Tuberculosis of the Breast in Togo: A Series of 28 Presumed Cases.

Our study aimed to describe the epidemiological, clinical and histological aspects of mammary tuberculosis in Togo. This is a descriptive cross-sectional study of breast tuberculosis for which the diagnosis was presumed on histological grounds in the pathology department (LAP) of the Lomé Tokoin university hospital from January 1995 to December 2016 (20 years). A total of 28 presumed cases of mammary tuberculosis were identified. There were 26 women and 2 men, with an average age of 34.2 ± 0.3 years. The clinical signs were nodule (84.1%), tumefaction (75%), abscess (63.6%) and tumefaction with cutaneous fistulization (59.1%). Breast involvement was isolated in 31.8% of cases and associated with pleuropulmonary tuberculosis in 54.5% of cases. Co-infection with HIV was found in 63.9 % of cases. Histology showed inflammatory granulomas made of Langhans giant cells, epithelioid cells and lymphocytes around the foci of caseous necrosis. Thoracic radiography was abnormal in 16 patients (57.1%).Mammary tuberculosis is not rare in our country. Clinical presentation is often misleading and is a diagnostic challenge, more particularly with breast abscess or cancer.

[Analysis of a series of 44 cases of peritoneal tuberculosis diagnosed in the pathology laboratory of the Tokoin teaching hospital of Lomé (1993-2014)]. / Analyse d'une série de 44 cas de tuberculose péritonéale diagnostiqués au laboratoire d'anatomie pathologique du CHU Tokoin de Lomé (1993-2014).

It is a descriptive and cross-sectional study on all issues relating to peritoneal tuberculosis histological diagnosed in the pathology department (LAP) of the Lomé Tokoin CHU from January 1993 to December 2014 (20 years). A total of 44 cases of peritoneal tuberculosis were included. They were 18 women and 26 men, with a mean age of 37.6±0.2 years. The circumstances of discovery were dominated by ascites (84.1%), fever (75%), weight loss (63.6%) and abdominal pain (59.1%). The peritoneal involvement was isolated in 31.8% of cases, and associated with pleuropulmonary tuberculosis in 54.5% of cases. Co-infection with HIV was present in 63.9% of cases. Twenty-five patients (69.4%) with information about their social conditions had low socioeconomic level: unemployed (10 cases; 40%), workers (10 cases; 40%) and retired (5 cases; 20%). An increase in cell count was observed in 94.6% of cases. Histology revealed the epithelial giant cell granuloma associated with caseous necrosis in 38 cases (86.4%) and cheesy isolated in 6 patients. Peritoneal tuberculosis is not exceptional in our country. The diagnosis should be considered in febrile ascites, and will be confirmed by laparoscopy with histological samples for a histological diagnosis.

[Histological aspect of urinary schistosomiasis in Togo: results of a cohort of 192 cases]. / Aspect histologique des séquelles de la bilharziose urinaire au Togo: résultats d'une série de 192 cas.

The high prevalence of urinary schistosomiasis in Togo and its late management often lead to sequels. This study takes stock of these cancerous and non-cancerous lesions observed on histological pieces in the pathology laboratory of the Teaching Hospital of Lome in 10 years. We find 28.1 % of malignant tumor lesions, dominated by urothelial carcinoma.

[Malignant parotid tumors: epidemiology in Togo]. / Tumeurs malignes de la parotide: épidémiologie au Togo.

INTRODUCTION: We had for aim to determine the epidemiological profile of malignant parotid tumors in sub-Saharan country: Togo. PATIENTS AND METHODS: We retrospectively studied the files of patients seen and treated for malignant parotid tumors, from January 1989 to December 31, 2008, at the Tokoin teaching hospital. Patients treated for another malignant tumor at the same time were excluded from the study. RESULT AND DISCUSSION: Ninety-six patients were included. Thirty-one tumors (32.29%) were malignant, in 18 male and 13 female patients with a sex ratio of 1.38. The average age was 39years (range 24-70years of age). Two patients could not undergo surgery. Histologically, there were 10 cases of squamous cell carcinoma (32.26%), 6 cases of adenoid cystic carcinoma (19.4%), 6 cases of adenocarcinoma (19.4%), 4 cases of carcinoma in pleomorphic adenoma (12.90%), 3 cases of mucoepidermoid carcinoma (9.7%), 1 case of acinar carcinoma (3.2%), and 1 case of cystadenocarcinoma (3.2%). DISCUSSION: Squamous cell carcinoma was the most frequent histological type observed in Togo, contrary to literature data for which mucoepidermoid carcinoma is the most frequent malignant parotid tumor.

Preliminary evaluation of the wound healing effect of Vitex doniana sweet (Verbenaceae) in mice.

Vitex doniana is traditionally used in Togo to treat various diseases including wounds. The aim of this work was to evaluate the efficiency of Vitex doniana on cutaneous wound healing. Wounds were induced in ICR mice divided into four groups as following: Group I received carbopol 974P NF empty gel, Groups II and III were treated topically with carbopol gel containing 2.5% and 5% of Vitex doniana extract. Group IV received Betadine® 10% as standard drug. The efficacy of treatment was evaluated by planimetry and histological analysis. We secondary used the gel containing Vitex doniana at 2.5% and the pure extract at 10 mg/ml on the model of ear edema induced by xylene. Skin toxicity test was performed with the gel containing Vitex doniana at 5% and the pure extract at 30 mg/ml. Vitex doniana at 5% and 2.5% provided better wound contraction (91.14% and 86.38%) at day 12 post-excision when compared to control (51.15%). The results of histological evaluation supported the outcome of excision wound model. Moreover Vitex doniana inhibited significantly edema induced by xylene when compared to control (p< 0.05). In skin toxicity test, no abnormal symptoms were developed over 14 day-time period. Vitex doniana inhibits the topical inflammation and accelerate cutaneous wound repair.

[Epidemiological and pathological aspects of the gynecological and mammary cancers in Togo]. / Aspects epidémiologiques et histopathologiques des cancers gynéco-mammaires au Togo.

OBJECTIVE: Gynecologic and mammary cancers occupy a prominent place in female tumor pathology. The purpose of this report is to describe aspects of these cancers in Togo. MATERIAL AND METHODS: This retrospective and descriptive study includes all gynecologic and mammary cancers diagnosed between 1987 and 2006 in the pathology laboratory of Tokoin University Hospital in Lomé, Togo. RESULTS: During the study period, 882 gynecologic and mammary cancers were diagnosed. Breast cancer accounted for 440 cases (49.88%). The most common gynecologic cancer locations were the cervix in 212 cases (24.03%) and uterine corpus in 108 cases (12.25%). Mean patient age was 48.3 years overall, 48,6 years for breast cancer and 49 years for cervical cancer. In almost all cases, cancer was diagnosed at an invasive stage. CONCLUSION: Gynecologic and mammary cancers are common in Togo and most cases are diagnosed at a late stage. An epidemiological monitoring program is needed.

[Skin cancers in Togo: a 223-case series]. / Les cancers cutanés au Togo: 223 observations.

OBJECTIVES: The aim of this retrospective study was to determine the relative frequency and trends of skin cancers in Togo. METHOD: The records of patients with primitive skin cancers diagnosed in the pathology laboratory of Lomé teaching hospital from 1994 to 2005 were reviewed. RESULTS: During the study period, 223 cases of skin cancers were recorded. The overall mean patient age and male-to-female ratio were 42 +/- 17 years and 1.56 respectively. The most common forms of skin cancers observed were Kaposi's sarcoma in 103 cases (46.2%), skin carcinoma in 75 cases (33.6%), melanoma in 23 cases (10.3%), and dermatofibrosarcoma protuberans in 16 cases (7.2%). In the Kaposi's syndrome group, the average age and male-to-female ratio were 39 +/- 15 years and 2.68 respectively and the main location was the lower limbs (77.9%). In the cutaneous carcinoma group, 64 cases involved squamous cell carcinoma with an average age and male-to-female ratio of 48 +/- 17 years and 1.29 respectively. In 18 cases squamous cell carcinoma developed on chronic leg ulcer. In the melanoma group, the average age and male-to-female ratio were 55 +/- 16 years and 0.64 respectively and the main location was the distal extremities. In the dermatofibrosarcoma protuberans group, the average age and male-to-female ratio were 45 +/- 20 years and 0.78 respectively. The other types of skin cancers observed were mycosis fongoides in 4 cases (1.8%) and Paget's disease in 2. CONCLUSION: This study showed that Kaposi's sarcoma was the most frequent skin cancer in Togo in conjunction with the current HIV infection epidemic. Findings also indicated that the incidence of other types of skin cancers was relatively stable.

[Epidemiology and pathological profile of childhood ovary tumours in Togo: about 32 cases]. / Profil histo-épidémiologique des tumeurs ovariennes de l'enfant au Togo: à propos de 32 cas.

PURPOSE: Tumours of the ovary is rare in childhood. The aim of our work was to describe the epidemiology and histological aspects of these tumours in Togo. MATERIAL AND METHODS: Retrospective review of the epidemiologic and pathologic features of the ovary tumours in childhood (0 to 15 years), observed from 1988 to 2007 at the laboratory of pathology of the Tokoin teaching hospital in Lomé, Togo. RESULTS: During our study period, we observed 32 cases of childhood ovary tumours that represent 8.16% of all ovarian tumours. The average age of occurring was 10.7 years. Histologically it was germ cell tumours in 40.6% of cases (mature teratomas: 34.4% ; immature teratomas: 3.1% ; yolk sac tumours: 3.1%), sex cord-stromal tumours in 21.8% of cases (granulosa cell tumours: 18.7% ; fibroma: 3.1%) and Burkitt lymphoma in 37.6%. CONCLUSION: The childhood ovary tumours although rare, exist in Togo dominated by Burkitt lymphoma.

[Epidemiology and histopronostic of prostatic cancer in Togo: about 202 cases diagnosed at the laboratory of pathology of the Tokoin teaching hospital of Lome]. / Epidémiologie et histopronostic du cancer de la prostate au Togo : à propos de 202cas diagnostiqués au laboratoire d'anatomie pathologique du CHU Tokoin de Lomé.

OBJECTIVES: Describe the epidemiological and histological aspects of the prostate cancer in Togo. METHODS: It was a retrospective descriptive study relating to 202 cases diagnosed between 1984 and 2003 at the Laboratory of Pathology of the Tokoin teaching hospital of Lome. The parameters studied were: frequency, age, circumstances of discovery, PSA value and histological type. RESULTS: The frequency of prostate cancer was 10 cases on average. The average age of patients was 70 years (45 to 95 years). The circumstances of discovery were dominated by voiding disorders and the average PSA was 88.5 ng/ml (7.8 to 560.4). Histologically, it was adenocarcinoma in 97.5% of cases and squamous cell carcinoma in 1.9% of cases. CONCLUSION: The prostate cancer although uncommon in Togo remains a public health problem because of the weak accessibility of the population to the diagnosis. So, a national program of screening is needed.

Epidemiological and pathological aspects of gastrointestinal tumors in Togo.

PURPOSE: The incidence of gastrointestinal tumors is difficult to estimate in Togo, so the purpose of this report was to describe the tumors diagnosed by the national pathology laboratory. METHODS: This was a retrospective descriptive study of 742 gastrointestinal tumors diagnosed between 1986 and 2005 by the pathology laboratory of the Tokoin university hospital in Lomé, Togo. RESULTS: There was an annual incidence of 37 gastrointestinal tumors, including 27 cancers, with twice as many tumors diagnosed in men as in women. The average age of patients diagnosed with a benign tumor was 44 years compared with 52 years for those with a malignant tumor. Stomach tumors predominated (n=306; 41.2%). Papilloma was the most frequent benign tumor type (n=100; 47.8%), while malignant tumors were mostly gastric adenocarcinoma (n=224; 42% of all cancers), esophageal squamous cell carcinoma (n=100; 19%) and colorectal adenocarcinoma (n=89; 17%). CONCLUSION: Gastrointestinal tumors are frequently seen in Togo, and an epidemiological monitoring program is needed.

[Gastrointestinal lymphomas in Togo: epidemiological and prognosis aspects]. / Lymphomes gastro-intestinaux au Togo: aspects epidemiologiques et histopronostiques.

The digestive tract is the principal site of the extranodal non Hodgkin lymphomas. The purpose of our work was to describe the epidemiology and the prognosis of gastro-intestinal lymphomas in Togo. It was about a retrospective study relating to 32 cases diagnosed in Togo during 20 years. The gastro-intestinal lymphomas are not very frequent affection in Togo accounting for 5.6% of cancers of the digestive tract and occurring at 37 years an average age with a sex-ratio H/F to 1.5. Histologically, the lymphomas of intermediate rank were most observed according to the classification of Working Formulation (62.6%), where in fact the MALT lymphomas of high rank of malignity prevailed according to the classification of Isaacson. Their preferential topography was the stomach (59%). The narrowness of our technical plate poses enormous diagnostic problems of these lymphomas.

Lymphomes gastro-intestinaux au Togo : aspects epidemiologiques et histopronostiques

Le tube digestif est le site principal des lymphomes non hodgkinien extra ganglionnaires. Le but de notre travail etait de decrire l'epidemiologie et l'histopronostic des lymphomes gastro-intestinaux au Togo. Il s'est agi d'une etude retrospective portant sur 32 cas diagnostiques au Togo pendant 20 ans. Les lymphomes gastro-intestinaux constituent une affection peu frequente au Togo representant 5;6des cancers du tube digestif et survenant a un age moyen de 37 ans avec un sex-ratio H/F a 1;5. Au plan histologique; les lymphomes de grade intermediaire etaient les plus observes suivant la classification de la Working Formulation (62;6); alors que ce sont les lymphomes de MALT de haut grade de malignite qui predominaient suivant la classification d'Isaacson. Leur topographie preferentielle etait l'estomac (59des cas). L'etroitesse du plateau technique de notre Laboratoire d'Anatomie Pathologique pose d'enormes problemes diagnostiques de ces lymphomes

[Tumours of the accessory salivary glands. Epidemiological and anatomopathological aspects]. / Tumeurs des glandes salivaires accessoires. Aspects epidémiologiques et anatomopathologiques.

INTRODUCTION: Several series of studies on the tumours of the accessory salivary glands have shed light on their anatomopathological and epidemiological aspects in Western countries. Only a few studies of this kind have been carried out in our countries. OBJECTIVES: To study the anatomopathological and epidemiological aspects of the accessory salivary glands in order to compare the literature data. METHODOLOGY: This is an analytic, descriptive and retrospective study conducted over a period of 10 years at the ENT and the Anatomo-pathology Departments of the CHU in Lomé. RESULTS: Tumours of the salivary glands represented in our study 17.19% of the ORL tumours. Tumours of the accessory salivary glands represented 71.43% of tumours of the salivary glands. Benign tumours represented 71.43% and malignant tumours 21.43%. Women were more affected than men. The average age of appearance of benign tumours was 47.87 years for men and 31.91 year for women. The average age of appearance of malignant tumours was 38 years far the women. The commonest site was the palate. The majority of benign tumours were pleomorphic adenomas. Adenoid cystic carcinoma was the principal malignant tumor. CONCLUSION: Pleomorphic adenoma and adenoid cystic carcinoma were the principal tumours of the accessory salivary glands. The commonest site was the palate. Women were more affected than men. The average age of appearance of malignant tumours was seven years later than benign tumours. (full article translated in English available on www.ent-review.com).

[Is endoscopic diagnosis of Candida albicans esophagitis reliable? Correlations with pathology and mycology]. / Le diagnostic endoscopique d'oesophagite à Candida albicans est-il fiable?

AIM OF STUDY: To assess the reliability of endoscopic diagnosis of Candida albicans esophagitis. PATIENTS AND METHODS: A case - control prospective study was carried out from November 1997 to July 1998 at the Campus Teaching Hospital of Lome, in patients with esophagitis macroscopically suggestive of Candida albicans origin at upper digestive endoscopy. Fifteen subjects with normal endoscopy served as controls. Esophageal biopsies for mycologic and pathological examination were performed, as well as HIV serology. RESULTS: During the study period, 26 of the 850 endoscopies performed in our Unit revealed an esophagitis suggestive of Candida albicans origin. Mycology confirmed the presence of filamentous form of Candida albicans in 23 patients and pathology showed non-specific lesions of esophagitis, 20 with intramucous hyphae. HIV serology was positive in 19/23 patients (82.6%) and in 1/15 controls (6.6%). Sensitivity and specificity of upper GI endoscopy for the diagnosis of Candida albicans were 100 and 83.3% respectively; positive and negative predictive values were 88.5 and 100%, respectively. CONCLUSION: Upper digestive endoscopy is a reliable method for the diagnosis of Candida albicans esophagitis. However, mycological confirmation is warranted.

[Malignant non-Hodgkin's lymphoma of the lip: a case report]. / Lymphome malin non-hodgkinien de la lèvre: à propos d'un cas.

The non Hodgkin's lymphoma of the lip is rare. A 3-year-old child with non-Hodgkin's lymphoma of the upper lip (stage I in the Ann Harbor system) was reported. An immunodeficiency, been in correspondence with a food deficiency, was probably a causal factor. A post-chemotherapy residual lesion justified a surgery.

[Primary nephrotic syndrome in the black African child]. / Le syndrome néphrotique primitif de l'enfant en Afrique noire.

Idiopathic nephrotic syndrome (INS) in black African children differs from that of children in temperate areas. The main differences are the high rate of corticosteroid non-responders and the low rate of minimal change glomerulopathy in black African children, possibly related to a racial factor. The identification of a high corticosensibility in certain African regions (Togo and Ghana) can lead to the identification of an ethnic factor. Further genetic studies should be carried out in order to provide a better approach to INS in Africa.

[Non-tumor dermatoses diagnosed in the pathologic anatomy laboratory of the Tokoin University hospital center, Lomé (Togo)]. / Les dermatoses non tumorales diagnostiquées dans le laboratoire d'anatomie pathologique du CHU Tokoin, Lomé (Togo).

The non-tumorous skin diseases are common in hospital consultation in tropical countries. These infections constitute a great health problem in black Africa. Their diagnosis is often clinically easy, but sometimes histologically examination is necessary to have the positive diagnosis. In Togo, a retrospective study conducted during ten years, allowed to note 516 cases of non-tumoural dermatosis which were histologically diagnosed. The principal infections were: inflammatory dermatosis 339 cases (213 cases were not specific against 108 specific cases predominated by leprosy: 82 cases), epidermal dermatosis (97 cases, predominated by eczema and psoriasis), dermal lesions (44 cases), lesions of dermic and epidermic junction (23 cases), hypodermic (13 cases). The results of this study shows the diversity of non-tumorous dermatosis diagnosed by the histology. The eradication of these diseases in Africa needs to have efficient laboratory diagnosis and research means in every country.

[Cutaneous cancers in Togo]. / Les cancers cutanés au Togo.

A retrospective study was conducted during 20 years to determine the epidemiological features of skin cancer diagnosed in the pathology laboratory in Lome teaching hospital. During this period, 518 cases of theses affections were noted: 288 cases of carcinoma (56.6%); out of 288 carcinomas 254 were spinocellular carcinoma, which developed on 143 chronic phagedenic ulcer, the others cancer were: malignant melanoma 63 cases (12.3%), Kaposi's sarcoma 72 cases (13.9%), skin sarcoma 95 cases (18.3%). The results of this study shows that the spinocellular carcinoma were mostly the skin cancer in Black African, and confirm the particularity of malignant melanoma in Black subjects.

Les cancers cutanes en consultation dermatologique a Lome (Togo)

Une etude retrospective a ete menee sur une periode de 15 ans; afin de determiner la prevalence et les differents types de cancers cutanes observes au cours d'une consultation dermatologique a Lome. Au cours de la periode d'etude; 69 sur 25;600 nouvelles consultations (0;02 pour cent) ont souffert d'un cancer cutane histologiquement diagnostique. Les cancers cutanes representaient 7;91 pour cent des tumeurs cutanees recontrees en dermatologie. Les principaux cancers cutanes etaient : la maladie de Kaposi (40 cas); les epitheliomas (10 cas); les dermatofibrosarcomes (6 cas); les hemathodermies (5 cas); le melanome malin (4 cas); la maladie de Bowen (2 cas); la maladie de paget (2 cas). Exceptee la maladie de Kaposi cette etude confirme la rarete des cancers cutanes chez le noir africain

Le lymphome de Burkitt au Togo: aspects epidemiologique; clinique; therapeutique et evolutif

Une etude retrospective portant sur 332 dossiers d'enfants traites pour lymphome de burkitt sur une periode de 10 ans dans le service de pediatrie du CHU de Lome-Tokoin a ete effectuee afin d'analyser les differents aspects epidemiologiques; cliniques; therapeutiques et proposer des solutions pour une meilleure prise en charge des patients. 28 enfants ont ete retenus soit 2;8 cas par an; 0;04 pour cent des hospitalisations en pediatrie et 73;68 pour cent des lymphomes malins non hodgkiniens durant la periode consideree. L'age des patients a varie entre 13 mois et 14 ans avec une moyenne de 7;5 ans; le sexe masculin est predominant (sex-ratio = 1;5); 72 pour cent des patients sont de famille ayant un bas niveau socio-economique et 66;4 pour cent sont originaires du Sud du pays. Le delai moyen avant consultation est de 3 mois; les localisations maxillo-faciales ont ete constatees dans pour 100 cas soit isolement (32;1 pour cent) ou associees aux localisations abdominales (25 pour cent); ganglionnaires (25 pour cent) et medullaires (10;7 pour cent). Le protocole therapeutique utilise est a la base de cyclophosphamide. Les resultats ne sont pas tres satisfaisants puisque la letalite est elevee de l'ordre de 25 pour cent. Le suivi des malades en remission est tres difficile; les patients ne venant pas regulierement aux controles. Les conclusions de cette etude permettent de formuler les recommandations suivantes: - Sensibilisation des parents sur la necessite d'un suivi regulier au long cours; - Approvisionnement regulier des services hospitaliers en drogues antimitotiques; - Creation d'un service d'onco-hematologie avec une unite de radiotherapie