Pseudo-polymyositic aspect of amyotrophic lateral sclerosis

The causes of skeletal muscle weakness are multiple and their diagnosis is difficult, particularly in atypical myopathy. We report the observation of 58-old woman, who presents a muscle weakness of lower limbs with elevation of muscle's enzymes. These symptoms were bound initially to polymyosistis. However, the absence of inflammatory biologic syndrome and the results of muscular biopsy, make this diagnosis unlikely. The aggravation of the myopathy with extension to spinal muscles, the apparition of fasciculations and bulbar signs, the results of the electromyogram pose the diagnosis of amyotrophic lateral sclerosis.     

Multiple lymphomatous polyposis of the gastrointestinal tract: a Tunisian case

Multiple lymphomatous polyposis is a distinctive primary gastrointestinal lymphoma which endoscopical, histopathological et immunophenotypical characteristics are well known. This lymphoma is rare and its prognosis is bad because of frequency of stage IV patients. We report the case of a 75-year-old male patient with multiple lymphomatous polyposis affecting the rectum, the colon and the stomach associated with an involvement of lymphadenopathies, bone marrow and liver. Treatment by chemotherapy was ineffective and patient dead after 3 sessions of CEOP protocol.     

Actinomycosis: report of 21 cases. Experience of the Anatomy and Cytopathologic Pathology Laboratory of the Rabta Hospital

Actinomycosis is a chronic suppurative granulomatous disease caused by an anaerobic Gram positive germ, Actinomyces. From 1994 to 1999, 21 cases of actinomycosis have been diagnosed in our laboratory. The main localisations were cervicofacial and gynecologic the diagnosis relies on histopathologic examination that shows actinomycosic granules.     

Autologous hematopoietic stem cell transplantation for mediastinal extramedullary plasmocytoma

Extramedullary plasmocytoma (EMP) is a rare cell neoplasm most frequently localised in the upper respiratory tract. We report the case of a 43 year-old-man, with an unusual presentation of EMP developing in the mediastinum, two years after a diagnosis of solitary plasmocytoma of the bone which was successfully treated by local irradiation. In this aggressive presentation, we decided to perform an autologous hematopoietic stem cell transplantation. Two months after transplantation, CT scan showed disappearance of the mediastinal mass and immunofixation of the serum was normal. Selected cases of diffuse EMP, could benefit from intensive treatment followed by autologous hematopoietic stem cell transplantation.     

Endometrioid carcinoma of the Fallopian tube arising in tubo-ovarian endometriosis. A case report

The primitive endometrioid carcinoma of the fallopian tube is exceptional. Only three cases have been reported in the literature. Its rise on tubal endometriosis like for the ovary needs to meet the strict histological criteria established by Sampson and Scott in 1953. We report one case observed on a patient aged 45 years, who needed a total hysterectomy with bilateral annexectomy for menometrorrhagias associated to uterine leiomyomas which resisted to medical treatment. The finding of a primitive intra-epithelial endometrioid carcinoma of the left fallopian tube developed on bilateral tubo-ovarian endometriosis was fortuitously found during histological examination. Our observation seems to be unique since it shows an evident filiation between the lesions of tubal endometriosis and the adjoining endometrioid carcinoma contrary to the similar unique case reported in the literature where the link between the two lesions has not been demonstrated.