Search

Background: Transrectal prostate biopsy is a major prostate cancer diagnosis procedure that can cause infectious complications. Osteoarticular localization is uncommon. Aim: To report a case of spondylodiscitis due to a transrectal prostate biopsy and highlight therapeutical principles. Case Presentation: A 60-year-old male underwent transrectal prostate biopsy performed because of high PSA level, and presented 48 hours later with back pain, fever at 40°C associated with an obnubilation. He was treated for malaria without favorable evolution. Persistance of pain and occurrence of neurologic manifestations motivated dorso-lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) which permitted diagnosis of spondylodiscitis. The treatment was made by triple antibiotic therapy combining Imipenem 500 mg/8h (IV); Ofloxacin 200 mg/12h (IV) and Metronidazole 500 mg/8h (IV) over four weeks. Evolution under treatment was favorable. Conclusion: Spondylodiscitis is an exceptional complication of transrectal prostate biopsy. It may be evocated in case of bones pain after prostate biopsy.

Background: This study aimed to describe the results of mammography done during breast cancer awareness campaigns in Lome. Methods: This was a retrospective multicenter study which focused on the analysis of mammographic examinations, with or without breast ultrasound, carried out in three (3) clinics in Lome over a period of five (5) years during the breast cancer awareness month (Pink October) campaigns. We included in our study women of all ages who underwent a mammography during the study period. Additional ultrasound was performed as needed in some women to better characterize a lesion. The parameters studied were socio-demographic data, and aspects of breast lesions. We classified the lesions in order of severity according to the BI-RADS classification. Results: During the study we counted one thousand and seventy-four (1074) women who underwent mammography examinations, corresponding to an average of 214.8 women per year. The median age of the women was 46 years. The most represented age group was 40 - 49, constituting 30% of cases. Mammography was performed on all women and ultrasound was performed on 51.3% of women. Lesions suspicious for malignancy (BI-RADS IV) and lesions highly suggestive of malignancy (BI-RADS V) represented 3.5% and 1.9% of cases respectively, amounting to a prevalence of 5.4%. They occurred more frequently from the age of 30 years with a statistically significant difference (p = 0.02). These lesions could be identified on mammograms as masses with irregular shapes and spiculated margins representing 16.1% and 9.7% of masses respectively. On ultrasound, these were solid masses with irregular and ill-defined borders, representing 25.2% and 5.2% of solid masses respectively. Lesions suspicious for malignancy were most often found in the UOQ (upper outer quadrant) in 70% of cases. Conclusion: Mammography screening for breast cancer remains a necessity in our community, even if the rate of cancer detected remains low. It allows for early diagnosis of cancers, promoting better management.

Background: This study aimed to determine the level of continuing medical education (CME) of medical imaging technicians in French-speaking West Africa. Materials and methods: This opinion survey was administered to radiology technicians in French-speaking West Africa from 1st June to 31st October 2020, i.e. over a period of 5 months concerning their level of CME and their need for CME. Results: Out of 100 technicians, 69% were men. The mean age was 40 years, with extremes ranging from age 23 to age 57. The majority of technicians (64%) worked in the public sector and 78% had work experience of less than 11 years. Most technicians were holders of a Bachelor’s degree (73%). The types of CMEs they knew were congresses, seminars, and modular training in 46% of the cases. The most available CMEs were seminars (63%). All technicians agreed on the need for CME and 96% said it had an impact on the delivery of radiology services. Technicians who had received CME at least once represented 61%. For 90% of technicians, the specific CME sought was management in radiology (33.33%) and radiation protection (25.81%). Conclusion: The need for CME is increasingly indisputable to radiology technicians in French-speaking West Africa; however, it remains a luxury for them, due to its scarcity and its high cost.

Background: Radiology in elderly as pediatric radiology poses a number of problems. The normal radiological appearance of the elderly patient’s chest is very varied and the changes are ubiquitous. Purpose: To describe the computed tomography profile of the elderly subject’s chest. Materials and Methods: Descriptive prospective study from January 1st to June 30th, 2018 carried out at the University Campus Hospital of Lome. Results: We recorded 64 chest CT scans. The average age of the patients was 71.3. Internists (n = 21, 32.8%) and general practitioner (n = 16, 25%) were the major applicants for these tests. In most cases, thoracic CT examinations were requested as part of an extension assessment (n = 21, 32.8%), dyspnea and pneumonitis in 18.8% of cases each. All thoracic CT examinations were performed with contrast injection. CT with the TAP protocol was the most observed, accounted for more than half of the exams (56%). The main pathological lesions observed were diffuse parenchymal lesions (39.5%), pleurisy (11.1%) and PAH (11.1%). Conclusion: Computed tomography occupies an important place in the care of the elderly but the actors involved in their care must be trained to take optimal care.

We report the case of a 50-year-old patient, who was explored in mammography, ultrasound and CT for a large painful mass of the right breast that had been evolving for 30 years and gradually increasing in size. There was a typical “sausage slice” appearance with clear center macrocalcifications on the mammogram; an aspect of “breast in the breast” on ultrasound. The scanner had made it possible to specify the dimensions of the mass, which measured 21.4 cm in height; 18.6 cm wide and 9.5 cm thick. Histology after exeresis noted the adenolipofibromatous nature of the mass.

Background: Core needle biopsy (CNB) under ultrasound guidance is an accepted standard of care for the diagnosis of breast lesions. It is safe, cost-effective and minimally invasive compared with surgical excision. Objective: The aim of this study was to evaluate the CNB’s results regarding the procedure, complications, histopathological findings and their correlation with the imaging data and surgical histopathological findings. Method: A cross-sectional prospective and descriptive study of a consecutive series of ultrasound-guided CNB of breast lesions in women conduced from January 2015 to December 2016 at the Sylvanus Olympio university hospital of Lome, in Togo. Results: There were 72 CNB performed under ultrasound guidance in women; from which 54 were retained for the study. The mean age was 44.9 years ± 9.8. 11.1% had a family history of breast cancer. Lesions were most often palpable (90.7%). They were located in the left breast in 54.7%. Lesions were categorized probably malignant or malignant (Birads 4 and 5) in 70.4% and probably benign (Birads 3) in 29.6%. Their mean size was 24.8 mm ± 7.6 at ultrasound. There were no major complications during the procedure. One CNB (1.9%) considered inconclusive was repeated. Histologically, invasive ductal carcinoma (61.1%) was the most common lesion. Fifty-three women underwent surgical procedure and histopathological confirmation. Ultrasound-guided CNB had a sensitivity of 97.5%, specificity of 100%, positive predictive value of 100%, negative predictive value of 92.8%, and an overall diagnostic accuracy of 98.1%. Breast Imaging Reporting and Data System (Birads) categorization had a sensitivity of 94.8%, specificity of 100%, positive predictive value of 100%, negative predictive value of 87.4%, and diagnostic accuracy of 96.2%. Conclusion: Ultrasound guided CNB represent accurate methods for the characterization of breast lesions, with high values of diagnostic accuracy, sensitivity, specificity and negative predictive value. It does not involve a major complication, even in tropical environments.

Studies of male breast cancer are rare in Africa. In Togo in particular, no work has focused on the epidemiological, mammo-echographic, pathological, therapeutic or prognostic aspects of male breast cancer. The aim of this study is to report cases of male breast cancer in Togo by describing the main epidemiological, mammo-echographic and pathological aspects. This was a retrospective, descriptive and analytical study of 10 cases of male patients presenting with breast cancer confirmed by the pathologic examination on the echo-guided samples over a period of 6 years in University Teaching Hospital in Lome. A total of ten patients were retained. The mean age of patients was 55 years with extremes of 39 years and 65 years. All patients had a palpable breast mass. The lesions were classified in 60% American College of Radiology (ACR) 5 and 40% ACR 4. The axillary lymph node invasion rate was 40%. Infiltrating ductal carcinoma was the histologic type diagnosed in all patients. Any breast mass in an elderly male subject is suspected with high predictive value. Mammography ultrasound plays an important role in the diagnosis alongside pathology.

Background: In French-speaking sub-Saharan Africa, thanatological imaging is not integrated into the training of radiology technicians. Thus, this raises a question about the knowledge level of radiology

Wandering spleen is a rare pathology. Spleen infarction which results from the torsion of the pedicle is its main complication. We report a case of torsion of a wandering spleen diagnosed by computed tomography. The therapeutic sanction was a splenectomy because of the infarction. Nowadays, splenopexy is the best treatment if the diagnosis is done early.La rate ectopique ou baladeuse est une entité pathologique rare. Sa complication majeure est la torsion de son pédicule pouvant conduire à un infarctus splénique. Nous rapportons un cas de torsion de rate ectopique dont le scanner avait permis de poser le diagnostic. La splénectomie a été la sanction thérapeutique à cause de son infarcissement. Actuellement, la splénopexie est proposée quand le diagnostic est fait précocement.