[Contribution of the CT scanner to the diagnosis of liposarcoma]. / Apport du scanner au diagnostic des liposarcomes.

Analysis of the CT aspect and anatomopathologic correlation of 11 liposarcomas of the abdomen and chest enabled definition of CT criteria for diagnosis. Anatomo-radiologic correlation could be established both for well-defined and poorly-defined tumors. However, due to the uneasy localization and high recurrence rate of poorly defined tumors, the data provided by CT did not improve the prognostic rates.

An unusual cause of sigmoid tumour: primary Hodgkin's disease. Case report.

Localized primary extranodal Hodgkin's disease is rare, especially in the digestive tract. A case is reported in which primary Hodgkin's disease presented as an ulcerated tumour of the sigmoid colon. The prognosis and management of such localized extranodal Hodgkin's lesions are discussed.

Primary pulmonary Hodgkin's disease and the dilemma of E stage.

Primary pulmonary Hodgkin's disease is rare. We report the case of a previously healthy 23-year-old woman who presented with isolated involvement of the right upper pulmonary lobe. Nodular sclerosing Hodgkin's disease was diagnosed after curative surgery. The clinical stage is felt to be IEBL+. The reasons for this staging, as opposed to a stage IV, are discussed. Adjuvant radiotherapy was given, delivering 39.6 grays in 22 courses of 1.8 grays. Three years after diagnosis, the patient is well and free of disease. A review of the literature indicates that the majority of primary pulmonary Hodgkin's disease present as a single mass amenable to curative surgery and radiation therapy. Chemotherapy can be reserved for the rare diffuse presentation.

[Occult gastric adenocarcinoma with pulmonary carcinomatous lymphangitis and microangiopathic hemolytic anemia in a young adult]. / Adénocarcinome gastrique occulte avec lymphangite carcinomateuse pulmonaire et anémie hémolytique microangiopathique chez un jeune adulte.

The case is reported of a 19-year-old patient with gastric carcinoma, in which clinical presentation (intermittent fever, myalgia, proximal muscle weakness and diffuse nodular-trabeculated infiltration of both lungs) was very unusual. The patient developed further complications (microangiopathic hemolytic anemia with disseminated intravascular coagulation) and died of subdural hematoma. Bone-marrow biopsy showed metastatic mucin-producing adenocarcinoma, but the gastric primary site of the tumor could only be demonstrated at autopsy.

[Cardiac myxoma. Ultrastructural and immunohistochemical study of two cases]. / Myxome cardiaque. Etude ultrastructurale et immunohistochimique de deux cas.

Two cases of cardiac myxoma studied by electron microscopy and by immunohistochemical methods are reported. In one case, the initial clinical manifestation was systemic embolization, and histological sections from the arterial deobstruction material set the diagnosis of an embolizing cardiac myxoma. In the second case, the investigations of a post-capillary pulmonary hypertension with echocardiography disclosed a left intraauricular tumor. Ultrastructural studies demonstrated mesenchymal tumor cells of various degrees of differentiation characterized by numerous cytoplasmic microfilaments and intermediate-sized filaments. The most differentiated cells were surrounded by a continuous basement membrane; there were intracellular junctions and microvilli. Furthermore these cells contained numerous micropinocytosis vesicles, several Weibel-Palade bodies and an abundant rough endoplasmic reticulum. Analysis of their cytoskeleton, using indirect immunofluorescnece techniques, showed that these cells were laden with actin and myosin microfilaments; the intermediate filaments were composed of vimentine. Staining with anti-desmin and anti-prekeratin sera remained negative. These results contribute to confirm that cardiac myxomas represent tumors originating from the primitive multipotential mesenchymal cells. An obvious tendency to differentiate into endothelial cells is noted in the two cases studied.

Primary aldosteronism with bilateral adrenal adenomas.

An unusual case of primary aldosteronism with bilateral single adenomas is reported. The two tumors were revealed by computerized axial tomography and subsequently confirmed by surgical exploration. Spironolactone therapy prior to the operation induced the formation of spironolactone bodies in only one of the two adenomas. As it has been postulated that these cytoplasmic inclusions may reflect the activity of the adenomatous cells, the presence of the bodies in a single adenoma would indicate a unilateral source of the hyperaldosteronism. Thus, the existence of spironolactone bodies could corroborate the data of functional localizing tests more closely than the morphological findings of computerized tomography.

[Lymph node lesions simulating a malignant lymphoma]. / Les lymphadénopathies simulant un lymphome malin.

Examples are reported of lymph node lesions simulating histologically and/or clinically malignant lymphomas. Two main categories of alterations have been distinguished: A. hyperplastic lymph node alterations associated with systemic disease and/or viral or drug-induced lymphadenitis; B. anatomo-clinical entities such as giant lymph node hyperplasia, massive lymphadenopathy with sinus histiocytosis, and angio-immunoblastic lymphadenopathy. It is suggested that in some situations such as angio-immunoblastic lymphadenopathy the borderline between reactive and enoplastic alterations is not clear cut. To evaluate such changes, close collaboration between the clinician, the hematologist and the patholigist is necessary.