Metastase axillaire d'un carcinome papillaire de la thyroïde: À propos d'un cas

Les métastases axillaires dans le cadre d'un cancer de la thyroïde sont extrêmement rares. Plusieurs hypothèses expliquent ce drainage. Nousrapportons le cas d'un patient de 78 ans ayant pour antécédents  chirurgicaux une lobo-isthmectomie en 1987, puis une totalisation chirurgicale en 1997 non documentés, admis en septembre 2008 pour exploration d'une masse latéro-cervicale gauche. Le reste de l'examen clinique révèle la présence de multiples adénopathies axillaires bilatérales. La biopsie exérèse d'une adénopathie axillaire droite (côté controlatéral) retrouve une métastase ganglionnaire d'un carcinome papillaire de la thyroïde avec effraction capsulaire. La tomodensitométrie cervico-thoracique note la présence d'un processus tumoral latéro-cervical gauche, un lobe thyroïdien droit siège de multiples nodules hypodenses, des adénopathies cervicales et axillaires et des lésions suspectes au niveau du parenchyme pulmonaire. Une thyroïdectomie totale avec curage  ganglionnaire cervical est décidée, complétée par une ablation des ganglions axillaires macroscopiquement atteints. Des cures d'iode  radioactif (IRA-thérapie) sont indiquées. Bien qu'exceptionnelle, la  présence de métastases axillaires d'un carcinome thyroïdien est de  pronostic péjoratif. On se demande alors si ces patients ne nécessitent pas une prise en charge particulière. Une réflexion à une stratégie  thérapeutique est donc nécessaire

Neurinome du nerf facial - A propos d’un cas et revue de la littérature

Introduction: Le neurinome du nerf facial est une tumeur bénigne rare qui peut intéresser n’importe quel segment du nerf facial et se révèle par une paralysie faciale soit isolée soit associée à des signes auditifs.Observation : Nous rapportons le cas d’une patiente de 18 ans qui a présenté une paralysie faciale grade v d’aggravation progressive associée à une discrète surdité de transmission. L’imagerie (TDM et IRM) était très évocatrice d’un neurinome de la portion tympanique et mastoïdienne du nerf facial. Le traitement a consisté en une résection tumorale par voie transmastoïdienne avec greffe nerveuse, sans détérioration de la fonction auditive avec bon résultat sur la fonction faciale.Commentaires et conclusion : La symptomatologie du neurinome du nerf facial dépend essentiellement de sa localisation, elle est donc très variable allant de la surdité légère isolée au syndrome cochleo-vestibulaire avec paralysie faciale. A travers cette observation et une revue de la littérature, les auteurs rappellent les particularités cliniques, paracliniques, thérapeutiques et évolutives de cette pathologie rare en insistant sur l’approche thérapeutique adaptée au stade d’extension tumorale et la fonction faciale préopératoire.Mots clés : schwannome du nerf facial, paralysie faciale, résection  nerveuse, greffe nerveus

Comparative pathology of some monogenean and copepod ectoparasites on the gills of Acanthopagrus australis (family Sparidae)

The monogenean Haliotrema spariensis was associated with several foci of hyperplastic epithelium and varying amounts of cellular infiltration resulting from attachment by hamuli penetrating the lamellar blood vessels and, presumably, from feeding. Lamellodiscus major was associated with fewer but larger foci containing more extensive infiltration, suggesting a more sessile habit. The copepod Dermoergasilus acanthopagri encircled the filament with its second antenna, occluded arteries and compressed the epithelium, resulting in hyperplasia, oedema and infiltration. Ergasilus lizae inserted its second antennae into the epithelium and subepithelial region and was associated with a localized proliferative response occasionally fusing adjacent filaments. The large copepod Lernanthropus atrox caused tissue disruption, hyperplasia, haemorrhage, oedema and infiltration. Hyperplastic epithelial cells had a rounded nucleus containing variable amounts of heterochromatin, dilated organelles, deposits of glycogen‐like particles, cyoplasmic vesicles and vacuoles. Oedematous epithelial cells were less altered. Degenerating chloride cells were present in both oedematous and proliferated epithelia

Monthly variation in recruitment, infection, size, fecundity and mating of Naobranchia variabilis (Copepoda: Naobranchiidae) parasitic on the gills of toadfish Tetractenos hamiltoni from Moreton Bay, Australia

Naobranchia variabilis on the gills of Tetractenos hamiltoni were sampled monthly from July to June. Recruitment began in August, peaked in October, and was low from January. Most late juveniles occurred in November. Numbers of subadults declined from July, with none in October; intensity peaked during November-December. Adult prevalence and intensity declined from August, to consist only of large, mature individuals in October with many large eggs and with a large percentage of these adults shedding eggs. Adult prevalence and intensity peaked in January; average adult size and number of eggs were consistent after January. The presence of small adults from November reduced the average number and size of eggs. Adults produced at least two batches of eggs, and eggs were produced and shed all year round. At least 75% of the female N. variabilis had no male attached, but numbers of males and females in each age class were correlated. Most males on late-juvenile and subadult females occurred during the period of greatest recruitment, but was later for adult females because of the preference of males for pre-adult stages

Population dynamics of the monogenean Anoplodiscus cirrusspiralis on the snapper, Pagrus auratus

Populations of Anoplodiscus cirrusspiralis were monitored for 1 year on tagged individual snapper in experimental cages kept in a large on-shore pond with flow-through filtered sea water. The cages were stocked with small and large fish at either low or high initial density. Irrespective of size and density, snapper with light initial infections maintained light infections, whereas fish with heavy initial infections showed fluctuations in parasite population size throughout the year. These data indicate that some snapper have an innate resistance to infection by A. cirrusspiralis, with little evidence for acquired immunity induced by heavy infection. Parasite longevity was greater on the pectoral fin than caudal fin, and greater on large than small fish irrespective of fish density; longevity was greater on susceptible fish than on resistant fish Recruitment and mortality rates were greater on the pectoral fin and in low density cages, but were not influenced by fork length

Studies on marteilia sydneyi, agent of qx disease in the sydney rock oyster, saccostrea commercialism with implications for its life cycle

An indirect fluorescent antibody test (IFAT) was developed to test for mature and immature stages of Marteilia sydneyi in the digestive gland of the Sydney rock oyster, Saccostrea commercialis. Immunogold labelling of sections for electron microscopy showed that the sporont membrane, refringent granules, spore wall and haplosporosomes were particularly antigenic. The antibody did not react with any myxosporidean parasite found in local fish. Large numbers of sporonts were shed by infected oysters before oyster death. Lightly infected oysters were apparently able to shed all of their parasites and recover. Refringent granules were proteinaceous and an unlikely energy source for the shed parasite. Growth of the sporont was associated with the enlargement and production of refringent granules. The findings implicate filter-feeding or detritivorous invertebrates rather than scavenging invertebrates or fish in the life cycle of Marteilia parasites