast and placental stromal cells in the first trimester and at term placenta. The pattern of distribution suggests that a functional netrin-4-neogenin pathway might be restricted to syncytiotrophoblasts, mesenchymal cells, and villous endothelial cells. This pathway function might vary with its localization in the placenta. It is possibly involved in angiogenesis, morphogenesis, and differentiation.

Anatomical modifications of the temporomandibular joint during ageing.

It is essential to know the normal and pathological changes of ageing in the temporomandibular joint (TMJ) because of the frequency of pathology in this joint and the increased duration of life in current populations. A study was done on 70 TMJs harvested from 35 subjects older than 75 years. These joints were studied macroscopically, radiologically and histologically. Degenerative pathology of the TMJ affected more than 50% of the subjects studied and the disc was perforated in 7%. Ageing of the TMJ without any degenerative pathology is marked by radiographic signs which are not specific to the TMJ (cortical thinning, demineralisation). Histologically, amyloid degeneration was present in nearly 50% of TMJs studied.

Lymph node infection by Trichomonas tenax: report of a case with co-infection by Mycobacterium tuberculosis.

In an 82-year-old woman, presenting with fever and asthenia, cervical adenopathy was noted. Clinical and radiological investigations were fruitless. Laboratory examinations detected a refractory anemia. The lymph node was excised and showed numerous trichomonads on touch preparations. Histologically, the node showed caseous necrosis and macrophagic reaction. Diagnosis of lymph node infection by Trichomonas tenax was made. Three weeks later, culture of the node showed Mycobacterium tuberculosis and let us conclude co-infection. T tenax is usually regarded as a harmless saprophyte of the oral cavity. This exceptional observation shows for the first time an invasive potential of T tenax. It raises questions about links with tuberculosis and refractory anemia.

[Detection of human papillomavirus in cutaneous extragenital Bowen's disease in immunocompetent patients]. / Détection de papillomavirus humains dans la maladie de Bowen cutanée extragénitale chez le sujet immunocompétent.

INTRODUCTION: A specific link between human papillomavirus (HPV) types 16, 18, 31, and 33 and genital carcinomas and between HPV type 5 and cutaneous extragenital carcinomas in patients with epidermodysplasia verruciformis and renal transplant has been previously found. The aim of this prospective study was to detect HPV in cases of cutaneous extragenital Bowen's disease (BD) from non-immunosuppressed patients. PATIENTS AND METHODS: Twelve cases of cutaneous extragenital BD or Bowen's carcinoma (BC), seen in the period 1994-1996 and confirmed by histologic examination, were included in the study. Tissue sections were studied by in situ hybridization with a mixture of HPV DNA probes and specific HPV DNA probes. In addition, study on fresh materiel from 1995 included: Southern blot hybridization with various usual HPV probes (6, 11, 16, 18, 31, 33, 35, 39, 42), polymerase chain reaction (PCR) with hybridization using consensus HPV probes and probes specific for HPV types 6, 11, 16, 18 and 33. In positive samples with conventional PCR, in situ PCR with probes specific for HPV types 6/11 and 16 was performed on tissue sections. RESULTS: In situ hybridization was negative in all the cases. Southern blot hybridization was negative in our 9 studied cases. Three cases studied by consensus PCR were positive. PCR with specific HPV probes revealed positivity on two of these cases: HPV 6 in one, and HPV 16 in another. In situ PCR was positive with a mixed 6/11 HPV probe in the third positive consensus PCR case. DISCUSSION: Our study revealed the presence of HPV in 3 out of 12 cases of cutaneous extragenital BD and BC. HPV type 16, found in BC of skull, was the most usually found type in the literature. HPV types 6/11, detected in 2 cases, were rarely found in cutaneous extragenital BD and BC and these results are in favor of the oncogenic effect of these virus types. In our study, in situ hybridization and Southern blot hybridization were negative in all the cases; HPV was only found in 3 cases by conventional PCR and in 1 case by in situ PCR. The low range of detection of HPV in cutaneous extragenital BD may be due to the used methods, to difficulties related to sampling and/or to a low number of copies of the HPV genoma.

[Pre-leukemic granulocytic sarcoma of the uterus. Report of a case]. / Sarcome granulocytaire pré-leucémique de l'utérus. A propos d'un cas.

A case of pre-leukemic granulocytic sarcoma (GS) of the uterus was found in a 73-year old woman. The diagnosis was suggested by vaginal cytology and the green color of the gross lesions, then confirmed by naphthol AS-D chloro acetate esterase stain and immunohistochemistry on fixed tissue with the anti-lysozyme, anti-myeloperoxidase, CD 43 and CD15 antibodies. At the time of GS discovery, the patient presented no evident leukemia but myelogram contained 20% of blast cells. She developed acute myeloid leukemia 2 months later. Cytogenetic study of the bone marrow revealed chromosome 21 trisomy. GS is frequently mistaken for malignant lymphoma since it expresses some of the leukocytic antigens (leukocyte common antigen, CD 45 RO (UCHL1), MB2). Therefore, the use of a large panel of antibodies, including anti-myeloperoxidase, anti-lysozyme and CD15, is recommended. Precise diagnosis is essential because all GS must be treated as acute myeloid leukemias.

[Foreign body granuloma mimicking bronchial tumor. Aspects in x-ray computed tomography with views by virtual endoscopy]. / Granulome à corps étranger mimant une tumeur bronchique. Aspects en TDM avec vue par endoscopie virtuelle.

The aim of this study is to report the spiral CT findings of an endobronchial foreign body (chicken's bone) unknown on the postero-anterior chest radiograph and on the first bronchoscopy. The double originality of this case is the association with endobronchial actinomycosis mimicking a bronchial neoplasm and the utilization of virtual endoscopy by endoluminal 3D reconstruction in this context which has never been reported. The endoluminal 3D reconstruction of the bronchial tree could help guide the endoscopic procedure by better localization of the lesions.

Salivary trichomoniasis. A case report of infestation of a submaxillary gland by Trichomonas tenax.

A tumor was suspected after detection of an asymptomatic submaxillary swelling in an 85-year-old woman. Clinical, radiologic, and biologic investigations were fruitless. Transcutaneous needle aspiration revealed numerous trichomonads and led to the conclusion that a salivary duct was infested by Trichomonas tenax. The patient recovered following treatment with metronidazole, and there has been no recurrence after 2 years. This case sheds new light on the pathogenic properties of trichomonads. Peculiar features of this previously unreported location are discussed. Trichomonas tenax is often unrecognized by pathologists, and surely such cases are often misdiagnosed.

[Leiomyosarcoma of the inferior vena cava. Review of the literature apropos of a case]. / Le Léiomyosarcome de la veine cave inférieure. Revue générale à propos d'un cas.

The authors report a case of leiomyosarcoma (LMS) of the second segment of the inferior vena (IVC) with liver metastasis. Treatment by surgery and chemotherapy proved to be effective, as the patient is asymptomatic 8 years after the first operation. A review of the literature shows that these tumours are rare and have a slow course. The symptoms are often relatively minor and depend on the caval segment involved. The best examination for positive and topographic diagnosis remains computed tomography, but MR Imaging is promising. The prognosis remains severe (mean survival: 2 years) and surgery is the main treatment, with various techniques according to the caval segment involved.

[Malignant fibrous histiocytoma of the right ventricle and pulmonary artery. Apropos of a case. Review of the literature]. / Histiocytome fibreux malin ventriculaire droit et de l'artère pulmonaire. A propos d'un cas. Revue de la littérature.

The authors report a case of malignant cardiac fibrohistiocytoma involving the right ventricular infundibulum and the pulmonary artery and responsible for a pseudo-thromboembolic right heart failure syndrome. Following discovery of the tumour mass on ultrasonography and catheterisation, wide excision of the pulmonary artery, pulmonary valve and the roof of the infundibulum as far as the middle part of the ventricle was performed under cardio-pulmonary by-pass. Reconstruction was performed with a valveless woven Dacron tube. The postoperative course was uncomplicated and the patient was still alive after 18 months. Histology revealed malignant fibrohistiocytoma. The authors also present a review of the literature of these rare tumours of the right-sided cavities (5 cases reported).

[Leiomyosarcoma of the inferior vena cava. General review apropos of a case]. / Le léiomyosarcome de la veine cave inférieure. Revue générale à propos d'un cas.

The authors report a case of leiomyosarcoma (LMS) of the second segment of the inferior vena (IVC) with liver metastasis. Treatment by surgery and chemotherapy proved to be effective, as the patient is asymptomatic 8 years after the first operation. A review of the literature shows that these tumours are rare and have a slow course. The symptoms are often relatively minor and depend on the caval segment involved. The best examination for positive and topographic diagnosis remains computed tomography, but MR Imaging is promising. The prognosis remains severe (mean survival: 2 years) and surgery is the main treatment, with various techniques according to the caval segment involved.

[Cardiac tumor mass. Diagnostic and therapeutic approach. Apropos of 46 cases]. / Masse tumorale cardiaque. Approche diagnostique et thérapeutique. A propos de quarante-six cas.

The authors analyse a series of 46 operated intracardiac tumours (0.4% of all cases of cardiac surgery). The predominant symptoms were episodes of heart failure and pseudo-valvular disease. Peripheral emboli and pericardiac syndromes with tamponade occurred more rarely and constituted surgical emergencies. Non-invasive investigations, dominated by echocardiography, allow early diagnosis. The majority of tumours were situated in the left atrium and consisted, histologically, of myxomas, the surgical treatment of which consists of wide excision of the pedicle. Malignant tumours (17.7%) were dominated by cardiac sarcomas. When possible, extensive resection of these tumours may improve the chances of medium-term and long-term survival. The operative mortality was 8.8%. The delayed mortality was due to malignant tumours (17.3%). Myxomas must be followed in the long-term by systematic echocardiography. The authors observed 11% of recurrences occurring after a interval of 12 to 144 months (3 cases).

[Malignant fibrous histiocytoma of the right ventricle and pulmonary artery. Apropos of a case. Review of the literature]. / Histiocytome fibreux malin ventriculaire droit et de l'artère pulmonaire. A propos d'un cas. Revue de la littérature.

The authors report a case of malignant cardiac fibrohistiocytoma involving the right ventricular infundibulum and the pulmonary artery and responsible for a pseudo-thromboembolic right heart failure syndrome. Following discovery of the tumour mass on ultrasonography and catheterisation, wide excision of the pulmonary artery, pulmonary valve and the roof of the infundibulum as far as the middle part of the ventricle was performed under cardio-pulmonary by-pass. Reconstruction was performed with a valveless woven Dacron tube. The postoperative course was uncomplicated and the patient was still alive after 18 months. Histology revealed malignant fibrohistiocytoma. The authors also present a review of the literature of these rare tumours of the right-sided cavities (5 cases reported).

Diffuse storage of vegetal wax hydrocarbons of dietary origin. Pathologic and chemical findings in a case.

A 55-year-old man died suddenly, after presenting with unstable angina and an asymptomatic micronodular pulmonary pattern. Autopsy revealed storage of a crystallized fatty substance in the lymph nodes, liver, spleen, adrenal glands, and lungs. In the latter organ, the deposition formed foreign body granulomas, accounting for the radiographic appearance. Mass spectrometry identified the fatty substance as straight-chain saturated hydrocarbons (n-alkanes) of carbon-29 and carbon-31 atoms, which are naturally present in the cuticular wax of many vegetals. The case history and the elimination as causal agent of products manipulated in the patient's work led to the conclusion that the storage was due to excessive consumption of apples, and to a lesser degree of Brussels sprouts. We present the light-microscopic findings and the principal biochemical results. Pathogenic mechanisms are described. As far as we are aware, this is the only observation of vegetal alkane storage to be described to date.

Primary malignant fibrous histiocytoma of the right ventricle and main pulmonary trunk with a review of the literature.

We report the case of a 76-year-old man with a malignant fibrous histiocytoma of the right ventricle and main pulmonary trunk, diagnosed through echocardiography and catheterization. Extensive resection of the right ventricular outflow tract, pulmonary valve apparatus, and main pulmonary trunk was performed, and the defect was repaired with a valveless ventriculo-pulmonary Dacron graft. The patient recovered uneventfully, and was doing well 18 months after surgery. To our knowledge, this is only the 15th case of primary malignant fibrous histiocytoma of the heart that has been documented in the literature since histologic criteria and cases were published in 1977-78, and the 2nd such case of a primary tumor that has arisen in a right cardiac chamber. The case is presented in detail, along with a review of the literature since 1978.

A new human pathology with visceral accumulation of long-chain n-alkanes; tissue distribution of the stored compounds and pathophysiological hypotheses.

This report deals with a new human disorder characterized by the accumulation of plant long-chain n-alkanes in viscera of a human patient. Lipid analysis of tissues from an adult male after sudden death (affected with diffuse visceral granuloma containing lipophilic crystallized material) showed the presence of abnormal compounds identified as long-chain n-alkanes with 29 (n-nonacosane), 31 (n-hentriacontane) and 33 carbons (n-tritriacontane). Study of n-alkane distribution in patient tissues showed a major accumulation in lumbo-aortic lymph nodes, adrenal glands, lung (the highest levels were found in lung granulomas) and liver; significantly lower amounts were detected in myocardium and kidney, whereas no detectable level was found in brain. On the basis of the structural composition and of the tissue distribution of the accumulated n-alkanes, their dietary (plant) origin and the pathophysiological mechanism of the storage are discussed.