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Lalevée S, Catano J, Ingen-Housz-Oro S, Surenaud M, Tran Van Nhieu J, Schlemmer F, Bendib I, Mekontso-Dessap A, Hue S, de Prost N. Acute lung injury in mechanically ventilated patients with epidermal necrolysis: an exposed-unexposed retrospective cohort study. Burns & Trauma 2020; 8:tkaa041. [PMID: 33324706 PMCID: PMC7723417 DOI: 10.1093/burnst/tkaa041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 11/13/2022]
Affiliation(s)
- S Lalevée
- Service de dermatologie, AP-HP, hôpital Henri Mondor, Créteil, France
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
| | - J Catano
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France
| | - S Ingen-Housz-Oro
- Service de dermatologie, AP-HP, hôpital Henri Mondor, Créteil, France
- EA7379 EpidermE, UPEC, Créteil, France
- Centre de référence des dermatoses bulleuses toxiques et toxidermies graves TOXIBUL, Créteil, France
| | - M Surenaud
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
| | - J Tran Van Nhieu
- Service d’Anatomopathologie, AP-HP, hôpital Henri Mondor, Créteil, France
| | - F Schlemmer
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Unité de Pneumologie, Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France
| | - I Bendib
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France
- Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, Créteil Cedex 94010, France
| | - A Mekontso-Dessap
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, Créteil Cedex 94010, France
| | - S Hue
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Centre de référence des dermatoses bulleuses toxiques et toxidermies graves TOXIBUL, Créteil, France
- AP-HP, Département d'Hématologie et d'Immunologie biologiques, Groupe hospitalo-universitaire Chenevier Mondor, Assistance Publique-Hôpitaux de Paris F-94010 Créteil, France
| | - N de Prost
- Université Paris Est Créteil, INSERM U955, IMRB, F-94010 Créteil, France
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil Cedex 94010, France
- Centre de référence des dermatoses bulleuses toxiques et toxidermies graves TOXIBUL, Créteil, France
- Groupe de Recherche Clinique CARMAS, Faculté de Santé de Créteil, Université Paris Est Créteil, Créteil Cedex 94010, France
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Chanal J, Duong TA, Valeyrie-Allanore L, Bosc R, Mayer J, Tran Van Nhieu J, Wolkenstein P, Chosidow O. Necrotizing fasciitis of the thigh revealing a Crohn's disease. J Eur Acad Dermatol Venereol 2014; 29:1648-9. [PMID: 24750384 DOI: 10.1111/jdv.12524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- J Chanal
- Department of Dermatology, Groupe Hospitalier Henri-Mondor, APHP, Créteil, France
| | - T-A Duong
- Department of Dermatology, Groupe Hospitalier Henri-Mondor, APHP, Créteil, France.,Université Paris Est-Créteil Val de Marne, Créteil, France
| | - L Valeyrie-Allanore
- Department of Dermatology, Groupe Hospitalier Henri-Mondor, APHP, Créteil, France.,Laboratoire d'Investigation Clinique EA EA439, Créteil, France
| | - R Bosc
- Université Paris Est-Créteil Val de Marne, Créteil, France.,Department of Plastic Surgery, Groupe Hospitalier Henri-Mondor, APHP, Créteil, France
| | - J Mayer
- Université Paris Est-Créteil Val de Marne, Créteil, France.,Department of Radiology, Groupe Hospitalier Henri-Mondor, APHP, Créteil, France
| | - J Tran Van Nhieu
- Université Paris Est-Créteil Val de Marne, Créteil, France.,Department of Pathology, Groupe Hospitalier Henri-Mondor, APHP, Créteil, France
| | - P Wolkenstein
- Department of Dermatology, Groupe Hospitalier Henri-Mondor, APHP, Créteil, France.,Université Paris Est-Créteil Val de Marne, Créteil, France.,Laboratoire d'Investigation Clinique EA EA439, Créteil, France
| | - O Chosidow
- Department of Dermatology, Groupe Hospitalier Henri-Mondor, APHP, Créteil, France.,Université Paris Est-Créteil Val de Marne, Créteil, France.,French satellite of the Cochrane Skin Group, Créteil, France.,INSERM, Centre d'Investigation Clinique 006, Créteil, France
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Chouillard E, Gumbs A, Fangio P, Torcivia A, Tayar C, Laurent A, Dache A, Lacherade JC, Van Nhieu JT, Cherqui D. Liver resection for cystic lesions: a 15-year experience. MINERVA CHIR 2010; 65:495-506. [PMID: 21081861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM The aim pf this paper was to review the management strategies in patients who had hepatic resection for cystic lesions. If symptomatic, a simple liver cyst (SC) is best treated by unroofing. A hydatid cyst (HC) is treated by simple cystectomy or pericystectomy. Many procedures have been described for the management of complex non-HCS including aspiration, sclerosing therapy, drainage, unroofing, and resection. METHODS A retrospective review of patients who had liver resection for cystic lesions between January 1, 1992, and December 31, 2006. The study was carried out at a University Hospital and a General Community Hospital affiliated with a University program. Management strategies were detailed, including clinical, biological, and imaging features. Operative morbidity and mortality as well as long-term outcome were also assessed. A comparison between preoperative and postoperative diagnoses was performed. RESULTS Thirty-three patients (24 women and 9 men) underwent 39 liver resections, including 14 left lateral resections, 12 right hemi-hepatectomies, 7 left hemi-hepatectomies and 6 segmentectomies or wedge resections. The final diagnosis included hydatid cyst in 10 patients (30%), cystadenoma in 6 (18%), simple cysts in 6 (18%), Caroli's disease in 4 (12%), cystadenocarcinoma in 3 (9%) and miscellaneous in the 4 remaining (12%). There was no mortality and the postoperative morbidity rate was 15%. Long-term follow-up revealed that, besides patients with malignancies whose outcome was dismal, overall prognosis was positive with efficacious symptom control. CONCLUSION; Accurate preoperative diagnosis of liver cystic lesions may be difficult. However, liver resection for such lesions is a safe procedure that provides long-term symptomatic control in benign disease and may be curative in cases of underlying malignancy. Even if nearly 50% of liver cystic lesions treated by resection were either symptomatic SC or HC, we recommend en-bloc liver resection for all liver cystic lesions that are not clearly parasitic or simple cysts.
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Affiliation(s)
- E Chouillard
- Department of General Surgery, Hospital Center of Poissy, Poissy, France.
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4
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Gorea G, Demy M, Tran Van Nhieu J, Tigori J, Aubé C, Cherqui D, Oberti F, Caroli-Bosc FX, Calès P. Radiation-induced cholangitis with hepatocellular carcinoma. ACTA ACUST UNITED AC 2009; 34:35-9. [PMID: 19800750 DOI: 10.1016/j.gcb.2009.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 05/12/2009] [Accepted: 06/13/2009] [Indexed: 11/26/2022]
Abstract
There are no reports of hepatocellular carcinoma complicating postradiotherapy cholangitis. We report the case of a 45-year-old patient who had undergone upper abdominal radiotherapy for Hodgkin's disease, 21 years before, which was complicated years later by cholangitis with stricture of the common bile duct. Biliodigestive anastomosic surgery was scheduled due to recurrent angiocholitis, and hepatocellular carcinoma was discovered. The patient died from carcinoma some months later.
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Affiliation(s)
- G Gorea
- Department of Hepato-Gastroenterology, University Hospital, Angers, France
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Karoui M, Koubaa W, Delbaldo C, Charachon A, Laurent A, Piedbois P, Cherqui D, Tran Van Nhieu J. Chemotherapy has also an effect on primary tumor in colon carcinoma. Ann Surg Oncol 2008; 15:3440-6. [PMID: 18850249 DOI: 10.1245/s10434-008-0167-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Revised: 08/20/2008] [Accepted: 08/23/2008] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study characterizes the histological effect of chemotherapy (CT) on primary colonic tumors. METHODS Between 2000 and 2006, 38 patients with stage IV colon cancer underwent resection of the primary, after chemotherapy (CT group, n = 16) or without preoperative CT (control group, n = 22). For all primary tumors, histological analysis included: fibrosis, acellular necrosis, acellular mucin pools, lymphoplasmacytic infiltration, and changes at tumor surface. Tumor regression grade (TRG) was determined by the amount of residual tumor cells and was graded from 1 to 5. RESULTS No patient had complete histological response. Major histological tumor regression (TRG2) was observed in 70% of patients treated by CT and none of the not treated patients (P < 0.0001). Fibrosis, acellular necrosis, and surface changes were significantly increased in the CT group. TRG in the primary was comparable to the TRG in the corresponding liver metastases for 7/9 patients who underwent both colonic and hepatic resection after CT. CONCLUSION CT induces major histological response in 70% of colon cancers. Response to CT in the primary and the corresponding liver metastases are correlated. These results support a policy of initial CT management for stage IV colon cancer and may warrant future studies of neoadjuvant CT in locally advanced colon carcinomas.
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Affiliation(s)
- M Karoui
- Department of General and Hepatobiliary Surgery, Henri Mondor University Hospital, Créteil Cedex, France.
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6
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Dumoulin A, Boulmerka H, Tran Van Nhieu J, Lang P, Baron C. Severe recurrent cytomegalovirus disease revealed by a colocutaneous fistula in a kidney transplant recipient. Transpl Infect Dis 2008; 5:147-50. [PMID: 14617304 DOI: 10.1034/j.1399-3062.2003.00014.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Intestinal disorders are classical complications of cytomegalovirus (CMV) infection in kidney transplant recipients (Helderman JH, Goral S. Gastrointestinal complications of transplant immunosuppression. J Am Soc Nephrol 2002: 13: 277-287). Severe ulcerative colitis that is sometimes lethal has been reported (Foucar E, Mukai K, Foucar K, Sutherland DE, Van Buren CT. Colon ulceration in lethal cytomegalovirus infection. Am J Clin Pathol 1981: 76: 788-801 and Frankel AH, Barker F, Williams G, Benjamin IS, Lechler R, Rees AJ. Neutropenic enterocolitis in a renal transplant patient. Transplantation 1991: 52: 913-914). The immunosuppressive drugs currently used, and notably mycophenolate mofetil (Cellcept), cause significant changes in the incidence, duration, and viral load of CMV infections with severe atypical forms of CMV disease (De Maar EF, Verschuuren EA, Homan vd Heide JJ, et al. Effects of changing immunosuppressive regimen on the incidence, duration and viral load of cytomegalovirus infection in renal transplantation: a single center report. Transpl Infect Dis 2002: 4: 17-24 and Perez Valentin MA, Cofan F, Sole M, et al. Atypical cytomegalovirus in renal transplantation: a new form of presentation. Nefrologia 2002: 22: 381-385). This report describes a patient who suffered from several episodes of colitis due to an unusual and late-appearing CMV infection.
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Affiliation(s)
- A Dumoulin
- Service de Néphrologie et de Transplantation, Hôpital Henri Mondor, Créteil, France.
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7
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Teixeira-Clerc F, Julien B, Grenard P, Tran Van Nhieu J, Deveaux V, Hezode C, Mallat A, Lotersztajn S. Le système endocannabinoïde, une nouvelle cible pour le traitement de la fibrose hépatique. ACTA ACUST UNITED AC 2008; 56:36-8. [PMID: 17412522 DOI: 10.1016/j.patbio.2007.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Accepted: 01/11/2007] [Indexed: 11/30/2022]
Abstract
The cannabinoid system comprises specific G protein-coupled receptors (CB1 and CB2), exogenous (marijuana-derived cannabinoids) and endogenous (endocannabinoids) ligands, and a machinery dedicated to endocannabinoid synthesis and degradation. Studies over two decades have extensively documented the crucial role of the cannabinoid system in the regulation of a variety of pathophysiological conditions. However, its role in liver pathology has only been recently unravelled, probably given the low expression of CB1 and CB2 in the normal liver. We have recently demonstrated that CB1 and CB2 receptors display opposite effects in the regulation of liver fibrogenesis during chronic liver injury. Indeed, both receptors are up-regulated in the liver of cirrhotic patients, and expressed in liver fibrogenic cells. Moreover, CB1 receptors are profibrogenic and accordingly, the CB1 antagonist rimonabant reduces fibrosis progression in three experimental models. In keeping with these results, daily cannabis smoking is a risk factor for fibrosis progression in patients with chronic hepatitis C. In contrast, CB2 display antifibrogenic effects, by a mechanism involving reduction of liver fibrogenic cell accumulation. These results may offer new perspectives for the treatment of liver fibrosis, combining CB2 agonist and CB1 antagonist therapy.
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Tran Van Nhieu J. Hépatotoxicité médicamenteuse. Ann Pathol 2004. [DOI: 10.1016/s0242-6498(04)94046-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Bioulac-Sage P, Jeannot E, Scoazec J, Guettier C, Tran Van Nhieu J, Paradis V, Leteurtre E, Wendum D, Fabre M, Michalak-Provost S, De Muret A, Zucman-Rossi J. CO24 - Les adénomes hépatocellulaires : corrélations morphologie et mutation du gène hnf1alpha. étude multicentrique française de 79 cas. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/s0399-8320(04)95086-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Zafrani ES, Tran Van Nhieu J, Germanidis G, Mavier P. [Auto-immune cholangiopathies]. Gastroenterol Clin Biol 1998; 22:43-9. [PMID: 9762165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- E S Zafrani
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Henri-Mondor, Crétiel
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Mathieu D, Paret M, Mahfouz AE, Caseiro-Alves F, Tran Van Nhieu J, Anglade MC, Rahmouni A, Vasile N. Hyperintense benign liver lesions on spin-echo T1-weighted MR images: pathologic correlations. Abdom Imaging 1997; 22:410-7. [PMID: 9157862 DOI: 10.1007/s002619900222] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND To determine the incidence of hyperintensity on T1-weighted spin echo (SE) images in benign liver lesions, value of fat-suppressed magnetic resonance (MR) imaging for the detection of fat within these lesions, and the causes of hyperintensity by correlation to pathologic examinations. METHODS Five hundred forty-nine patients with 805 benign liver lesions including 585 hemangiomas, 188 focal nodular hyperplasias (FNHs), 14 hepatic adenomas (HAs), 14 focal fatty infiltrations (FFIs), two biliary cystadenomas, and two hemorrhagic cysts were examined by T2-weighted and T1-weighted SE MR imaging. For hyperintense lesions on T1-weighted SE images, fat-suppressed images were obtained by selective presaturation of fat. RESULTS Thirty-two lesions (four FNHs, 10 HAs, 14 FFIs, two biliary cystadenomas, and two hemorrhagic cysts) appeared hyperintense on T1-weighted SE images; 21 of these became hypointense on the fat-suppressed T1 weighted SE images (one FNH, six HAs, and 14 FFIs) and contained fat at pathological examination. The other 11 lesions remained hyperintense on fat-suppressed T1-weighted SE images and had no fat deposition. Causes of hyperintensity in these cases were sinusoidal dilatation, copper deposition, hemorrhage, and high protein content. CONCLUSION Among benign liver lesions, hyperintensity on T1-weighted SE images is rare (3.9%). Causes of this hyperintensity are fat deposition, copper accumulation, sinusoidal dilatation, bemorrhage, and high protein content. Fat-suppressed imaging can distinguish fat deposition from other causes of hyperintensity.
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Affiliation(s)
- D Mathieu
- Department of Radiology, Hôpital Henri Mondor, Créteil, France
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12
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Bralet MP, Roudot-Thoraval F, Pawlotsky JM, Bastie A, Tran Van Nhieu J, Duval J, Dhumeaux D, Zafrani ES. Histopathologic impact of GB virus C infection on chronic hepatitis C. Gastroenterology 1997; 112:188-92. [PMID: 8978358 DOI: 10.1016/s0016-5085(97)70234-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND & AIMS Dual infection by hepatitis GB virus type C (GBV-C) and hepatitis C virus (HCV) is common. To assess the histopathologic impact of GBV-C infection on liver lesions, liver biopsy specimens of 105 patients chronically infected with HCV, 17 of whom (15%) were also infected with GBV-C, were reviewed. METHODS Semiquantitative histopathologic assessment of liver lesions was performed using the Knodell's score and the METAVIR grading system. RESULTS Hepatitis activity was mild, moderate, or severe in 3 (18%), 11 (64%), and 3 (18%) patients, respectively, infected with GBV-C and HCV vs. 26 (29%), 56 (64%), and 6 (7%) patients, respectively, infected with HCV alone (no significant difference). Cirrhosis was present in 4 (24%) coinfected patients vs. 19 (22%) HCV-positive patients (no significant difference). No significant difference in fibrosis, presence of portal lymphoid aggregates, steatosis, and hemosiderosis was observed between the two groups. There was no significant difference in the evaluation of each item of the Knodell's score. CONCLUSIONS This detailed histopathologic evaluation of GBV-C infection in chronic hepatitis C shows that GBV-C infection does not affect histopathologic severity and characteristics of chronic hepatitis C, thus suggesting a minor role of GBV-C infection in liver disease.
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Affiliation(s)
- M P Bralet
- Department of Pathology, Hospital Henri Mondor, University Paris XII, Créteil, France
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Abstract
Pulmonary alveolar proteinosis (AP) is a rare cause of progressive respiratory failure in the normal host. It was first described by Rosen and coworkers in 1958 on the morphological basis of the accumulation of a PAS-positive material in the alveolar space. A couple of years later, AP was found to be unexpectedly associated with malignant diseases, especially with acute or chronic myeloid leukemias. These forms were called secondary AP in opposition to the primary forms observed in normal hosts. Probably because of its morphological definition and late diagnosis by means of histology or autopsy material, secondary AP has been considered to be life-threatening for a long time. However, recent observations show that AP can be diagnosed early in the course of the disease, especially through bronchoalveolar lavage, as long as the pathologist is aware of this possibility. Another point is that secondary AP can be reversible, both clinically and morphologically. This article summarizes the clinical features, morphological findings, and the main malignant diseases associated with secondary AP. We also comment on the hypotheses proposed in the literature to explain the association of AP, malignant disease, and immunosuppression. Alveolar macrophage is likely a key factor in the occurrence of secondary AP.
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Affiliation(s)
- S Ladeb
- Service d'Hématologie Clinique, Hôpital Henri Mondor, Créteil, France
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Tran Van Nhieu J, Misset B, Lebargy F, Carlet J, Bernaudin JF. Expression of tumor necrosis factor-alpha gene in alveolar macrophages from patients with the adult respiratory distress syndrome. Am Rev Respir Dis 1993; 147:1585-9. [PMID: 8503572 DOI: 10.1164/ajrccm/147.6_pt_1.1585] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The adult respiratory distress syndrome (ARDS) is a complex syndrome in which pathogenesis is multifactorial. TNF-alpha, known to be pivotal in tissue damage, has been shown to have high levels in blood and alveolar fluid in ARDS. The identification of the cells responsible for this production in the alveolar milieu has not yet been reported. In order to evaluate the TNF-alpha gene expression in ARDS we have analyzed by in situ hybridization, using RNA probes, alveolar macrophages (AM) obtained by BAL from seven patients with ARDS, eight patients with miscellaneous respiratory diseases, and three control patients. In freshly collected AM from patients with ARDS, 66 +/- 14.5% cells expressed the TNF-alpha gene without in vitro stimulation. This TNF-alpha expression does not result from the BAL procedure itself since only a few unstimulated control AM contained TNF-alpha mRNA transcripts. TNF-alpha expression in AM is not restricted to patients with ARDS since it has also been observed in miscellaneous respiratory diseases; however, this expression is a constant feature in ARDS. These results demonstrated the major role of AM in the intra-alveolar production of TNF-alpha, and they point out the necessity in ARDS for a specific intra-alveolar therapy.
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Tran Van Nhieu J, Vojtek AM, Bernaudin JF, Escudier E, Fleury-Feith J. Pulmonary alveolar proteinosis associated with Pneumocystis carinii. Ultrastructural identification in bronchoalveolar lavage in AIDS and immunocompromised non-AIDS patients. Chest 1990; 98:801-5. [PMID: 2209133 DOI: 10.1378/chest.98.4.801] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Pneumocystis carinii (PC) has been recognized as frequently responsible for most opportunistic pulmonary infections occurring in immunocompromised AIDS and non-AIDS patients. Moreover, these patients can be considered at risk for secondary pulmonary alveolar proteinosis. Therefore, we have investigated the occurrence of associated secondary alveolar proteinosis and PC pneumonitis in AIDS and non-AIDS immunocompromised patients. In a series of 26 bronchoalveolar lavages (BAL) in patients with PC pneumonitis (19 AIDS and seven non-AIDS patients), we observed on light microscopy, in addition to the honeycombed material, areas of an extracellular material that had a different pattern which was suggestive of that described in alveolar proteinosis. A systematic ultrastructural study of these 26 BAL fluid samples demonstrated in each of them an accumulation of phospholipid surfactantlike extracellular material mixed or not with the PC cysts. In nine cases, the observation of lipoproteinaceous material on light microscopy and abundant phospholipid material with myelinlike and myelin tubular laminated structures on electron microscopy was highly suggestive of an associated pulmonary alveolar proteinosis (PAP). Such an accumulation of extracellular material was not observed in the 11 BAL fluid samples collected in immunocompromised patients (seven AIDS and four non-AIDS patients) without PC pneumonitis. These findings demonstrated a particular frequency of associated PAP with PC pneumonitis. These results raise important questions concerning (1) the consequence of such an alveolar accumulation of lipoproteinaceous material on the clinical status and prognosis of the pneumonitis, and (2) the mechanisms responsible for this accumulation.
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Tran Van Nhieu J, Valeyre D, Rainfray M, Daupleix D, Amouroux J, Meyrier A, Battesti JP. [Idiopathic pulmonary fibrosis and familial benign hypercalcemia syndrome without deficiency in leukocyte myeloperoxidase. A case]. Presse Med 1988; 17:637-8. [PMID: 2835758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A case of diffuse primary interstitial lung fibrosis associated with familial benign hypercalcaemia is reported. This, and the 3 cases previously published, suggests that both diseases share a common genetic mode of transmission.
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