The birth of the clinicopathological method in France: the rise of morbid anatomy in France during the first half of the nineteenth century.

Morbid anatomy underwent extraordinary development in Paris during the last years of the eighteenth and the first half of the nineteenth century, for both philosophical and political reasons. The protagonists of this progress were primarily clinicians whose purpose was to link symptoms with pathological lesions and to elaborate a pertinent nosology. Pierre-Joseph Desault and Jean-Nicolas Corvisart were the forerunners, along with Xavier Bichat, a genius who died before he was able to realize his full potential. Guillaume Dupuytren, a renowned surgeon, founded an Anatomical Society with enthusiastic students; while Gaspard-Laurent Bayle and René-Theophile Laennec studied tuberculosis and developed the principles of clinicopathological correlations. Laennec's invention of the stethoscope in 1816 constituted a dramatic improvement of the possibilities of clinical examination and effectively established the clinicopathological method. A chair of morbid anatomy was created in 1835 for J. Cruveilhier, while a museum of morbid anatomy was established thanks to a 200,000 francs donation on behalf of G. Dupuytren. The French practitioners, however, did not believe that the microscope would play a major part in further medical progress, and after the revolution of 1848, the so-called School of Paris declined.

Pleomorphic hyalinizing angiectatic tumor of soft parts: ultrastructural analysis of a case with original features.

Pleomorphic hyalinizing angiectatic tumor, a rare neoplasm of uncertain lineage resembling malignant fibrous histiocytoma and schwannoma, was first described in 1996 by M. E. F. Smith et al. (Am Surg Pathol. 20:21-29). To date, less than 100 cases have been reported in the international literature. It occurs in subcutaneous and intramuscular soft tissues of extremities or trunk in adults without sex predilection. All lesions are composed of sheets and fascicles of spindled and pleomorphic cells associated with clusters of thick-walled ectatic vessels surrounded by a perivascular hyaline material and inflammatory cells such as mast cells. About one-half of these neoplasms express CD34. No patient has developed metastases but occasional local recurrences are possible. This tumor of uncertain lineage is suggested to be an aggressive locally growing low-grade sarcoma. Only 3 cases were previously studied by electron microscopy and appeared to consist of primitive fibroblastic cells. The authors report histological and ultrastructural characteristics of a new case of PHAT excised from the right buttock of a 66-year-old man with the presence of ganglion-like cells, a feature that has not been previously reported, and unusual central ischemic necrosis. The features of this case are suggestive of a fibroblastic origin.

[Heterotopic mesenteric ossification: a rare cause of postoperative occlusion]. / Ossification hétérotopique du mésentère: une cause rare d'occlusion post-opératoire.

Intraabdominal heterotopic ossification is a very rare lesion, especially in the mesentery. In all reported series, there was a history of traumatic injury of the abdomen. We report two cases of heterotopic mesenteric ossification occurring after laparotomy in adults.

Intraneural reticular perineurioma of the neck.

Perineuriomas are infrequent tumors that may be intraneural or extraneural in soft tissue with no apparent relation with a nerve. Some cases of soft tissue perineurioma may have a retiform pattern, but this pattern has not been described to date in intraneural perineurioma. We report a case of a unique perineurioma arising in a nerve of the neck that had a distinctive reticular pattern and was intraneural. The patient was a 21-year-old woman who had a lump on the left side of the neck abutting the vena jugularis. The tumor had features of both reticular perineurioma and intraneural perineurioma with pseudo-onion bulb pattern. The tumor cells were positive for epithelial membrane antigen. The patient is free of tumor 6 months after operation.