Respective prevalence of high-risk HPVgenotypes in cervical neoplasia in Senegal.

OBJECTIVES: With the perspective of prophylactic vaccination against high-risk human papillomavirus (HPV), we analyzed the viral epidemiology of cervical neoplasia in Senegal. METHODS: All patients were treated at the Institut Joliot Curie du Cancer in Dakar. HPV genotypes were characterized using a real-time polymerase chain reaction-based approach and sequencing. RESULTS: Histologically, there were 224 invasive carcinomas, 17 high-grade intraepithelial neoplasia (CIN), and five undetermined histologies. Molecular analysis was conclusive in 241 cases. HPV DNA was found in 207/241 (85.9%) cases while 34/241 (14.1%) remained HPV negative. There was one single genotype in 127/207 (61.4%) cases and several in 80/207 (38.6%) corresponding to 308 genotypes identified. Viral genotyping found HPV16 in 175 (56.8%) cases, HPV18 in 45 (14.6%), HPV45 in 40 (13.0%), HPV58 in 35 (11.4%), HPV33 in 6 (2.0%), HPV35 in 3 (1.0%), HPV31 in 2 (0.6%), HPV39 and HPV56 in one (0.3% each). CONCLUSION: Our analysis showed that 98.4% of the HPV-positive cases were associated with viral genotypes covered by the 9-valent HPV vaccine. However, 14.1% of cases remained HPV negative. Therefore, prophylactic vaccination using a 9-valent vaccine should dramatically reduce the incidence of HPV-associated neoplasia but the detection and treatment of CIN remain necessary for the optimal prevention of cervical cancer.

[Appendicitis schistosomiasis]. / La bilharziose appendiculaire.

Appendiceal schistosomiasis is a rare disease of only histopathological diagnosis. Appendectomy should be followed by treatment with praziquantel to avoid complications. We report two cases of appendiceal schistosomiasis and discuss the role of this infection of this infection in the pathogenesis of appendicitis. Finally, we recommend a routine pathological examination of all appendicectomy specimen in endemic areas for better care for patients.

Retinoblastoma in children: a case series from Senegal.

Retinoblastoma is the most common tumor of the eye in Senegalese children. Diagnosis occurs often at a late stage, when enucleation is unavoidable. In this report, we describe all recorded cases occurring in Senegal over a 10-year period (2005-14). For the 106 cases clinically and radiological identified, the mean age at diagnosis was 30 months (2 months / 10 years). Leucocoria (74.6%) and exophthalmos (42.3%) were common signs of the disease. For the 67 cases identified through patient-file examination, extra-ocular forms were present in 30% of cases at the time of diagnosis and retinal detachment in 19% of cases. Chemotherapy and surgery were the only available therapeutic methods. Overall survival at 5 years was 70%. Retinoblastoma is a serious illness that threatens the lives and sight of affected children. There are about 10 cases per year in Senegal. Management can be enhanced by improving existing technical platforms and training medical staff.

[Atherosclerosis and coronary artery disease in Senegal: an autopsy series of 116 african patients at Aristide Le Dantec Hospital (Dakar-Senegal)]. / Athérosclérose aortique et coronarienne au Sénégal : à propos d'une série autopsique de 116 patients d'origine africaine au CHNU Aristide Le Dantec (Dakar-Sénégal).

OBJECTIVE: To study the prevalence of atherosclerosis (aortic and coronary lesions) in Senegalese people, to determine main risks factors and morphological patterns. METHODS: A prospective autopsy study was conducted in the pathology department of Aristide Le Dantec Hospital (Dakar-Senegal) where 116 specimens aged over 5 years old were studied. RESULTS: Autopsy study of 116 Senegalese specimens for atherosclerotic lesions revealed aortic lesions in 100 cases (86%), aortic and coronary lesions both in 48 cases. There were 88 men versus 12 women. The median age was 37.1 years comprised 5 to 77 years old. Hypertensive, smoking and abdominal obesity were detected respectively in 5 cases, 37 cases and 33 cases. In aortic vessel, the main lesions detected were severe fibrous plaques detected in 40 cases. In coronary arteries, fibrous plaques were detected in 18 cases, severe fibrous plaques in 17 cases. CONCLUSION: Our study in Senegalese population showed existence of atherosclerotic lesions. These lesions were more responsible for complications as myocardial infarction.

[A rare parotid tumor]. / Une tumeur parotidienne rare.

INTRODUCTION: Sebaceous lymphadenoma of the parotid (SLP) is a rare, benign tumor with similar epidemiological and macroscopic characteristics with other sebaceous differentiated tumors of the parotid (SDTP). The authors report a case of SLP in an 80-year-old woman. They then recall the distinctive histological and immunohistochemical criteria of SDTP. OBSERVATION: Mrs P. D. was received during a surgical consultation for the management of a painless right parotid swelling that has evolved for 10years, increasing slightly in volume. At admission, the mass was movable, firm with a healthy skin without facial paralysis or satellite lymphadenopathy. The surgical intervention performed removed a nodular mass measuring 7cm, encapsulated, yellowish. It was made of regular epithelial cells without atypia or mitoses organized in nests, trabeculae and massifs. This tumor also included small canalicular cystic dilatations associated with several islands of sebaceous glands. The stroma was dense lymphoid with follicles and germinal centers. The tumor cells were CK7+, P63+, MSA+ and had a Ki67<5%. The diagnosis of an SLP was retained. No additional therapy was performed. One year after surgery, the patient had no local recurrence or metastatic foci. CONCLUSION: SLP is a rare tumor with a particular histological and immunohistochemical profile. It is an epithelial tumor with sebaceous islands, a dense reactional lymphoid stroma, expression of luminal and basal epithelial markers and a low proliferation index.

[Exceptional etiology of acute renal: Burkitt's lymphoma]. / Une étiologie exceptionnelle de l'insuffisance rénale aiguë : le lymphome de Burkitt.

INTRODUCTION: Burkitt's lymphoma (BL) is an exceptional cause of acute renal failure (ARF). The origin of the tumor clone may be lymphoid follicles secondary to renal Epstein-Barr virus (EBV) infection. With the presentation of this clinical case, the pathogenesis, diagnostic criteria and evolution of this extremely rare affection will be discussed. OBSERVATION: A 4-year-old patient with a recent history of acute osteomyelitis of the right thigh presented an ARF without indications of post-infectious glomerulonephritis. Ultrasound showed enlarged kidneys without dilation of the excretory cavities. Diffuse interstitial infiltration of atypical lymphoid cells of medium size were noted upon renal biopsy. The tumor cells expressed antibodies against CD20, CD10, Bcl6, and Ki67 but not against Bcl2 or CD3. The search for an EBV infection was positive. A few days after diagnosis, the evolution was spontaneously fatal. DISCUSSION/CONCLUSION: BL of the kidney is a rare condition that accounts for less than 1 % of kidney tumors, associated almost invariably with EBV infection. The diagnosis is confirmed histologically by renal biopsy and the criteria of Malbrain affirms the primitive character of the lymphoma. BL of the kidney is a diagnostic and therapeutic emergency and may be fatal.

[Intra-thyroid metastasis and the pathologist]. / La métastase intra-thyroïdienne et le pathologiste.

Intra-thyroid metastases (ITM) are rarely observed clinically. The high blood flow of the thyroid and its high content of iodine explain this rarity. The clinical and radiological criteria of ITM are not very specific. The pathologist is the principal actor of ITM diagnosis. Cytology, intraoperative examination and histological techniques are the means available. The microscopic aspects of ITM are varied. Art is to differentiate ITM to undifferentiated primary tumor. We report two cases of ITM in patients aged 49 and 52 years, respectively. We discuss diagnostic methods and challenges for pathologists in identifying such lesions.

[Rectal endometriosis: An exceptional etiology of acute intestinal occlusion]. / Endométriose rectale : une cause exceptionnelle d'occlusion intestinale aiguë.

The intestinal occlusion acute is an emergency and therapeutic diagnostic. A rectal tumor is rarely the cause in a young adult. We are carrying the case of a patient of 43years old, received at emergency on a board of intestinal occlusion acute due to a rectal tumor of a fortuitous discovery during the operation. The final diagnosis after a histopathologic examination was for the less unexpected. It was rectal endometriosis in its tumor-like. A complementary medical care obtains satisfactory results.

[Morpho-epidemiological profile of elderly subject cancer in Dakar]. / Profils morpho-épidémiologiques des cancers du sujet âgé à Dakar.

UNLABELLED: The elderly is defined by WHO as any individual who has a chronological age greater than or equal to 60 years. The number of elderly is growing. The scarcity of work on malignant tumor pathology elderly contrasting with the difficulty of support have raised the interest of this work. MATERIALS AND METHODS: This is a descriptive and retrospective study carried out on a periode of 5 years based on the reported analyses of all public laboratories of anatomical pathology and cytology in Dakar. RESULTS: During the five years of our study on 1,264 cases of tumors of the elderly we identified 699 cases of cancer. The average age of patients was 68.82 years with a discreet male predominance (sex ratio=1.07). The most common malignant tumors were cancers of the prostate (23.74%), cancers of the cervix (16.88%), cancer of the breast (10.72%) and cancers of the skin and soft tissues (9.15%). Some tumor sites (stomach, larynx, esophagus, ganglion, sinus, bladder, liver, lungs and bronchi, vulva, eye, jaw, pancreas, bone) had always proved malignant. Tumor location was primitive in 97.56% and metastatic in 2.44%. The histological type of primary cancer was met by far dominated by carcinomas (91.20%) followed by lymphoma (3.81%), sarcomas (3.66%) and melanoma (1.31%). All cases of metastatic were carcinomas.

[Secretory breast carcinoma in a man. A case report with rapid evolution unfavorable]. / Carcinome sécrétoire du sein chez l'homme. A propos d'un cas d'évolution rapide.

Secretory carcinoma or juvenile carcinoma of the breast is a very rare tumor of male adults. Generally, it has a good prognosis after locoregional treatment. The authors report an observation of a secretory carcinoma occurring in a 20 year old man. The lesion presented as a voluminous tumor 12 cm in diameter with 3 positive lymph nodes; it was treated by mastectomy and axillary dissection. Tumor developed in a few months, with visceral metastasis and fatal issue. The cytological, histological and immuno-histochemical features necessary to the diagnosis are described. The rapid development of this case of secretory carcinoma is unusual. This leads the authors to propose the use of an additional treatment for adult secretory breast carcinoma with more than 3 positive lymph nodes.