A Collaborative Nationwide Lymphoma Study in Lebanon: Incidence of Various Subtypes and Analysis of Associations with Viruses

Incidence of various Hodgkin (HL) and non-Hodgkin lymphoma (NHL) subtypes and association with viruses in Lebanon are not known. We undertook a nationwide study of 272 patients diagnosed with lymphoma in 2007. HL comprised 32.7 % (n?=?89) of cases while NHL represented 67.3 % (n?=?183). Consistent with the literature, nodular sclerosis was the most predominant HL subtype (n?=?57/89). Among NHL, B-cell NHL represented 88 % (n?=?161/183), T-cell NHL 9 % (n?=?17/183), whereas in 2.7 % it was not classifiable. The B-cell NHL comprised predominantly diffuse large B-cell lymphoma (46 %) and follicular lymphoma (23 %). 81 cases were reviewed by a panel of pathologists with 87.6 % concordance rate. Serology was negative for hepatitis C in 122 tested cases. HIV was positive in 2 cases. Two adult T-cell leukemia/lymphoma were HTLV-I positive. EBV IgG were positive in 88.5 % of cases. 38 EBV seropositive cases [27 NHL (24 B-cell, 3 T-cell) and 11 HL] were studied for EBV genome expression using EBV-encoded RNA (EBER)-in situ hybridization. EBER expression was positive in 8 (21 %) cases (6 HL, 2 T-cell NHL). The distribution of lymphoma subtypes in Lebanon appears similar to that of Western countries. The high rate of EBV positivity in HL and T-cell lymphoma by EBER deserves further investigation.     

Atrial septum aneurysm. Report of 20 cases

Atrial septum aneurysm (ASA) is an uncommon congenital malformation, which is more frequently diagnosed since the introduction of transoesophageal echocardiography. ASA is often involved in the etiology of cerebral and systemic embolic events. The purpose of our study is to determine from our experience the frequency, the diagnostic aspect and therapeutic modalities of ASA. We report in this study 20 cases of ASA collected from the echocardiographic register. The prevalence of this malformation is 0.08%, with a high male predominance. The mean age was 51 years. ASA was detected after brain embolism in 55% of cases. The diagnosis was established in all cases by transesophageal echocardiography, however only 5 cases were diagnosed by Transthoracic echocardiography. The patients showed favorable evolutions after a of follow up of three years.     

Hydatid pulmonary embolism

Hydatid pulmonary embolism is an uncommon condition resulting from the rupture of hydatid heart cyst or the opening of a visceral hydatid cyst often in the liver into the venous circulation. We report a case of 60 years old woman, admitted to hospital for acute heart pulmonale due to fistulization of an hepatic hydatid cyst into the inferior vena cava.