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A case of a low grade chondrosarcoma of the cricoid cartilage which had been diagnosed initially as a chondroma is presented. The tumour recurred twice after limited surgical resections. Total laryngectomy was inevitable due to near total involvement of the cricoid cartilage and subsequent histological examination revealed a low grade chondrosarcoma. We have discussed in brief, the diagnosis and treatment of chondrosarcomas of the larynx and support the view of conservative surgical management for low grade tumours as they are slow growing and metastases are infrequent. A total laryngectomy may be reserved for salvage or primarily when more than half of the cricoid cartilage needs to be resected. Histological grading reveals the biological behaviour of the tumour and CT scans help in planning the surgery. A regular follow-up is necessary for early detection of recurrences and metastases.

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Primary pleural non-Hodgkin's lymphomas (NHLs) have been described mostly in Japan and occasionally in western countries. We report three cases occurring in nonimmunocompromised patients demonstrating close similarities to the Japanese cases. These lymphomas occurred more than 20 years after thoracoplasty for the treatment of pleural or pulmonary tuberculosis. They were all high grade lymphomas of B phenotype (two immunoblastic with plasmocytoid differentiation and one immunoblastic with anaplastic large cells). In situ hybridization (ISH) detected small nuclear RNAs encoded by Epstein-Barr virus (EBERs) in most lymphomatous cells in all cases. This suggests a link between primary pleural lymphoma and the longstanding chronic inflammation, which could favor a clonal evolution of Epstein-Barr virus (EBV)-infected B cells through the production of growth factors or immunosuppressive cytokines produced by inflammatory cells.

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The authors report a case of primary renal carcinoid in a 57-year-old woman in whom the diagnosis, established by histological findings, was confirmed by argyrophilia and immunohistochemical studies using anti-neuron-specific enolase, chromogranin A, serotonin and somatostatin antibodies. The clinical and pathological features of this rare renal tumor are discussed.

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The aim of this study was to specify the signs and course of patients with a dilated common bile duct without obstruction. We included patients with a dilated common bile duct of more than 12 mm on endoscopic retrograde cholangiography, and we excluded patients with stones, tumor or other visible obstruction. Two hundred and seven patients (8.4 p. 100 of endoscopic retrograde cholangiography) were included. One hundred and nineteen (57.5 p. 100) had undergone cholecystectomy. Sixty-five p. 100 of patients had signs suggesting biliary tract disease, and 78 p. 100 had biological signs of cholestasis. The size of the common bile duct was not different whether the patient had been cholecystectomized (16.2 +/- 0.3 mm.M +/- SEM) or not (16.2 +/- 0.4 mm). Forty-one patients in the non cholecystectomized group had gallbladder stones. Thus, 47 of our 207 patients (23 p. 100) had neither gallbladder stones nor previous cholecystectomy. Endoscopic retrograde cholangiography was completed by endoscopic sphincterotomy in 130 patients, either in the intent of not missing obstruction, or for therapeutic purposes. Follow-up more than one month after endoscopic retrograde cholangiography was available for 159 patients (77 p. 100). The median survival was 73 months. One hundred and ten patients (69 p. 100) were asymptomatic, 36 (23 p. 100) had atypical abdominal pain while 13 (8 p. 100) patients had episodes of biliary colic and/or fever and/or jaundice. During follow-up, an initially unrecognized obstacle was discovered in 8 patients: 5 common bile duct stones, 2 ampullary tumors and one pancreatic tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

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Several clinical and experimental findings suggest that liver allografts are less sensitive than other organ allografts to lymphocytotoxic antibodies. In this experimental study in hypersensitized inbred rat recipients, rejection of liver allografts was delayed compared to that of heart allografts. Furthermore, there was a marked decrease in the level of cytotoxic antibodies after liver allografting but not after heart allografting in these animals. The decrease in the level of antibodies also occurred after donor-specific extracorporeal liver hemoperfusion in hypersensitized recipients. Whether the decrease was caused by a massive absorption of antibodies on the liver or related to excretion of major histocompatibility complex antigens in a soluble form remains to be demonstrated. These results support the hypothesis that the liver has a privileged position in regard to rejection and are consistent with clinical observations made following ABO incompatible or cross-match positive liver transplantations.

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Alcoholic hepatitis (AH) seems to be less frequent and to play a lesser role in the death of cirrhotic patients than previously acknowledged. The purpose of this work was: 1) to study the cause of death of cirrhotic patients 2) to determine the prevalence of AH among these patients and 3) to describe the clinical and laboratory features of cirrhotic patients with AH. The data were collected from a series of 107 necropsies in cirrhotic patients without hepatocellular carcinoma. The statistical analyses were carried out with an IRIS 80 computer. Severe liver failure with jaundice and encephalopathy, hemorrhage and uncontrolled infection with septic shock represented 84 p. 100 of the causes of death in patients with cirrhosis. Seventy-nine out of 107 patients (74 p. 100) had no AH (group 1), and 28 (26 p. 100) had AH (group 2): AH was mild in 15 cases and severe in 13 cases. All patients with AH died from a complication directly related to their liver disease while 21.5 p. 100 of patients without AH died from a complication not related to cirrhosis. The clinical and laboratory features of the patients without AH and cirrhosis differed from those of patients without AH by: a more frequent presence of fever (p less than 0.01), the absence of important weight loss (p less than 0.001), the total absence of abstinence (p less than 0.05), a higher value of ASAT/ALAT ratio, of serum levels of total bilirubin (p less than 0.01) and conjugated bilirubin (p less than 0.05), gamma glutamyl transpeptidase (p less than 0.001) and total cholesterol (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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The association of glomerulonephritis and persistent HBs antigenemia is reported in 4 adults with nephrotic syndrome: 2 cases of membranous glomerulonephritis associated with chronic persistent hepatitis and 2 cases of membrano-proliferative glomerulonephritis associated with active cirrhosis. In 3 patients, all positive for HBsAg, anti-HBc and HBeAg by radioimmunoassay, indirect immunofluorescent study was performed on kidney and liver biopsies. Glomerular deposit of HBcAg was detected in two cases. HBsAg and HBcAg were not found in the liver. The pathogenesis of such glomerulonephritis remains uncertain and the role of HBs antigen-antibody circulating immune complexes is not clearly proved. Two patients were treated with vidarabine intravenously. Vidarabine produced a transitory decrease of HBsAg concentration in 2 cases and a transitory loss of DNA-polymerase activity associated with a decrease of HBeAg concentration in one case. Neither seroconversion nor improvement of the glomerular disease were ascertained.

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Spontaneous tolerance of liver allografts can be observed in inbred rats. In order to study the influence of the density of major histocompatibility complex alloantigens on the fate of liver allografts in the rat, liver allografts were performed in a semi-allogeneic and a fully allogeneic combination. Comparisons of the fate of heart and kidney allografts were made in the same combinations. A similar proportion of spontaneously tolerated liver allografts was observed in the two combinations; after a few months these animals were in a state of donor-specific unresponsiveness. A spontaneous prolongation of kidney allografts was observed only in the semi-allogeneic combination. These animals were not in a state of donor-specific unresponsiveness. These results suggest that induction of liver allograft tolerance in the rat is not decisively influenced by the importance of the density of major histocompatibility complex antigens present on the graft and that its mechanism may be different from that which causes spontaneous prolongation of semi-allogeneic kidney allografts.

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This paper presents the results of acute, subacute, and chronic toxicity studies on ethyl fluclozepate (CM 9612). Acute toxicity was studied in rats and mice of both sexes by oral and intraperitoneal routes. This study established the very low toxicity of this compound. The LD0 by the oral route in these two species is at least higher than 4 g/kg, whereas by the intraperitoneal route the compound has a LD50 of 645 mg/kg at the lowest level. The 3- and 6-month subacute and chronic toxicity studies were carried out in baboons and in rats. The only effects observed during these studies were sedation in the baboon, a slight decrease of the heart rate also in baboons (6 months), and the presence of foam cells in rat lungs after only 6 months of treatment. The sedation and the decrease of heart rate are not toxic effects, but rather the consequence of the anxiolytic activity of CM 6912. Pulmonary foam cells occurred in rats only after a long period of treatment (6 months) and at very high dose levels. This lesion was considered evidence of pulmonary phospholipidosis, a change known to occur frequently with compounds of this nature.

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Three recent progresses allow to perform plastic embedding of moderate or large samples of tissue in limits of time close to those of the paraffin embedding and to obtain slices between 1 and 2,5 mu on which all current histochemical or even histo-immunological reactions are possible. These technics prevent the retraction of the tissues, give a good preservation of the structure of the cells and permit a good analysis of the tiny lesions of all kinds of tissues. From our experience about 1362 varied biopsies, the best indications seems to be in order : kidney, hepatic, lung, medullary and nodes biopsies. It seems now justified to introduce these technics as a routine one, inside laboratories which have to detect tiny lesions on particular tissues or on experimental samples.

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One case of primary linitis plastica of the rectum is presented, adding to the 20 previous cases reported in the literature, the diagnosis was made aften excluding the stomach as a primary source by per operative palpation and radiographic examination. Absence of blood in the stools and predominant symptomatology of diarrhea explains the delay of diagnosis in this patient with chorea. About 20% of all reported cases occur in association with ulcerative colitis. The prognosis is poor; the maximal survival reported is 2 1/2 years; the mean survival time is about 4 months.

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