Uterine angiomyolipoma associated with pregnancy.

Uterine angiomyolipomas are rare lesions composed of mature adipose tissue, smooth muscle, fibrous connective tissue, and blood vessels in varying proportions. We reported the first case of angiomyolipoma associated with a normal pregnancy. Initially, the tumor developed intramurally and could have been confused with a partial molar gestation. After delivery, tumor development was extensive and subserosal, making differential diagnosis from a sarcoma difficult. The question of histological diagnosis, as well as that of immunocytochemical analysis which seems to be helpful in such cases, is discussed here.

[The place of composite flaps in maxillofacial surgery]. / Place des lambeaux composites en chirurgie maxillo-faciale.

The preferred composite flap is the musculocutaneous flap from pectoralis major for repair of loss of mucocutaneous substance due to cancer or injury. In rare indications the musculocutaneous flap from sternocleidomastoid muscle is used. When loss of bone substance combined with a cutaneous or mucosal defect has to be corrected use is made of the bone-muscle-skin flap from pectoralis major to include the 5th rib, or the bone-muscle-skin flap from sternocleidomastoid to include internal portion of clavicle. Reliability on use of these two flaps has led to their application in surgery for mandibular osteoradionecrosis. In addition to allowing repair of bone continuity, the vascular and cellular capacities of the flap provide colonization and rehabilitation of the borders of lost substance with live tissue, as shown by subsequent bone remodelling. Results of statistical analysis of 50 cases are presented.

[Current treatment of osteoradionecrosis]. / Le traitement actuel de l'ostéoradionécrose.

Conventional treatment of osteoradionecrosis of mandible is by antibiotics combined if necessary with a hemimandibulectomy. A method is proposed which reduces bone excision to infected and necrotic tissue while respecting mandibular continuity. The bone remaining is covered by a flap taken from a distant region. Five cases treated in this way are reported. When mandibular continuity has to be interrupted to suppress infected foci, immediate repair is performed using an osteo-musculo-cutaneous flap, and six cases treated by this method are reported. A part from their mechanical covering and reconstructing roles these well vascularized flaps improve vitality of tissues they enclose, including the mandibular bone.

Melanotic neurofibroma: a case report with ultrastructural study.

The authors report a case of a solitary melanotic neurofibroma involving the temporomalar area in a 17-year-old man. Light-microscopic study reveals a benign neurofibroma including melanin deposits. Electron microscopy shows typical premelanosomes and melanosomes within Schwann cell cytoplasm. The literature is reviewed, and theories of histogenesis for this unusual tumor are discussed.

Localization of lactoferrin and nonspecific cross-reacting antigen in human breast carcinomas. An immunohistochemical study using the avidin-biotin-peroxidase complex method.

A retrospective immunocytochemical study was performed on 67 human breast carcinomas to determine whether the epithelial cell-associated antigens, lactoferrin and nonspecific cross-reacting antigen (NCA), could be used as markers in the prognostic assessment of breast cancers. Fixed paraffin sections were tested with anti-lactoferrin and anti-NCA. Lactoferrin and NCA were found in 7.5% and 19% of the cases, respectively. Furthermore, the association between these two antigens in tumor cells was significant (P less than 0.05). Kappa-casein was observed in all antigen-positive cases. These antigens were observed more often in low-grade ductal carcinomas that had positive estrogen and progestin receptors, but no relationship could be established between lactoferrin or NCA and other prognostic indicators, such as histologic type and grade of the tumor, stromal elastosis, or steroid receptors. Although more antigen might have been detected in unfixed, frozen specimens, the results indicate that lactoferrin and NCA possess minimal value as epithelial cell markers and no prognostic value when detected on routinely fixed, paraffin-embedded samples.

[Localized myositis with eosinophilia]. / Myosite localisée avec éosinophilie.

A 49-year old man developed myositis of the left masticatory muscles followed by myositis of the right supinator longus; these two lesions were histologically confirmed. Blood and bone marrow eosinophilia was present. Cure was obtained with systemic corticosteroids. Only one similar case was found in the literature. These cases differ from the various localized or focal forms of myositis as well as from eosinophilic polymyositis. Despite some similarities with masseteric myopathies in animals, no hypothesis can be formulated concerning the cause of the disease.

[Current trends in the treatment of mandibular osteoradionecrosis. Use of a sternocleidomastoid osteomyocutaneous flap]. / Tendance actuelle dans le traitement des ostéo-radio-nécroses de la mandibule. Utilisation d'un lambeau ostéo-musculo-cutané sterno-cléido-mastoïdien.

An osteomusculocutaneous flap using the clavicle, and pedunculated on the sternocleidomastoid muscle, was used in two patients to repair loss of post-radicular mucosa and bone substance. Healing of mucosa and bone consolidation was obtained with evidence of production of bone callus on radiography. The hypothesis advanced to explain this reconstruction of necrosed mandible is the presence of the new vascular supply.

[Anatomical lesions of the condylar head in a case of temporomandibular joint syndrome]. / Lésions anatomiques de la tête condylienne dans un cas de S.A.D.A.M.

Radiography in a patient with this syndrome showed marked lesions in the condylar head. Histology after condylectomy showed alterations throughout the condyle with associated arthrosic and osteonecrotic lesions. Possible relations between the two processes are discussed, the extensive nature of the necrosis suggesting that this is the initial lesion.

Kappa casein, lactalbumin and GCDFP 70 localization in human breast carcinomas: an immunohistochemical study using the avidin-biotin-peroxidase complex method.

A retrospective study of 67 human breast carcinomas of various types and grades was conducted using the avidin-biotin-peroxidase complex (ABC) to localize casein, lactalbumin, and GCDFP 70 on paraffin sections. Estrogen and progesteron receptors also were evaluated. This study demonstrated the following: (1) Casein positive cells were present in all cases with a variable distribution and degree of staining, whereas lactalbumin and GCDFP 70 were seen in only 40 and 43% of the cases, respectively. (2) No significant relationship was observed between casein, lactalbumin, GCDFP 70 and the histologic types of tumors or the extent of stromal elastosis, with the exception GCDFP 70, which was observed more often in well-differentiated ductal carcinomas. (3) No significance was established in the relationship between antigens and steroid receptor content, with the exception of casein; strong casein immunostaining was significantly related to high progestin receptor levels. (4) Lactalbumin and GCDFP 70 were significantly associated with each other, but independently so of the histologic grades and types, the extent of stromal elastosis, and the steroid receptor content of the tumor cells.

[Primary adenocarcinoma of the bladder. Apropos of 5 cases]. / L'adénocarcinome primitif de la vessie. A propos de 5 observations.

The authors relate five cases of primary adenocarcinoma of the bladder that occurred between 1977 and 1983. Four tumours were located in the base and the lateral sides of the bladder, while the fifth was in the dome. Four tumours out of five were invading when diagnosis was done and were cured by a wide surgical cutting-away; the fifth which was a superficial one, was stopped by endoscopic resection. Bladder primary adenocarcinoma represent less than two percent of the whole epithelial tumours of this organ. They can be found under two specific topographic aspects: the first one, located in the dome or in the anterior wall is considered as a tumour of urachus, the second one, usually located in the trigonal and peri-trigonal area is considered as a vesical adenocarcinoma proper. The histogenesis of these lesions quite probably lies in a mechanism of vesical urothelium metaplasia under the influence of mechanical and infectious factors. Most of these tumours are isolated and invading when they are found out. One might distinguish adenocarcinomas similar to those of the gut, from urothelial carcinomas where the metaplastic glandular features are predominant. Clinically, glandular tumours hardly differ from the usual urothelial invading carcinoma except by a mucus secretion in the bladder that is, however quite unusual. Prognosis of such lesions is bad but a little better in urachus carcinoma cases. The treatment is surgical and involves a wide cutting-away, the extent of which can be discussed for urachus tumors. The impact of radiotherapy and chemotherapy upon them has still to be proved.(ABSTRACT TRUNCATED AT 250 WORDS)

[Glial fibrillary acidic protein and central nervous system tumors. Immunohistochemical study of a series of 207 cases. 2: Medulloblastomas. Hemangioblastomas. Other tumors. Discussion]. / Protéine gliofibrillaire acide (GFA) et tumeurs nerveuses centrales. Etude immunohistochimique d'une série de 207 cas. IIe Partie: Médulloblastomes. Hémangioblastomes. Autres tumeurs. Discussion.

The presence of glial fibrillary acidic protein (GFA) was tested in biopsy or autopsy specimens of 207 human central nervous system tumors. Samples were fixed, paraffin-embedded and GFA was detected using the peroxidase-antiperoxidase technique. The second part of this study dealt mainly with medulloblastomas and hemangioblastomas. Of the 17 cerebellar medulloblastomas, 15 contained less than 5% GFA positive cells. These were classified according to the Mannoji et al., 1981, criteria. Ten medulloblastomas contained type 1, 2 and 3 cells; 1 was composed of only type 1 cells, and 4 were composed of only type 3 cells. Of the 8 cerebellar or medullary hemangioblastomas, 3 contained only a few GFA positive cells which were, in two cases stroma cells and in another, astrocytes. GFA positive cells were found in 7 oligoastrocytomas, 3 gangliogliomas and 1 hamartoma of the hypothalamus. Similarly, a GFA positive astrocytic differentiation was found in a pineocytoma. In a case of tuberous sclerosis no GFA was found in the giant cells of cortical tubers. Nor was GFA observed in one intracerebral tumor of tuberous sclerosis. GFA was not found in 5 meningiomas, 4 oligodendrogliomas, 4 pituitary adenomas, 3 neurinomas of the VIII cranial nerve, 1 primary cerebellar malignant lymphoma, 1 familial lymphohistiocytosis with cerebellar involvement and 4 brain metastases. The authors also include diagnostic, histogenetic and nosological comments -about neuroglial tumors. The findings in the two parts of this study fail to establish a correlation between GFA positivity and histological grade of astrocytomas and glioblastomas.

[Glial fibrillary acidic protein and central nervous tumors. Immunohistochemical study of a series of 207 cases. 1: Astrocytomas. Glioblastomas. Ependymomas. Papillomas of the choroid plexus]. / Protéine gliofibrillaire acide (GFA) et tumeurs nerveuses centrales. Etude immunohistochimique d'une série de 207 cas. 1re partie: Astrocytomes. Glioblastomes. Ependymomes. Papillomes des plexus choroïdes.

The presence of glial fibrillary acidic protein (GFA) was tested in biopsy or autopsy specimens of 207 human central tumors. Samples were fixed, paraffin-embedded and GFA was detected using the peroxidase-antiperoxidase technic. The first part of this study dealt mainly with glioblastomas (36 cases) and astrocytomas (87 cases). Tumors were classified in three categories according to their histological grade: 24 astrocytomas grade I and II, 63 astrocytomas grade III and IV and 36 glioblastomas (grade IV). For each of these tumors GFA positive cells were counted in 5 different fields using objectives of 2,5, 10 and 25. The results were as follows: less than 50% GFA positive cells were found in 22 out of 24 low grade astrocytomas, 49 out of 63 high grade astrocytomas and 32 out of 36 glioblastomas. Conversely, over 50% GFA positivity was found in 2 benign astrocytomas, 14 malignant astrocytomas and 4 glioblastomas. In 3 high grade tumors (2 astrocytomas, 1 glioblastoma) GFA positivity was found to be over 75%. Of the 17 ependymomas, 14 were GFA positive; however, no correlation could be established between the degree of GFA positivity and histological grade. The three papillomas of the choroid plexus of the lateral ventricles found in children were GFA negative. In adults, a GFA positive focus of ependymal differentiation was found in a papilloma of the choroid plexus in the posterior cerebral fossa.

[Detection of glial fibrillary acidic protein in central nervous tumors using an immunohistochemical method. Preliminary study of 33 cases (author's transl)]. / Le diagnostic des tumeurs nerveuses centrales par un marqueur de la protéine gliofibrillaire acide. Etude préliminaire d'une série de 33 cas.

Thirty-two cases of human central nervous tumor and one experimental glioma were studied in fixed paraffin or epon embedded tissues using the peroxidase-antiperoxidase method. The present study confirms the usefulness of immunohistochemical methods for the diagnostic evaluation of neuro-epithelial neoplasms. The authors also include some prognostic and histogenetic comments about glial tumors.