Search

Yolk sac tumours are rare germinal neoplasms that often arise in ovary and testis. Extragonadal localisations such as mediastinum, retroperitoneum, brain and vagina are uncommon. Primary intraperitoneal tumours are exceedingly rare. We report a case of a 16-year-old girl who underwent laparotomy for an acute abdominal pain and circulatory dysfunction. Abdominal exploration disclosed a large mass involving mesentery of the transverse colon associated to three hepatic nodules and abundant peritoneal bleeding. Segmental hepatic resection was performed and the mesenteric mass was removed. Microscopic examination of the pathologic specimen concluded to a yolk sac tumour. Patient underwent intensive chemotherapy; she's free of disease 2 years after diagnosis. Through this case, clinicopathologic features of this rare neoplasm will be discussed., (Copyright © 2010. Published by Elsevier Masson SAS.)

Malignant germ cell tumors of the ovary are rare representing 3% of all ovarian neoplasms. Hence, they are the most common ovarian malignancy in girls and young women and account for approximately two-thirds of the ovarian cancers that occur in the first two decades of life. Germ cell tumors constitute a heterogeneous group of tumors and are often mixed associating at least two different tumoral components. Exceptionally, sarcomatous areas can be found. We present a case of a 15-year old girl admitted for a voluminous left ovarian mass revealed by pelvic pain. Pathological examination of the dissected material revealed the tumor to be a mixed germ cell tumor (immature teratoma and yolk sac tumor) with rhabdomyosarcomatous component of embryonal type. Clinico-pathological characteristics of such ovarian tumors will be discussed with emphasis on diagnostic difficulties., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Primary mantle cell lymphoma of the digestive tract is uncommon; it rarely involves the stomach and generally manifests as a lymphomatous polyposis. Isolated gastric localization is exceedingly rare. We present a case of a 57-year-old man who presented with a six-month history of atypical epigastric pain. Endoscopy revealed a large ulceration of the gastric mucosa. Histological examination of the biopsied specimens concluded to a marginal zone B-cell lymphoma (MALT-type) of low-grade. Patient underwent two courses of anti-Helicobacter pylori therapy followed by chemotherapy, without endoscopic amelioration. Histological control showed the persistence of a nodular lymphomatous proliferation that respects glands. It was made of monotonous small cells reactive with CD5 and cyclin D1. The diagnosis of gastric mantle cell lymphoma was made. No other digestive or nodal localization was found. Patient underwent intensive chemotherapy anti-CD20; he was free of disease three years after diagnosis. Primary mantle cell lymphoma of the stomach is an uncommon neoplasm. Diagnosis is often difficult and requires the use of CD5 to exclude a MALT-cell lymphoma, which is much more frequent in this location., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)

Aim: Report a new case of primary Synovialosarcoma., Case: We report a case of a 16 year old girl, who presented with a tumefaction on the right clavicle evolving for 3 months. Various explorations carried out, in particular thoracic scanner and imagery by magnetic resonance, showed a multilocular cystic formation of the seat and the clavicle reaching the mediastinum. A pathological examination of the part (piece) highlighted a biphasic synovialosarcoma of grade III. This diagnosis was validated by the immunohistochemistry study and the detection of transcribed specific fusion of the synovialosarcoma, SYT-SSX1., Conclusion: The unusual locations of the primitive SS must be known because the diversity of their microscopic aspects may cause confusion in the diagnosis. The immunohistochemistry, and more recently the cytogenetic studies, helps to solve these problems of differential diagnosis.

Background: Non alcohol steatohepatitis is an acquired chronic hepatopathy frequently of metabolic origin. Histopathologically, it is characterised by a steatosis associated with necrotic inflammatory lesions mimicking alcohol hepatitis. This disease is complicated by cirrhosis in 15 at 30% of cases and by hepatocellular carcinoma in 13% of cases. The aim of our study was to evaluate the clinico-epidemiological features of this disease and the histopathological degree of hepatic failure., Methods: 9 cases of non alcohol steatohepatitis are diagnosed in our hospital in 3 years between 2001 to 2004. The clinical features of patients were determined. The aspect and extent of steatosis was noted and the degree of the necrotical activity was evaluated by the Lee score., Results: We observed strong women prevalence with a sex-ratio of 0.125 and a high frequency between 40 and 60 years. Obesity and diabetes are the most common metabolic disorders encountered in our series. In opposition to published cases, a hepatomegaly and signs of portal hypertension are the most frequent clinical lesions noted in our study. Histopathological evaluation of Lee score finds a mild to moderate activity and fibrosis in nearly all our cases. One case of cirrhosis is noted.

Background: Three main polyposis syndromes are transmitted as an autosomal dominant disorder: familial adenomatous polyposis (FAP), juvenile polyposis syndrome (JPS) and Peutz-Jeghers syndrome., Aim: Evaluate this management of digestive polyposis., Methods: Our study included 20 patients which were collected in th departements of pathology surgery and garstroenterology of MT Maarmouri's Hospital, Nabeul city., Results: We reported 15 cases of adenomatous polyposis with 2 family groups. We identified a family group of JPS with 3 members and 2 cases of Peutz-Jeghers syndrome. We found 11 cases of colonic adenocarcinoma out of the 15 patients affected by adenomatous polyposes. FAP is a generalized disorder involving the entire colorectum segment with numerous extra-colonic manifestations. The risk to develop colonic cancer is 100%. JPS is characterised by the development of numerous gastrointestinal juvenile polyps and occurs usually before 20 years old, the progression to cancer is rarely observed., Conclusion: Peutz-Jeghers syndrome consists in hamartomatous polyps associated to a characteristic mucosal pigmentation. The patients are usually young adults and have an increased incidence of cancer in extradigestive sites.

Tuberculous dactylitis is an uncommon condition which is particularly difficult to differentiate from other lesions, particularly tumors. Diagnosis must be confirmed by histology and/or bacteriology studies. We report the case of a 64-year-old diabetic woman who consulted for a painful tumefaction on her fourth finger of the left hand which had developed after minimal trauma. The x-ray of the hand visualized multiple bony defects involving the second phalanx of the fourth finger and a fracture. Pathology examination of a biopsy specimen revealed granulomatous osteitis with typical caseous necrosis. The clinical signs and radiographic images resolved after anti-tuberculosis treatment.

Necrotizing sarcoid granulomatosis is a rare granulomatous pulmonary angeitis that was first described by Liebow in 1973. We report the case of a 36-year-old woman who was admitted for exploration of chest pain, cough and fever at 39 degrees which had progressed for more than 2 months. Chest X-ray showed several inconstant pulmonary opacities. The physical examination, the radiographic and endoscopic aspects were non-specific. The diagnosis was made only by open lung biopsy which showed histological findings of necrotizing sarcoid granulomatosis. The opacities disappeared with no recurrence spontaneously at one year.

Inflammatory fibroid polyp is a rare benign tumor of the digestive tract. The authors report three cases: two intestinal and one gastric. These cases are of particular interest because of the association ill one case of an intestinal submucosal lipoma with the inflammatory fibroid polyp, and the existence in the gastric case of an inflammatory reaction caused by food debris. This offers, further evidence in support of the theory implicating a chronic inflammatory reaction.