[Prevalence of hepatitis B and C virus, HTLV-1 and HIV in type B lymphoproliferative syndromes in Gabon]. / Prévalences des virus des hépatites B et C, de l'HTLV-1 et du VIH dans les syndromes lymphoprolifératifs de type B au Gabon.

B lymphoproliferative disorders (B-LPD) are the most frequent types of lymphoid malignancies encountered in Gabon where HCV, HBV, HTLV-I and HIV are highly prevalent and all known for lymphotropism. Prevalences of HBs Ag, antibodies to HCV, HTLV-I and HIV were compared in 40 patients (21 men, 19 women; 17 < age < 75 years) with newly diagnosed B-LPD (low grade lymphoma = 6, intermediate grade = 21, high grade = 8: chronic lymphocytic leukaemia = 5) and 160 age and sex-matched controls. None of the B-LPD patients had got transfusion or parenteral care from the onset of symptoms to the inclusion day. In the B-LPD group, 13 patients had HBs Ag and antibodies to HCV, HIV and HTLV-1 were detected in 11, 6 and 10 subjects. In monovariate analysis, HBs Ag, antibodies to HIV or HTLV-1 were risk factors for B-LPD but antibodies to HCV were not associated with such diseases. Multivariate analysis showed only a relationship between HBs Ag and B-LPD (OR = 3.86; IC: 1.11-13.48). In such patients, reactivation of B hepatitis by treatment of B-LBD may be an important concern. If a background poor immune system could explain both susceptibility to long standing virus carriage and lymphoma development, a participating action of the HBV in lymphomagenesis could not be excluded.

[Position of cervix cancer detection in Gabon over a period of 19 years]. / Place du dépistage du cancer du col utérin au Gabon, étude sur 19 ans: 1977-1995.

MATERIALS AND METHODS: We report the contribution of the cytology test for screening for cervix cancer in Gabon observed in a retrospective study over 19 years (1977-1995). Data from the Libreville Faculty of Medicine cytohistopathology laboratory were used. RESULTS: Over the 19-year period, 10,838 PAP smears were performed, an average of 570,42 smears per year. Sixty-eight cases of cervix cancer were diagnosed with this test: 40 invasive carcinomas (58.83%), 5 microinvasive carcinomas (7.35%), and 23 in situ carcinomas (33.82%). During the same period, 437 cervix cancers were reported in the same laboratory without prior cytology test. CONCLUSION: In Gabon, cervix cancer is usually diagnosed at an invasive stage, hence the need for systematic detection.

[Endometrial carcinomas in Gabon. A study of 34 cases in 11 years: 1988-1998]. / Carcinomes de léndomètre au Gabon. Etude de 34 cas sur 11 ans: 1988-1998.

The aim of this retrospective study was to determine the importance of endometrium cancer in Gabon over an eleven-year period (1988-1998). We studied 34 cases from the register of cancers at the Faculty of Medicine in Libreville. The incidence of endometrium cancers was 5.3%. The patients came from areas with medical care facilities. They were all mature women with a mean age of 58.8 years (range: 34 to 80 years). Most of these women were menopausal (88. 24%). Uterine bleeding was the main symptom (100% of cases). Histologically, endometrium adenocarcinomas (79.41%) were the most frequently observed. The setting up of medical facilities in rural areas and efforts to provide the population with information concerning these cancers may affect the incidence and prognosis of endometrium cancer in Gabon.

Cancer in Gabon, 1984-1993: a pathology registry based relative frequency study.

A pathology based cancer registry was established in 1977 in the pathology department of the faculty of health sciences of the University of Omar Bongo in Librevile, Gabon, which is the only pathology service catering to the needs of the population of approximately 1 million of Gabon. Analysis of the histologically diagnosed cancers during 1984 through 1993 revealed 1,367 male and 1,235 female cases. The leading sites in males were: skin (11.0%), liver (8.9%), non-Hodgkin's lymphoma (8.7%), prostate (7.8%), lung (6.9%), mouth (4.9%) and tongue (4.7%). The predominant sites in females were: uterine cervix (26.3%), breast (13.9%), non-Hodgkin's lymphoma (7.1%), skin (5.1%), liver (3.9%) and ovary (3.3%). Considering the little information available on cancer patterns in Africa, even relative frequency data for different periods from different sources are of considerable interest. We propose to establish population based cancer registration in Libreville (pop 400,000) where 40% of the national population lives, in the near future, which should provide reliable information on the cancer burden and patterns in Gabon.

[Primary lymphoma of frontoparietal localization in the cranial vault. Report of a case]. / Lymphome primitif de la voûte du crâne de localisation fronto-pariétale. Un cas.

The authors report an exceptional case of primary malignant non-Hodgkin's lymphoma of cranial vault, with intra(extradural)-extra-cranial extension. The duration of symptomatology before surgery was six months. The main clinical and radiological particularities were: large soft-tissue mass (17 x 12 cm); extensive osteolytic lesions of the left frontal and parietal bones, with intratumoral calcifications; contribution of meningeal and scalp vessels. Surgery was performed to relieve progressive intracranial compression. According to the international working formulation, it was classified as an intermediary malignant tumor. Unfortunately, the patient died of a traffic accident, six weeks after his discharge.

[Stage III and IV epithelial ovarian cancers. Therapeutic problems]. / Les cancers épithéliaux de l'ovaire stades III et IV. Problèmes thérapeutiques.

Between 1986 and 1989 (4 years), 11 epithelial malignant tumours of the ovary were treated in the department of gynecology and obstetrics of the Libreville teaching hospital group. Epithelial tumours accounted for 78 per cent of malignant tumours in the adult. Burkitt's lymphoma predominated in young girls. Cancer of the ovary takes sixth place among female cancers in Gabon, with an incidence identical to that of cancer of the liver. Cases involved stage III and IV malignancies. Four patients died (36 per cent) and seven are still alive (63.6 per cent) with a mean survival of 25 months at the time of the study (the longest living patient having a survival of 5 years). The fullest possible initial surgical excision is essential in ensuring the greater efficacy of polychemotherapy (including Cisplatin), the only guarantee of total second look surgery. Monitoring of residual disease was based upon ultrasonography. Pelvic radiotherapy was used in the presence of a residual pelvic mass measuring less than 3 cm. Future efforts must be direct towards early detection, in particular since more than 45 per cent of our patients were aged under 30.

Malignant lymphomas in Gabon (equatorial Africa): a morphologic study of 72 cases.

A retrospective morphologic analysis was conducted on 72 malignant lymphomas collected in Gabon, a country of the equatorial area in Africa. Non-Hodgkin's lymphomas (NHLs) were by far the most frequent type of lymphoma, representing 67 cases (93%); only five patients (7%) had Hodgkin's disease. Non-Hodgkin's lymphomas were classified according to two modern systems (Kiel and Working Formulation). The age distribution of NHL patients was bimodal, with the highest peak in the 0 to 14 years age group (these cases were almost exclusively associated with Burkitt's lymphomas), and with the second highest peak in the 55 to 64 years age group. The male to female ratio was 2.5:1, and the overall median age was 44 years. According to the Working Formulation, the NHL cases were composed of one follicular lymphoma (1.5%), 55 diffuse lymphomas (82%), and 11 miscellaneous lymphomas (16.5%). Burkitt's lymphoma was the most frequent NHL (17 cases; 25.4%), followed by diffuse large cell lymphoma (15 cases; 22.4%) and immunoblastic lymphoma (nine cases; 13.4%). Consequently, high-grade NHL formed the largest group (28 cases; 42%), intermediate-grade NHL formed the next largest group (21 cases; 31.3%), and low-grade NHL formed the smallest group (seven cases; 10.4%). These data are compared with series from developed and developing countries, and the observed differences in distribution of the histologic subtypes of malignant lymphoma are discussed.

[Fallopian tube bilharziasis caused by Schistosoma intercalatum disclosed by hemoperitoneum]. / Bilharziose tubaire à Schistosoma intercalatum révélée par un hémoperitoine.

Schistosomiasis due to Schistosoma intercalatumis common in Gabon and, since 1971, Schistosoma haematobium has been found in the south of the country. Genital involvement is infrequent: 0.8 per cent of gynecologic specimens sent to the pathology laboratory and ten of 622 fallopian tube specimens (1.5 per cent). We report an unusual clinical case with hemoperitoneum as the first manifestation: the schistosomal lesion was developed within the tubal serosa, and caused a breach in an arteriole responsible for a 2500 cc hemoperitoneum. Genital lesions preferentially involve the vulva, vagina, and cervix. Involvement of the tubes and ovaries is less common and seems to have an incidence on fertility only if bacterial superinfections cause adhesions around the tubes and ovaries. Genital schistosomiasis is usually asymptomatic. Ectopic pregnancies and infertility may occur.