[An exceptional hepatic tumor]. / Une tumeur hépatique exceptionnelle.

BACKGROUND: Hepatic localization of non Hodgkin's lymphoma is generally secondary. Primary localizations are rare. AIM: To report a rare case of primary hepatic lymphoma particular by its association with dermatopolymyositis. OBSERVATION: A 55-year-old woman with a past medical history of dermatopolymyositis diagnosed one year before presented with abdominal pain and fever. Laboratory tests showed pancytopenia. Radiologic examination revealed multiple hepatic masses. Surgical biopsy revealed a large B cell hepatic lymphoma. No other localizations were found so the diagnosis of primary hepatic lymphoma was retained. The patient died after a few days due to a severe sepsis. CONCLUSION: Primary hepatic lymphoma is a rare tumor with a bad prognosis. Its diagnosis is based on histologic examination. Treatment of these tumors remains non consensual.

Combined analysis of smoking, TP53, and FGFR3 mutations in Tunisian patients with invasive and superficial high-grade bladder tumors.

In our cohort, FGFR3 mutations were detected in 31.1% of bladder tumors and are associated with lower stage and grade. Concerning TP53, 62 mutations were found in tumors from 44 cases (48.88%) and are associated with advanced forms. The combined analysis of FGFR3 and TP53 mutations in our cohort showed an independent distribution. In addition, we have reported that FGFR3 mutations spectrum depends on the intensity of tobacco use (pack years: PY). Finally, we have found that the FGFR3wt/TP53mut genotype, which was associated with advanced bladder tumors; was overrepresented in light smokers (PY < 40) compared to nonsmoker patients (p =.01).

Multiple cutaneous bronchogenic cysts located on the neck and the scalp. A case report.

Bronchogenic cyst is a benign congenital developmental abnormality of the embryonic foregut. The skin is a rare site for bronchogenic cysts, and in this location it is often a solitary lesion. It is poorly recognized by clinicians and in almost all cases the diagnosis is established by histopathologic examination. This report documents a new case of multiple cutaneous bronchogenic cysts bilaterally located on the neck and on the scalp, which are unusual locations of this lesion.

A new case of signet ring cell carcinoma of the prostate.

Primary signet ring cell carcinoma of the prostate is a very rare variant of prostate cancer. Herein, we report a new case of primary signet ring cell carcinoma of the prostate in an 85-year-old man with voiding disorder and hematuria. Based on this case, we present the anatomopathologic, clinical, and therapeutic aspects of this rare entity.

[Collecting duct carcinoma associated with renal stones]. / Le carcinome des tubes collecteurs de Bellini associé a des calculs rénaux.

Collecting duct carcinoma is an extremely rare disease, representing less than 1% of all renal tumours. The authors report the case of a 72-year-old patient presenting with right low back pain associated with episodes of total macroscopic haematuria. Imaging showed a heterogeneous mass in the upper pole of the right kidney associated with pyelocaliceal stones. Multiple secondary lesions were observed in the liver. Macroscopically, the mid-renal tumour was 7.5 cm in diameter surrounding the stone-containing pyelocaliceal cavities. This tumour had spread to the cortex and invaded the perirenal fat. Histologically, the tumour was composed of ducts lined by cells with a hobnail appearance in an abundant desmoplastic and neutrophil-rich inflammatory stroma. Immunohistochemistry showed very intense labelling of tumour cells with cytokeratins: KL1, 7, 19, and 34_E12 and slightly less intense labelling with UER, Vimentin, EMA, and BNH9, while cytokeratin 20 was negative. The diagnosis of Fuhrman grade 3 collecting duct carcinoma associated with renal stones and liver metastases was adopted. The patient died postoperatively. The main differential diagnosis was urothelial carcinoma with a glandular component. In the present case, the diagnosis was made more difficult by the concomitant presence of renal stones. The diagnosis was established by histology and immunohistochemistry.

[Pelvic ganglioneuroma. Report of a case]. / Le ganglioneurome pelvien. A propos d'une observation.

Ganglioneuroma is a rare benign tumor. It is the most mature of neurogenic tumors. We report a case of a pelvic ganglioneuroma diagnosed in 24-year-old pregnant woman who presented with an urinary infection. Echographic examination suggested an ovarian mass. At surgical operation, the tumor was close to the sacrum. A total resection of the tumor was performed. Pathological examination proved it as a ganglioneuroma. Sixteen months later, the patient is free from disease.

[Cutaneous tuberculosis. A review of 38 cases]. / La tuberculose cutanée. A propos de 38 cas.

INTRODUCTION: Cutaneous tuberculosis (CT) represents only 2% of extra-pulmonary locations. This form should be studied because it may indicate visceral forms of tuberculosis. MATERIAL AND PROCEDURES: Retrospective study of patients affected by CT, conducted in the dermatology department of Charles Nicolle Hospital from 1991 to 2002. Tuberculids have been excluded. RESULTS: We have studied 38 cases of CT subdivided on 8 lupus tuberculosis, fourteen scrofuloderma, two warty tuberculosis, one association between lupus tuberculosis and scrofuloderma, twelve BCG specific reactions and one unclassifiable form. The average age of our patients was 43 years. The sex ratio (H/F) was 1,91. Concomitant visceral tuberculosis was discovered in 9 patients. All cases were confirmed by anatomopathologic examination and half of them had a caseous necrosis. CONCLUSIONS: The incidence of cutaneous tuberculosis seems to be increasing in our country: from 3 per 1000 new consultants in our dermatology department between 1970 and 1977 to 0.44 per 1000 new consultants from 1991 to 2002. Our study points out a male predominance in cutaneous tuberculosis. Clinical forms are still dominated by scrofuloderma which is a multibacillary form.

[Prostatic stromal sarcoma]. / Sarcome stromal de la prostate.

Prostatic sarcoma is a very rare tumour arising from the specialized stroma of the prostatic parenchyma. The clinical and histological features and biological behaviour of this entity are poorly elucidated at the present time. The authors report a case of prostatic stromal sarcoma in a 47-year-old man presenting with complete bladder retention. The initial diagnosis was that of benign prostatic hyperplasia and the patient was treated by suprapubic prostatectomy with no other complementary treatment. Histological examination demonstrated primary neuroectodermal tumour (PNET). The patient was subsequently lost to follow-up and was only reviewed 22 months later in a context of haematuria. Digital rectal examination revealed a large, soft prostate with an estimated weight of 83 grams on ultrasound. Transurethral resection was performed and histological examination of the resection material and review of the slides of the primary tumour showed identical microscopic and immunohistochemical features, corresponding to stromal sarcoma. The patient was treated by local and regional radiotherapy (60 Grays). With a follow-up of 36 months, he presents urinary symptoms with no signs of local extension or metastasis.

[A particular hepatocellular carcinoma combining the ordinary and the fibrolamellar variant]. / Un carcinome hepatocellulaire particulier associant la forme classique et la forme fibrolamellaire.

Fibrolamellar carcinoma (FLC) of the liver is a rare variant of hepatocellular carcinoma (HCC) occurring on non cirrhotic liver. Since its first description by Hugh Edmondson in 1956, 200 cases of FLC have been reported in the literature, but only some cases describe the association of the ordinary HCC with the FLC within the same lesion. We report in this study the case of a 14-year-old female patient with a hepatic mass whose radiological aspect evoked a nodular and focal hyperplasia. Histologically, this tumor was composed of area of FLC mixed with ordinary HCC. Staining for cytokeratine 7 was positive in the FL component and negative in the ordinary HCC component.

[Prognostic value of clinicopathologic factors in superficial bladder tumors: a retrospective analysis]. / Valeur pronostique des facteurs clinicopathologiques dans les tumeurs superficielles de la vessie: Etude rétrospective à propos de 59 cas.

OBJECTIVE: To study, through a series of superficial bladder tumors, the prognostic factors of recurrence and tumoral progression. MATERIALS AND METHODS: This is a retrospective study of a series of 59 urothelial tumors of the bladder at stage pTa or pT1. The following parameters were considered: age, sex, treatment, stage and grade. The chi square test was used in search of a correlation between the different parameters and the course (recurrence and progress) of the disease. A multivariate analysis was undertaken by integrating factors correlated with the course. RESULTS: Thirty two tumors (54 %) had recured versus 27 (46%) without recurrence. Eight tumors (25 %) progressed in grade and 4 (12,5 %) had become infiltrative. Age beyond 65 years, tumoral size > 3 cm and multifocality were predictive factors of recurrence with a relative risks of 2,36, 3,28 and 3,88 respectively. In a multivariate analysis, these factors remained significant with adjusted relatif risks respectively of 1,36, 1,6 and 1,7.

[Value of cytology in the diagnosis of thyroid nodules (93 cases)]. / Apport de la cytologie dans le diagnostic des nodules thyroïdiens (à propos de 93 cas).

This is a prospective study of 93 thyroid cytologic spécimen from the department of ORL of Charles Nicole Hospital and analysed by the department of Pathology of the same Hospital. The purpose of this study is to evaluate the accuracy of thyroid cytology in the diagnosis of thyroid nodules. The age average in our study was 40 years with a male-female ratio of 1/6. Thyroid cells were collected by a fine needle aspiration. The following results were obtained: an interpretability rate of 7.52%, a sensitivity of cytological examination as compaired with histopathological examination of 70% and a specificity of 97.43%.

[Dermatofibrosarcoma in children. Report of 7 Tunisian cases]. / Dermatofibrosarcome de l'enfant. A propos d'une série tunisienne de 7 cas.

Dermatofibrosarcoma (DFS) protuberans is a rare mesenchyma tumor in childhood characterised by slow growth. We report the result of a retrospective study of 7 childhood (4 males) cases of through a fifteen year period. The mean age was 13 years. 4 Tumors were (DFS) located on the limbs: 2 on the trunk: and on the scalp. Clinical types were multinodular and infiltrated in 3 cases, nodular in two cases and ulcerated with budding also in two cases. The mean delay between diagnostic and the appearance of the tumor was about 24 months for 4 initial tumors. Histological features were typical in all cases. We report 3 recurrences of dermatofibrosarcoma arising few months after surgical excision of an initial tumor, in one case the tumor was diagnosed histocytofibroma. Six patient underwent surgical excision with wide margins, and in one case the margins were considered borderline. No recurrences were reported, the follow-up was between 17 months to 9 years. It's a rare tumor in childhood, 160 cases were reported. The clinical and evolutive mode were entirely comparable to the adult cases. However the initial appearance as benign atrophic or indurated plaque is more frequent in childhood, but this appearance wasn't noted in our series.

[Epidemiological, clinical and parasitological data concerning intestinal amebiasis in northern Tunisia]. / Données épidémiologiques, cliniques et parasitologiques concernant l'amibiase intestinale dans le nord de la Tunisie.

In order to evaluate the principal characteristics of the intestinal amoebiasis in the north of Tunisia, one retrospective study review all cases diagnosed in principal gastroenterologic sections of the hospitals of Tunis. Twenty height cases of intestinal amoebiasis, 10 of which have an inflammatory bowel disease associated were included. Watery stools containing blood and mucus were the most important symptoms (25 cases). The endoscopic exam showed for all the cases non specific lesions. The diagnosis was based on histologic exam in 21 cases, on the positivity of serologic tests in 3 cases and on the presence of E. histolytica/dispar cysts in stools in 6 cases. In two cases, the diagnosis was made by therapeutic test.

[Pustular psoriasis in childhood in 15 cases]. / Psoriasis pustuleux juvenile. A propos de 15 cas.

Psoriasis is a common, chronic and recurrent, inflammatory disease of the skin. Children were affected in 30% of cases. Severe form can be observed: pustular psoriasis (PP), psoriatic arthropathy and erythrodermic psoriasis. There were 15 children with PP, with an age range of 1-15.5 years, (mean age 7.56 years). Psoriasis constituted 5% of the total dermatological disorders in children. The severe forms of psoriasis were rare in children Annular PP was the most common form of PP in children. Juvenile PP had generally better prognostic than in adults, but the evolution is characterized by recurrences.