Gastric MALT lymphoma. A clinico-pathological study of 65 cases. Relationship to Helicobacter pylori

We report 65 cases of MALT gastric lymphomas. HP was looked for with Giemsa and Whartin Starry stains. Immunohistochemistry was done with PAP method. Anti-HP treatment was used in 9 cases. 38 were of low grade of malignancy, 23 were high grade, 4 were high grade with a low grade component. The mean age was 51.5 years, the sex ratio 1.5. Epigastric pain was the most frequent feature (87.7% of cases). Endoscopically, low grade lymphomas presented as unique or multiple ulcerations (55.3% of cases) with antral localisation (52.6% of cases). 60% of our patients were stage IE, of which 61% had low grade lymphoma, 18% were at stage II2E, 10% at stage III and 10% at stage IV. From 23 operated patients, 29% had early lymphoma which was low grade malignant in 71.5% of cases, and 71% had lymphomas which were widely spread beyond the submucosa. HP was found in 63% of cases. Histologic regression of two early lymphomas of low grade malignancy was achieved after HP eradication.     

Nevus lipomatosus cutaneous superficialis: a clinico-pathological study of 13 cases

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare hamartomatous skin lesion histologically characterised by the presence of mature fat tissue within the dermis. Clinically, two types of NLCS can be distinguished: a multiple type of Hoffmann-Zurhelle and a solitary type. We report a retrospective study of 13 cases of NLCS seen in the Anatomopathological department of La Rabta hospital of Tunis during a period of 12 years (1992-2004). Two clinical forms were distinguished: the solitary form (11 cases) consisting of a unique papulo-nodular lesion and the multiple form (2 cases). Histologically, the tumor consisted in all cases on mature fat tissue.     

Sclerosing stromal tumor of the ovary. Report of 3 cases

Sclerosing Stromal Tumor (SST) is an uncommon benign tumor of the ovary, distinct from thecoma and fibroma because of predominant occurrence below 30 years of age, lack of hormonal manifestations and histologic heterogenity. Three cases of SST occuring in a 15, 26 and 56-year-old females are reported. Review of the literature and clinicopathological features are described in the present article. Histogenesis and differential diagnosis are also discussed.     

Rheumatologic manifestations of parvovirus B19 infection

Rheumatologic manifestations of parvovirus B19 infection is a recent individualization. They are rather frequent and varied and meet at the young adult's. Generally, it is responsible for acute, bilateral and symmetrical arthritis, usually involving distal joints and sometimes associated to signs caused by viral infections. Prolonged articular forms were discribed but are rare being able to sometimes feign a nocive rheumatoid arthritis because of their clinical aspect and of a seropositivity. Axial manifestations were also reported. The diagnosis of the recent infection by the parvovirus B19 can be confirmed by ELISA identification of specific IgM antibodies. The mechanism of the articular manifestations is still unknown and the link between parvovirus B19 and systemic vasculitis is questioned.     

Reactive arthritis

Reactive arthritis are definied as steriles arthropathies using classic bacteriological techniques. They are due to extra articular infection and are often associated with HLA B27. The outcome of these arthritis is characterised by the recurrence of flares with sometimes appearition of ankylosing spondylitis. The pathogenesis of reactive arthritis is modified when bacterial antigens or alive micro-organisms are discovered in involved joints. Several current works have underlined the interest of antibiotic therapy in the chlamydial reactive arthritis. Chronic forms can justify the use of anti-rheumatic drugs such as salazopyrine.     

Primary in situ squamous cell carcinoma of the endometrium,with extensive squamous metaplasia and dysplasia

BACKGROUND: Primary squamous cell carcinoma of the endometrium is exceedingly rare. It has been described in association with pyometra but its etiology is still unclear. CASE: The authors report the case of a 75-year-old woman who presented with pelvic pain and pyometra. No gross tumor was identified in the uterus; however, extensive epidermalization of the endometrial mucosa was noted. Microscopic findings were consistent with a primary in situ squamous carcinoma of the endometrium associated with extensive squamous metaplasia and areas of dysplasia. HPV antigen and DNA detection were negative in both the endometrial lesions and the cervix. CONCLUSIONS: These results support the sequence of change with squamous metaplasia, progressing through dysplasia to carcinoma as a possible pathogenetic process. HPV's role, however, remains uncertain.     

Lupus hepatitis

We report the case of 42 year-old man who presents an acute polyarthritis associated with systemic manifestation and immunologic disorders related to systemic lupus erythematosus. Hepatic tests show cholostase and cytolysis. Hepatic involvement is linked with systemic lupus erythematosus after exclusion of hepatotoxic drugs, viral hepatitis and absence of anti mitochondrial and anti muscle antibodies. Lupus hepatitis seems to be correlated with autoantibodies to ribosomal P protein. Its treatment remains to be defined.     

Endometrial adenofibroma: a rare entity

Endometrial adenofibroma is an uncommon mullerian mixed tumor composed of benign epithelial and mesenchymal components. This tumor must be distinguished from other malignant lesions of the uterus, particularly adenosarcoma. The authors report three cases of endometrial adenofibroma and discuss their clinical and histopathologic features. The tumors were diagnosed in patients 31, 55 and 63 years of age. In all three cases polypoid lesions of 13, 2 and 5 cm, respectively, were found in the uterine cavity. A polypectomy was performed in two cases; one patient underwent hysterectomy. Follow-up was available for two patients who are today alive and well.