The patterns and distribution of female genital tuberculosis among Togolese patients.

Tuberculosis is a real public health problem in developing countries. The aim of our article was to study the epidemiological, clinical, diagnostic characteristics of female genital tuberculosis in Togo. This was a descriptive and cross-sectional study on all cases concerning histologically diagnosed female genital tuberculosis in the department of pathological anatomy of Lomé in 1997-2018 (20 years). We collected 22 cases of women's Genital tuberculosis (GT), representing 2.2% (1008 cases) of extra-pulmonary tuberculosis. The mean age of the patients was 33.8 ± 0.2 years. Nine (9) patients had a history of treated GT. Depending on the location, the ovaries and fallopian tubes were the most affected (n=9 cases, 40.9%). Eighteen patients (81.8%) had at least one immunosuppression factor including HIV in 13 patients (72.2%). The reasons for consultation were metrorrhagia and pelvic pain with an associated mass in 7 women discovered on clinical examination and imaging. The macroscopic appearance of the specimens was suggestive of the diagnosis of genital tuberculosis in 12 cases (54.5%). Histology revealed caseous necrosis isolated in 3 patients (13.6%) and associated with gigantocellular epithelioid granulomas in 19 patients (86.4%). The patients received standard antibiotic treatment combining rifampicin, isoniazid, ethambutol and pyrazinamide. Genital tuberculosis is a rare extra-pulmonary location in Togo, often occurring in women with HIV, and the clinical polymorphism can lead to confusion with gynecological cancers.

Renal Leiomyosarcoma, a Rare Presentation.

Renal sarcomas are very rare malignant tumours with a very poor prognosis. Renal leiomyosarcoma, a malignant tumour of smooth muscle origin, is the most common histological type. The article reports a case of leiomyosarcoma of renal location, with a review of the literature. A 38-year-old female patient, with no previous pathological history, consulted the nephrology department of the Teaching Hospital of Lomé for abdominal pain that had been present for 4 years. Histology showed a tumour proliferation of fasciculated architecture, made of spindle cells arranged in long bundles, with cytonuclear atypia and cytoarchitectural abnormalities. Immunohistochemical examination showed positive staining for smooth muscle actin, h-caldesmone, desmin and CD34 and negative for pancytokeratin (AE1/AE3), myogenin and PS100. Renal leiomyosarcoma is an exceptional malignancy. It remains the most common renal sarcoma, the differential diagnosis of which is based on immunohistochemical findings.