M Polivka

Publications (22)50.08 Total impact

• Article: [Intracranial ependymomas in adult patients. Diagnosis and histological prognostic factors].

  D Figarella-Branger, P Metellus, M Barrié, A Maues de Paula, C Fernandez, M Polivka, A Vital, F Labrousse, J-M Vignaud, A Laquerrière, [......], P Babin, V Rigau, F Vandenbos, M Peoc'h, M Kujas, O Chinot, J Gouvernet, R Giorgi, J Guyotat, A Jouvet
  [show abstract] [hide abstract]
  ABSTRACT: Intracranial ependymomas are rare in adults and histopathological prognostic factors are poorly determined. A retrospective multicentric study was conducted in France in order to assess the prognostic value of histology. Between 1990 and 2004, 216 adult patients with newly diagnosed ependymomas were treated in 19 French centers. Eligibility required institutional histopathological confirmation of an ependymoma and available clinical history and MRI features (see comparison paper). Histological preparations and one paraffin embedded block from each patient were sent to Pr D. Figarella-Branger in Marseille. Central review by four neuropathologists (D. Figarella-Branger, A. Maues de Paula, C. Fernandez and A. Jouvet) was performed. Specimens for which all pathologists agreed with the histological diagnosis of ependymomas were included, whereas cases for which all disagree were excluded and reclassified. In the event of doubt and/or discrepancies between pathologists immunostaining was performed in order to reach a consensus diagnosis. Diagnostic of ependymomas was confirmed in 121 cases (56%). In theses cases, ependymomas were classified according to the WHO system (subtype and grade). The potential prognostic value (overall survival OS and disease free survival DFS) of the following histological parameters was examined: perivascular pseudorosettes, ependymal rosettes, hyalinized vessels, mitotic index, microvascular proliferation, necrosis, area of increased cellularity, nuclear atypia, brain invasion and Mib-1 labelling index. Among the 121 ependymomas, 88 were grade II (47 classic, 17 cellular, 2 papillar, 6 clear cells and 16 tanicytic) and 33 grade III. WHO grading, occurrence of microvascular proliferation, necrosis, nuclear atypia and high proliferative index were correlated with both OS and DFS. Moreover, quantification of certain parameters enabled a reproducible grading system correlated with both OS and DFS.
  Neurochirurgie 07/2007; 53(2-3 Pt 1):76-84. · 0.34 Impact Factor
• Article: Hereditary infantile hemiparesis, retinal arteriolar tortuosity, and leukoencephalopathy.

  K Vahedi, P Massin, J-P Guichard, S Miocque, M Polivka, F Goutières, D Dress, F Chapon, M-M Ruchoux, F Riant, A Joutel, A Gaudric, M-G Bousser, E Tournier-Lasserve
  [show abstract] [hide abstract]
  ABSTRACT: The main hereditary vascular conditions involving both retinal and cerebral vessels include cerebroretinal vasculopathy, HERNS (hereditary endotheliopathy with retinopathy, nephropathy, and stroke), and hereditary vascular retinopathy; all are linked to the same locus on chromosome 3p21. Hereditary retinal arteriolar tortuosity is a distinct, autosomal dominant condition characterized by retinal arteriolar tortuosity and recurrent retinal hemorrhages. This condition is known to affect only retinal vessels. Clinical and brain MRI investigations of eight members of a three-generation family and extensive biological and systemic vascular investigations within one affected family member were conducted. Six of eight family members were clinically symptomatic; disorders included infantile hemiparesis (2), migraine with aura (3), and retinal hemorrhage (1). Five individuals had retinal arteriolar tortuosities. A diffuse leukoencephalopathy in association with dilated perivascular spaces was observed in six individuals. Two family members had silent, deep cerebral infarcts as demonstrated on MRI. Genetic linkage analysis strongly suggests that this disorder is not linked to the 3p21 hereditary vascular retinopathy/cerebroretinal vasculopathy/HERNS locus. The authors describe a novel hereditary autosomal dominant condition affecting both retinal and cerebral vessels and characterized by infantile hemiparesis, migraine with aura, retinal hemorrhage, retinal arterial tortuosity, and leukoencephalopathy with dilatation of perivascular spaces and microbleeds on brain MRI. Investigation of additional families should help to map the gene and to better categorize the spectrum of hereditary cerebroretinal small vessel diseases.
  Neurology 02/2003; 60(1):57-63. · 8.31 Impact Factor
• Article: High frequency of a 30-bp deletion of Epstein-Barr virus latent membrane protein 1 gene in primary HIV non-Hodgkin's brain lymphomas.

  A-V Vallat-Decouvelaere, M-A Bretel, I Vassias, J-L Laplanche, M Polivka, M Wassef, M Brunet, J-B Thiebaut, B Gosselin, F Morinet, J Mikol
  [show abstract] [hide abstract]
  ABSTRACT: A characteristic 30-base pair (bp) deletion (del) in the 3' end of the Epstein-Barr virus (EBV) latent membrane protein 1 (LMP1) gene, coding for the C-terminal NF-kappa B activation domain, has been identified in various lymphoproliferative disorders and nasopharyngeal carcinomas. In the single report to date of human immunodeficiency virus primary brain lymphomas (HIV-PBLs), del-LMP1 was noted in seven cases out of nine. The present study was designed to identify this deletion in a series of 31 diffuse large B-cell HIV-PBLs, with the aim of determining its possible oncogenic action. The presence of EBV was confirmed by EBER mRNA in situ hybridization. After genomic extraction from frozen tissue, two 20-base oligonucleotide primers flanking the site of the 30-bp deletion were used. DNA sequencing of the polymerase chain reaction (PCR) products confirmed an identical segment spanning 30-bp and 69-bp, frequently associated with mutational hotspots in 19 cases (61%). A role for del-LMP1 in the oncogenic potential of EBV in systemic proliferations is a matter of debate. Its high incidence suggests that the oncogenic mechanism of LMP1 in the brain might differ significantly from that in systemic lymphoid proliferations, and might be enhanced by HIV infection.
  Neuropathology and Applied Neurobiology 01/2003; 28(6):471-9. · 3.80 Impact Factor
• Article: Pilocytic astrocytoma: unusual feature.

  S Berroir, F Lafitte, F Héran, H Boissonnet, M Polivka, J D Piekarski
  [show abstract] [hide abstract]
  ABSTRACT: Juvenile pilocytic astrocytoma is a well-defined brain tumor. It most often occurs in children and young adults. It is located in the posterior fossa and has typical imaging features, associating cystic and strongly contrast enhancing mural nodule. After complete surgical removal, its prognosis is excellent. Adult cases are seldom observed. They develop almost exclusively within the cerebral hemispheres and share the same imaging and prognostic characteristics as the pediatric forms. We describe the case of a 42-years-old man presenting with a huge heterogenous posterior fossa lesion. Histopathological analysis of the lesion after surgical resection diagnosed a juvenile pilocytic astrocytoma. These peculiar location and imaging features in an adult patient may be misdiagnosed for infectious lesions and must be recognized.
  Journal of Neuroradiology 01/2002; 28(4):249-52. · 1.21 Impact Factor
• Article: CRANIAL EPIDURAL TUBERCULOMA

  C. Jacques, M. Boukobza, M. Polivka, A. Ferrario, B. George, J. J. Merland
  [show abstract] [hide abstract]
  ABSTRACT: A 33-year-old patient with cranial epidural tuberculoma without history of tuberculosis is described. CT and MR imaging showed a lesion located on both sides of a right frontotemporal bone destruction with epidural extent. Except for a small necrotic core, the lesion enhanced intensely after contrast medium administration. Osteitis and subgaleal abscess were associated. The displaced dura mater delineated the epidural tuberculoma. Diagnosis was verified by histology and identification of Mycobacterium tuberculosis. After removal of the tuberculoma and combination therapy, there was a complete regression of abnormalities. Differential diagnoses are dural tuberculoma, focal tuberculous pachymeningitis and tuberculous epidural empyema.
  Acta Radiologica 12/2001; 41(4):367 - 370. · 1.37 Impact Factor
• Article: [Histological data in inflammatory myositis].

  J Mikol, M Polivka
  [show abstract] [hide abstract]
  ABSTRACT: Inflammatory muscular diseases of adult and child consist of dermatomyositis (DM), polymyositis (PM) and inclusion body myositis (IBM). Muscular biopsy takes a seminal place in their diagnosis, through analysis of the topography and clustering of individual histological lesions: endomysial, perimysial and perivascular inflammation, muscular necrosis with regeneration, fibre modifications, fibrosis, micro-angiopathy. They can be associated with collagen diseases or malignant tumors that usually precede them. IBM seems somewhat apart among inflammatory myopathies, being characterised by the association of neurogenic and myogenic features and the presence of vacuoles containing filaments with an accumulation of proteins previously reported in Alzheimer's disease (beta amyloid protein, tau, ubiquitin,.). Inflammation is of various intensity, lacking in familial IBM (hereditary inclusion body myopathy) that otherwise shares the same histologic characteristics as sporadic forms. Other inflammatory muscular diseases: focal myositis, eosinophilic polymyositis, are less frequent. Macrophagic myofasciitis, viral myositis and drug induced myositis are discussed in other articles.
  Annales de medecine interne 12/2001; 152(7):465-79.
• Article: Cranial epidural tuberculoma. A case report.

  C Jacques, M Boukobza, M Polivka, A Ferrario, B George, J J Merland
  [show abstract] [hide abstract]
  ABSTRACT: A 33-year-old patient with cranial epidural tuberculoma without history of tuberculosis is described. CT and MR imaging showed a lesion located on both sides of a right frontotemporal bone destruction with epidural extent. Except for a small necrotic core, the lesion enhanced intensely after contrast medium administration. Osteitis and subgaleal abscess were associated. The displaced dura mater delineated the epidural tuberculoma. Diagnosis was verified by histology and identification of Mycobacterium tuberculosis. After removal of the tuberculoma and combination therapy, there was a complete regression of abnormalities. Differential diagnoses are dural tuberculoma, focal tuberculous pachymeningitis and tuberculous epidural empyema.
  Acta Radiologica 08/2000; 41(4):367-70. · 1.37 Impact Factor
• Article: [Tuberculosis of the central nervous system. MRI features and clinical course in 12 cases].

  M Boukobza, I Tamer, J P Guichard, L Brunereau, M Polivka, F Leibinger, D Reizine, J J Merland
  [show abstract] [hide abstract]
  ABSTRACT: The aim of this study was to characterize the MR findings of various intracranial lesions in the central nervous system (CNS) tuberculosis. The MRI findings (T1, T2 and T1 sequence after contrast) of 12 proved cases (10 males, 2 females, 24 to 64 years old, average: 35) of CNS tuberculosis were reviewed; 4 patients were seropositive for HIV. Several types of lesions were identified: tuberculomas called miliary lesions if they were smaller than 2 mm in diameter (7 cases), in 1 case the tuberculoma was revealed by two large lesions and bi-hemispheric localisations, leptomeningitis (5 cases), infarction (4 cases), abscesses (3 cases with solitary lesions in 2/3 cases), hydrocephalus (3 cases), pachymeningitis (2 cases). A tuberculomas-leptomeningitis association was found in 4 patients. The pachymeningitis form had an unusual aspect in one case. Patients with leptomeningitis showed thick meningeal contrast enhancement involving all basal cisterns, expanding to the sylvian fissures level, and causing narrowing of the sylvian arteries. Massive infarctions resulted from arterial englobement or embols. In three out of five patients, leptomeningitis was the initial presentation. In seropositive patients, tuberculosis was severe with high mortality (3/4 patients), and associated with other multiple lesions. Central nervous system tuberculosis has different appearances, mostly tuberculomas and leptomeningitis. MR with contrast is necessary for follow-up during treatment.
  Journal of Neuroradiology 11/1999; 26(3):172-81. · 1.21 Impact Factor
• Article: [Eruptive epithelioid hemangioendothelioma with spindle cells. Nosological place in the spectrum of epithelioid vascular tumors].

  D Chatelain, M D Vignon-Pennamen, J Rivet, O Verola, M Polivka, A Janin
  [show abstract] [hide abstract]
  ABSTRACT: The epithelioid vascular tumors include epithelioid hemangioma, epithelioid hemangioendothelioma and epithelioid angiosarcoma. We report the case of a difficult to define vascular epithelioid tumor. The tumor localized in the head developed in an eruptive way in multiple bone and skin locations in a 22-year-old man. The lesions had the same histological features as those of epithelioid hemangioma and epithelioid hemangioendothelioma with a spindle-cell component. This tumor was called eruptive epithelioid hemangioendothelioma with spindle cells. In our case, its development with recurrences and destructive features has some similarities to tumors of intermediate malignancy.
  Annales de Pathologie 10/1999; 19(4):312-5. · 0.25 Impact Factor
• Article: Cerebral amyloid angiopathy (CAA) with presentation as a brain inflammatory pseudo-tumour.

  M Polivka, A V Vallat, F Woimant, G Lot, M Boukobza, J P Guichard, J Mikol
  [show abstract] [hide abstract]
  ABSTRACT: Cerebral amyloid angiopathy (CAA) is frequent but often asymptomatic. It can induce lobar haemorrhage, rapidly progressive dementia or recurrent transient neurological symptoms, other presentations being less frequent. We report 3 patients in their sixties presenting with a space occupying lesion which was the first manifestation of CAA. They were operated with a diagnosis of cerebral tumour. In all three cases, macroscopy was similar, the lesions were superficial in the cerebral cortex and the preoperative diagnoses were glioblastoma, meningioma and cavernoma. Histologically, the lesions consisted of a large inflammatory granuloma with numerous lipophages and siderophages surrounding capillaries with prominent endothelial cells. Vessels in the near cortex and meninges and within the granuloma harboured heavy amyloid deposits immunolabelled by anti-P component, anti-protein beta A4 with a A40 predominance and anti-apolipoprotein E. Adjacent cerebral cortex showed reactive gliosis and rare senile plaques. Amyloidosis is rarely considered among diagnoses of space occupying lesions. In our three cases, CT scan and MRI changes were related to the presence of an inflammatory granuloma around foci of haemorrhage and amyloid laden vessels.
  Clinical and experimental pathology 02/1999; 47(6):303-10.
• Article: Peripheral neuropathy in human immunodeficiency virus-infected patients with the diffuse infiltrative lymphocytosis syndrome.

  A Moulignier, F J Authier, M Baudrimont, G Pialoux, L Belec, M Polivka, B Clair, F Gray, J Mikol, R K Gherardi
  [show abstract] [hide abstract]
  ABSTRACT: A subset of human immunodeficiency virus (HIV)-infected patients develop persistent CD8 hyperlymphocytosis and a Sjogren's syndrome-like syndrome associated with multivisceral CD8 T-cell infiltration, known as the diffuse infiltrative lymphocytosis syndrome (DILS). Patients with DILS tend to have higher CD4 cell counts, fewer opportunistic infections, and longer survival times than other HIV-infected patients. Peripheral nerve involvement in DILS has been poorly documented. We studied 12 HIV-infected patients with CD8 hyperlymphocytosis, DILS, and clinical signs of peripheral neuropathy. Two of 4 patients who were HLA typed were HLA-DR5 and 1 was HLA-DR6. All patients had the sicca syndrome and multivisceral involvement. The neuropathy was acute or subacute, always painful, and symmetrical in 8 cases. Electrophysiology was consistent with axonal neuropathy in 10 of 12 patients. Nerve biopsy showed marked angiocentric CD8 infiltrates without mural necrosis (12 of 12), and abundant expression of HIV p24 protein in macrophages (12 of 12). The HIV genome was detected by polymerase chain reaction in nerve homogenates. Zidovudine therapy was associated with improvement in 6 of 6 patients and steroid therapy was beneficial in 4 of 5 patients. No T-cell lymphoma was observed during follow-up, but 2 patients developed a primary B-cell lymphoma. We conclude that DILS neuropathy represents HIV-associated neuropathy, characterized by marked CD8 infiltration and abundant HIV in nerve, that improves with zidovudine or steroid therapy, and probably reflects a systemic host-determined and antigen-driven response to HIV.
  Annals of Neurology 05/1997; 41(4):438-45. · 11.09 Impact Factor
• Article: [Nervous system lymphoma in HIV infection].

  J Mikol, M Polivka, A Gyuris, J Minarovits, F Morinet
  [show abstract] [hide abstract]
  ABSTRACT: Primary CNS lymphoma is recognized as one of the criteria of AIDS. The incidence is 0.4 to 0.56% of AIDS complications. Non-Hodgkin's lymphomas appear as multicentric tumours, mostly located in the hemispheres; they have a B phenotype and have a high grade of malignancy. They are sometimes associated with opportunistic infections. Survival is around 4 to 5 months. The presence of EBV in these tumours is an argument to propose a synergistic role of this virus in the pathogenesis of these tumours. Secondary lymphomas are observed in 40 to 47% of these tumours and must be systematically looked for. Hodgkin's disease is rare. It is mostly diagnosed as secondary compressive epidural tumors.
  Archives d'anatomie et de cytologie pathologiques 02/1997; 45(2-3):164-73.
• Article: Spinal cord compression due to concomitant primary lymphoma and Mycobacterium avium-intracellulare infection of the paravertebral muscles in an AIDS patient.

  A Moulignier, M Eliaszewicz, J Mikol, M Polivka, J B Thiebaut, B Dupont
  European Journal of Clinical Microbiology 12/1996; 15(11):891-3. · 2.86 Impact Factor
• Article: Spinal cord compression due to concomitant primary lymphoma andMycobacterium avium-intracellulare infection of the paravertebral muscles in an AIDS patient

  A. Moulignier, M. Eliaszewicz, J. Mikol, M. Polivka, J. B. Thiebaut, B. Dupont
  European Journal of Clinical Microbiology 10/1996; 15(11):891-893. · 2.86 Impact Factor
• Source

  Available from: Jacqueline Mikol

  Article: AIDS-associated cytomegalovirus infection mimicking central nervous system tumors: a diagnostic challenge.

  A Moulignier, J Mikol, G Gonzalez-Canali, M Polivka, G Pialoux, Y Welker, S Alain, J B Thiebaut, B Dupont
  [show abstract] [hide abstract]
  ABSTRACT: We reviewed cases of cytomegalovirus (CMV) infection of the central nervous system (CNS) that initially masqueraded as tumors in 37 of 543 consecutive patients infected with human immunodeficiency virus (HIV) and CMV who were seen at the Pasteur Institute Hospital and Saint-Louis Hospital (Paris) between 1992 and 1994. We detail the clinical features of three patients who presented with ring-enhanced space-occupying lesions mimicking CNS tumors. They were all profoundly immunodepressed (mean CD4 cell count, 13/mm3). Magnetic resonance imaging (MRI) showed enlargement of the spinal cord in one case, consistent with a space-occupying lesion and showing gadolinium enhancement; in the other two cases, ring-enhanced mass lesions were seen in the cerebral hemispheres. In all three cases marked edema and a mass effect were present. Image-guided stereotactic biopsies confirmed the diagnosis of CMV infection. The three patients' conditions improved with specific therapy. MRI showed enhanced focal intraparenchymal lesions consistent with marked focal necrosis, probably related to the severity of immunodepression, as HIV infection had been diagnosed several years previously. CMV infection should be considered as a cause of ring-enhanced space-occupying mass lesions in patients with HIV-1 infection. Earlier identification of these unusual tumorlike forms of CMV infection by means of MRI should result in improved outcome.
  Clinical Infectious Diseases 05/1996; 22(4):626-31. · 9.15 Impact Factor
• Article: [The epidemiology of cerebral lymphoma in AIDS].

  J Mikol, D Costagliola, M Polivka, J B Thiebaut, P Trotot
  [show abstract] [hide abstract]
  ABSTRACT: Cerebral lymphomas are one of the complications of AIDS. Their increasing frequency, especially in the last decade, has to be correlated with the incidence of systemic lymphomas and especially central nervous system (CNS) lymphomas in non immuno-compromised patients. CNS involvement is found in 40% of systemic lymphomas. Primary lymphomas have an incidence of 0.4-0.56% in epidemiological studies and 7.6% in post-mortem series. Primary lymphomas are noted in all patients, homosexuals, drug-addicts, children, with a lower rate in the haemophiliacs. Known risk factors are HIV itself Epstein-Barr virus almost constantly demonstrated in tumour cells. Epidemiological studies on cerebral lymphomas must still be completed as, until recently, they were included in the group entitled lymphomas, and risk factors have to be specified with more accuracy.
  Journal of Neuroradiology 10/1995; 22(3):204-6. · 1.21 Impact Factor
• Article: [Seven cases of subependymoma. Anatomoclinical study and review of the literature].

  M Polivka, G Lot, F Woimant, A Lavergne, F Chédru, J Mikol
  [show abstract] [hide abstract]
  ABSTRACT: Subependymomas are uncommon, benign, slowly growing lesions usually located in the fourth ventricle. Their morphology is characteristic, but their histogenesis remains controversial. Seven cases observed in our laboratory over a period of 7 years are reported. Most tumors were located axially in the brain stem, and symptoms were more variable than usually reported. The histological appearance was fairly uniform. Immunohistochemistry showed that the fibrillary component was composed of glial fibers. Ependymary differentiation is inconstant on electron microscopy. The pathogenesis of the lesion (tumor, hamartoma or reactive proliferation) is debated in the literature as is the histogenesis.
  Archives d'anatomie et de cytologie pathologiques 02/1994; 42(3-4):141-8.
• Article: [Intramedullary localization of a primary cerebral lymphoma in AIDS].

  F Chrétien, M Flament-Saillour, F Paraire, M Polivka, P de Truchis, J Mikol, M Durigon, F Gray
  [show abstract] [hide abstract]
  ABSTRACT: A 36 years-old male with AIDS, presented with left hemiparesis revealing a right parietal tumour. Stereotactic biopsy demonstrated a malignant non-Hodgkin's lymphoma. His condition partially improved following radiotherapy and chemotherapy. Three months later he was re-admitted with progressive bilateral root pain and urinary incontinence resulting in paraplegia with sensory loss below T10. He died one month later from generalized sepsis. Neuropathology confirmed an immunoblastic B-cell malignant non-Hodgkin's lymphoma in the white matter of the right parietal lobe and revealed a centrospinal localisation of the lymphoma in the thoracic cord at T10. There was no visceral localisation of the tumour. Secondary spread to the spinal cord of malignant non Hodgkin's lymphomas, usually causes meningo-myelo-radiculitis. Intraspinal deposits of primary cerebral lymphomas are uncommon and have never been previously described in AIDS, to our knowledge. Their pathogenesis is unclear. In our case, neuropathological findings are consistent with diffusion of the primary tumour to leptomeninges and secondary infiltration of the spinal cord along the perivascular spaces.
  Archives d'anatomie et de cytologie pathologiques 02/1994; 42(6):297-303.
• Article: [Report of a case of rhabdomyosarcoma of the central nervous system. Histologic, immunohistochemical and ultrastructural study].

  M Polivka, G Lot, F Woimant, J Vaunaize, Y Leclerc, J Mikol
  [show abstract] [hide abstract]
  ABSTRACT: A patient, aged 26, had a large parietal tumor, clinically revealed by intracranial hypertension and left sized paresthesia. Removal of tumor was followed by a rapid recurrence. Rhabdomyosarcoma was diagnosed on the second surgical specimen. These tumors are rare in the central nervous system. They occur mostly, though not exclusively, in young adults. Their prognosis is poor and their histogenesis is still unclear.
  Annales de Pathologie 02/1993; 13(2):118-22. · 0.25 Impact Factor
• Article: [Cisternal cysticercosis of the cerebellopontine angle. A surgically-treated case and review of the literature].

  M A Celis, K L Mourier, M Polivka, H Boissonnet, T Kato, G Lot, B George, J Cophignon
  [show abstract] [hide abstract]
  ABSTRACT: Most neurocysticercosis (N.C.C.) cases reported occur in undeveloped countries where contaminated food by Taenia solium gives rise to human infection. People of developed countries are exposed by migrations and travels. We report a case of a 36 years old french woman living at La Reunion. Her symptomatology consisted of left unilateral hypoacusis progressing over a two years period accompagnied by intermittent headaches. CT scan showed a hypodense mass with a ring enhancement in the left cerebello pontine angle (C.P.A.). M.R.I. showed multicystic arrangement of vesicles in a racemous fashion that spread out to peduncular and carotid cisterns. Parenchymatous or ventricular involvement was not observed. A lateral suboccipital craniectomy was carried up in the sitting position. After division of a thickened arachnoid in the C.P.A., the vesicles were dissected an pulled out easily because the membranes had not any adhesions. Progressive improvement of hearing was observed in the next week. Primary cisternal involvement of N.C.C. is rare and, in literature, there is not any other reported case in the C.P.A. Different mechanisms of invasion to the C.N.S. are discussed.
  Neurochirurgie 02/1992; 38(2):108-12. · 0.34 Impact Factor