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ABSTRACT: La malakoplakie est une maladie inflammatoire granulomateuse chronique, qui affecte généralement le tractus génito-urinair
e et moins fréquemment les autres sites tels que le rétropéritoine et le tractus gastro- intestinal. L’origine infectieuse
associée à un déficit dans la digestion macrophagique des bactéries est la théorie physiopathologique la plus soutenue. Sa
définition est anatomopathologique. Les auteurs rapportent un cas de malakoplakie rétropéritonéale pseudotumorale chez un
patient sous corticothérapie au long cours admis aux urgences pour une masse douloureuse et fébrile du flanc gauche. Les explorations
radiologiques étaient en faveur d’une collection abcédée nécessitant un drainage chirurgical en urgence. L’examen histologique
des prélèvements réalisés au niveau de la graisse rétropéritonéale révélait une inflammation granulomateuse faite d’histiocytes
dénommés cellules de Von Hansemann, renfermant des granulations pathognomoniques de Michaelis-Gutmann. Le patient a été mis
sous traitement médical à base de ciprofloxacine avec bonne évolution clinique et radiologique.
Malacoplakia is a granulomatous inflammatory disease, has a preference for the urogenital tract and less frequently affects
gastrointestinal tract and the retroperitoneal region. It is caused by a disorder of macrophage bactericidal function. Its
definition is pathological. We report the unusual case of a male patient who was under long term corticotherapy to the long
course. He presented with retroperitoneal pseudotumoral malacoplakia revealed by left flank mass and pain. Radiological examination
showed a pararenal abscess localized in the retroperitoneum and extended to psoas muscle. Pathological examination for biopsy
specimen confirmed the lesion to be malakoplakia characterized by the presence of von Hansemann cells and Michaelis-Gutmann
bodies. The patient was treated with ciprofloxacin. He remains on a regular check-up with good clinical and radiological response.
Mots clésMalakoplakie–Michaelis-Gutmann–Rétropéritoine
African Journal of Urology 04/2012; 16(2):65-68.
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ABSTRACT: L’adénomyome de l’ampoule de Vater est une lésion bénigne qui peut simuler, tant dans sa présentation clinique que dans son
expression iconographique, une pathologie tumorale du carrefour biliopancréatique. Ces similitudes conduisent à la réalisation
de duodénopancréatectomies céphaliques inutiles. Nous rapportons deux cas d’adénomyome de l’ampoule de Vater ayant conduit
à une duodénopancréatectomie céphalique. L’analyse de ces cas et la revue de la littérature montrent que la connaissance de
cette pathologie, tant du point de vue de l’imagerie que de l’anatomopathologie, associée à des explorations invasives pré-
et peropératoires (biopsies sous échoendoscopie, examens extemporanés) permettent parfois de confirmer l’existence d’adénomyome,
ce qui permet d’éviter des résections inutiles.
Adenomyoma of ampulla of Vater is a benign neoplasm but its clinical and radiological features are similar to pancreatic or
biliary cancer. These similarities lead to the realization of unnecessary pancreaticoduodenectomy. We report here two cases
of adenomyoma of the ampulla of Vater treated by pancreatoduodenectomy. The analysis of these two cases and the review of
literature show that radiological and pathological knowledge of this disease, associated with pre- and intra-operative evaluation
(echoendoscopyguided biopsy, intraoperative biopsy), can achieve diagnosis and thus may avoid inappropriate resection.
Mots clésAdénomyome–Ampoule de Vater–Duodénopancréatectomie céphalique
KeywordsAdenomyoma–Ampulla of Vater–Pancreatoduodenectomy
Acta Endoscopica 04/2012; 41(3):141-144. · 0.09 Impact Factor
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ABSTRACT: RésuméLes tumeurs pseudopapillaires et solides du pancréas (TPPSP) sont des tumeurs rares qui atteignent dans la plupart des cas
des femmes jeunes. Leur pronostic est relativement favorable, avec un faible potentiel de malignité. Nous rapportons quatre
nouvelles observations. Le but de ce travail était de rapporter, de préciser les caractéristiques anatomocliniqes de cette
tumeur rare et de discuter son histogenèse.
Matériel et méthodeÉtude rétrospective ayant porté sur quatre patientes marocaines opérées entre janvier 2005 et janvier 2009. Les dossiers ont
été identifiés dans une banque de données anatomopathologiques constituée rétrospectivement. Une étude immunohistochimique
a été réalisée dans tous les cas.
RésultatsIl s’agissait de quatre femmes avec une médiane d’âge de 38 ans (15–69 ans). Une masse abdominale aux dépens du pancréas était
le principal symptôme clinique. La taille tumorale était comprise entre 7 et 11 cm. Toutes les patientes ont bénéficié d’une
résection chirurgicale sans aucun traitement adjuvant. Une complication sévère était survenue dans un cas. L’évolution était
favorable chez nos quatre patientes, sans récidive, avec un recul moyen de 24,4 mois (6 et 48 mois).
ConclusionLes TPPSP sont des tumeurs rares qui présentent des caractéristiques clinicopathologiques distinctes. En dépit de diverses
études, l’histogenèse reste indéterminée. Cette tumeur doit être distinguée d’autres tumeurs du pancréas, car son pronostic
est excellent après résection chirurgicale complète.
AbstractSolid pseudopapillary tumours of the pancreas is a rare neoplasm, for the most part, affects young women and has a relatively
favourable prognosis with a low malignant potential. We report 4 new cases. Our objective is to specify clinical and pathological
characteristics of this rare neoplasm and to discuss its histogenesis.
MethodsA retrospective review was considered on 4 Morrocan patients who had solid pseudopapillary tumours of the pancreas managed
between January 2005 and January 2009. A review of medical registries and morphological analysis with immunohistochemical
study were carried out in all cases.
ResultsThe 4 patients were female with a median age 38 years (range: 15–69 years). Abdominal mass was the most common initial symptom.
Tumour size was between 7 and 11 cm. All patients underwent surgical resection. No adjuvant therapy was recommended. Mean
follow up period was 24.4 months (range: 6–48 months). A severe complication occurred in one patient. Except for this patient,
none experienced tumour recurrence ortumour-relatedmortality during the follow up period.
ConclusionSolid pseudopapillary tumours of the pancreas is an uncommon neoplasm which shows distinct clinicopathological characteristics.
Despite diverse studies, its histogenesis remains undetermined. This tumour should be distinguished from other pancreatic
neoplasms because its prognosis is excellent after surgical resection.
Mots clésTumeur pseudopapillaire et solide-Pancréas-Anatomie pathologique
KeywordsSolid pseudopapillary tumors-Pancreas-Pathological anatomy
Journal Africain d?Hépato-Gastroentérologie 04/2012; 4(3):161-165.
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ABSTRACT: IntroductionLa pseudotumeur fibreuse calcifiante est une tumeur bénigne rare composée histologiquement de paquets épais de collagène,
de fibroblastes, et de corps psammomateux avec calcifications. Nous présentons un cas de pseudotumeur fibreuse calcifiante
de l’intestin grêle révélée par une invagination intestinale aiguë. À notre connaissance, c’est la seconde observation décrite
au niveau du tractus gastro-intestinal.
Observation cliniqueIl s’agit d’une femme âgée de 37 ans ayant présenté un syndrome occlusif. L’abdomen sans préparation avait objectivé des niveaux
hydroaériques. La tomodensitométrie a montré l’image en cocarde en faveur d’une invagination intestinale aiguë. L’examen macroscopique
de la résection intestinale a montré la présence d’un polype mural sessile blanchâtre mesurant 1 × 1 cm dur à la coupe. L’examen
histologique a posé le diagnostic de pseudotumeur fibreuse calcifiante. À l’immunohistochimie, les cellules ont montré un
marquage positif par la vimentine, et négatif par l’actine muscle lisse, desmine, protéine S100, CD34 et bcl2.
DiscussionLa pseudotumeur fibreuse calcifiante est rare, décrite essentiellement au niveau des tissus mous, la plèvre et le péritoine.
La localisation grêlique est extrêmement rare. La pathogénie demeure incertaine. Nous discutons, à travers notre observation,
avec une revue de la littérature des aspects histopathologiques, des problèmes du diagnostic différentiel et des modalités
thérapeutiques de ce cas le plus peu commun.
IntroductionCalcifying fibrous pseudotumor is an unusual benign tumor whose unique histological features consist of thick collagen bundles,
scattered fibroblasts, psammomatous and dystrophic calcification. We present a case of calcifying fibrous pseudotumor of the
small bowel. To our knowledge, this is the second such case to be described in the gastrointestinal tract.
Case reportThe present case is a 37-year-old woman with occlusive syndrome. A computed tomography scan revealed a sign of acute intestinal
invagination. The macroscopic examination of the intestinal resection indicated the presence of a white wall polyp measuring
1 × 1 cm with calcification. Histologic examination posed the diagnosis of calcifying fibrous pseudotumor. In immunohistochemistry
spindle cells tested positive for vimentin and negative for smooth muscle actin, desmin, S100 protein, CD34 and bcl2.
DiscussionCalcifying fibrous pseudotumor is one of the benign tumors and is located mostly in soft tissues, pleura and peritoneum. Its
location in the gastrointestinal tract is extremely rare. The pathogenesis remains uncertain. We discuss through our observation,
accompanied by a review of the literature, the histopathological features, the problems of differential diagnosis and the
surgical treatment of this most unusual case.
Journal Africain d?Hépato-Gastroentérologie 04/2012; 2(1):31-33.
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ABSTRACT: Le mélanome anorectal est une tumeur maligne rare. Elle représente moins de 2 % des mélanomes et moins de 4 % des tumeurs
malignes anorectales. C’est une pathologie de l’adulte qui est de mauvais pronostic. Le but de notre travail est d’évaluer
l’apport de l’étude microscopique dans le diagnostic positif de ces tumeurs. Nous rapportons deux observations de mélanome
anorectal colligées au service d’anatomie pathologique du CHU Ibn-Sina de Rabat au Maroc. La première patiente était âgée
de 47 ans et a consulté pour rectorragies et douleurs périnéales. La rectosigmoïdoscopie a révélé une tumeur brunâtre ulcérobourgeonnante
à 1 cm de la marge anale avec infiltration périnéale. La TDM abdominopelvienne a permis de retrouver des adénopathies profondes
avec compression urétérale bilatérale. L’étude anatomopathologique a posé le diagnostic de mélanome malin. La seconde patiente
était âgée de 50 ans et présentait des rectorragies avec, à la rectosigmoïdoscopie, une tumeur anale remontant jusqu’à 10
cm dans le rectum. L’étude microscopique a posé le diagnostic de mélanome anorectal. Le mélanome anorectal est une tumeur
maligne rare. La latence de la traduction clinique et l’absence de la suspicion diagnostique du fait de la rareté de la lésion
contribuent au retard de prise en charge. La confirmation du diagnostic repose essentiellement sur l’étude histologique couplée
à l’étude immunohistochimique. Le traitement est chirurgical en cas de résécabilité associée aux thérapeutiques adjuvantes
radiochimiothérapiques. Le pronostic reste sombre du fait des métastases synchrones au moment du diagnostic.
Anorectal melanoma is a rare malignant tumor. It represents less than 2% of melanomas and less than 4% of malignant anorectal
tumors. It is an adult pathology of poor prognosis. The purpose of our study is to assess the contribution of the microscopic
examination in the positive diagnosis of these tumors. We report to observations of the department of pathology of the Ibn-Sina
hospital Rabat, in Morocco. The first patient was 47 years old and presented rectal bleeding and perineal pain. Rectosigmoidoscopy
revealed a brownish ulcerated and budding tumor at 1 cm of the anal margin. Computed tomography of the pelvis showed deep
lymph nodes and bilateral ureteral compression. Pathologic examination concluded to the diagnosis of anorectal melanoma. The
second patient was 50 years old and presented rectal bleeding with an anal tumor that rises to 10 cm in the rectum at the
rectosigmoidoscopy. Microscopic study revealed an anorectal melanoma. Anorectal melanoma is a rare tumor. The absence of early
clinical manifestations and the lack of clinical suspicion due to its infrequency contribute to delayed diagnosis. The confirmation
of the diagnosis is based principally on the histological study coupled with immunohistochemistry. Surgery is the main treatment
when it is technically feasible associated to adjuvant therapeutics such as chemotherapy and irradiation. The prognosis remains
poor because of synchronous metastasis when the tumor is diagnosed.
Journal Africain d?Hépato-Gastroentérologie 04/2012; 3(4):216-218.
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ABSTRACT: Les tumeurs myofibroblastiques inflammatoires (TMI) sont des tumeurs de classe intermédiaire. Elles sont rares et d’étiologie
inconnue. Décrites initialement au niveau des poumons, elles ont été observées dans plusieurs autres localisations, essentiellement
abdominales et pelviennes. Sa localisation au niveau de l’estomac est extrêmement rare. Nous rapportons l’observation d’une
patiente âgée de 52 ans, qui présentait une tumeur gastrique de localisation extraluminale associée à une sensibilité épigastrique
sans masse palpable. L’échographie et le scanner abdominal ont mis en évidence une masse de 7 cm siégeant entre le foie et
l’estomac. Après l’exérèse chirurgicale de cette masse, l’examen histologique et immunohistochimique était en faveur d’une
TMI gastrique. Les caractéristiques cliniques et histologiques de cette entité anatomoclinique seront discutées à la lumière
des données de la littérature.
Inflammatory myofibroblastic tumor (IMT) is a clinical and pathological disease entity, which is an inflammatory lesion with
unknown etiology and is classified as intermediate neoplasm in theWorld Health Organization histological typing. It usually
originates from the lung, but can also arise in any sites in the body. IMT of the stomach in adults is extremely rare, with
unpredictable prognosis. We present a 52-year-old woman with exophytic tumor of the stomach. Physical examination showed mild
abdominal tenderness in the hypogastrium, but no palpable abdominal mass. Abdominal CT scan showed a mass of approximately
7 cm, between stomach and liver. The final diagnosis was consistent with the IMT that originated from the gastric wall. The
clinical and histopathological features of this rare lesion are described with a review of the previously reported cases.
Mots clésTumeur gastrique-Pseudotumeur-Tumeur myofibroblastique inflammatoire
KeywordsStomach meoplasm-Pseudotumor-Inflammatory myofibroblastic tumor
Journal Africain d?Hépato-Gastroentérologie 04/2012; 4(4):241-245.
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ABSTRACT: Gastrointestinal stromal tumors (GISTs) represent the majority of primary non-epithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by immunohistochemical staining for the CD117 antigen. Extragastrointestinal stromal tumors (EGISTs), neoplasms with immunohistological features overlapping those of GISTs, are found in the abdomen outside of the gastrointestinal tract with no connection to the gastric or intestinal wall. The present report presents the clinical, macroscopic and immunohistological features of an EGIST arising in the greater omentum of a 63-year-old woman, and discusses the clinical behavior and prognostic factors of such lesions in comparison to their gastrointestinal counterparts.
Gastroentérologie Clinique et Biologique 02/2011; 35(8-9):590-3. · 0.80 Impact Factor
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Revue des Maladies Respiratoires 09/2010; 27(7):751-4. · 0.59 Impact Factor
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Archives de Pédiatrie 07/2010; 17(7):1111-3. · 0.30 Impact Factor
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ABSTRACT: Pulmonary alveolar microlithiasis is a rare disease characterised by the formation and deposition of calcium phosphate microliths in the lung. It is an autosomal recessive disorder, for which mutation in the SLC34A2 gene was recently found to be responsible for the disease.
We report on four cases of pulmonary alveolar microlithiasis. Three patients were asymptomatic. The diagnosis was made after histological confirmation in three patients. The outcome was marked by the death of one patient.
Pulmonary alveolar microlithiasis is a rare disease. Diagnosis is made with high-resolution computed tomography, which exhibits the calcic character and distribution of the lesions, thus avoiding the need to perform lung biopsy. We suggest that a literature review be performed.
Revue de Pneumologie Clinique 11/2008; 64(5):221-4. · 0.24 Impact Factor
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ABSTRACT: Angiodysplasia is a relatively rare lesion that however may be a major source of upper and lower gastrointestinal bleeding. It's mostly related to the aging and degeneration of the blood vessels, as it occurs in older adults. Clinical presentation is variable, ranging from asymptomatic cases over iron deficiency anaemia to acute or recurrent bleeding. We present a case of 60 year-old woman presented with anaemia and intestinal obstruction. Diagnosis can usually be made using endoscopy, sometimes with additional biopsy. Treatment can be symptomatic, including iron supplements and transfusion therapy or causal, including therapeutic endoscopy (laser, electrocautery, heater probe or injection sclerotherapy), therapeutic angiography and surgery.
Revue médicale de Liège 04/2008; 63(3):149-52.
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I Tadlaoui,
S Qasmi,
F Belgnaoui,
J Bouhllab,
Y Afifi,
M Meziane,
K Senouci,
B Hassam,
F Zouaidia,
B El Khannoussi, N Mahassini
Annales de Dermatologie et de Vénéréologie 04/2008; 135(3):249-50. · 0.72 Impact Factor
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ABSTRACT: Intrathoracic neurogenic tumors are rare and interest primarily the mediastinum. Their endobronchial localization is exceptional, a fortiori in the child. The authors report a case of endobronchial benign schwannoma in a 11 year-old-child treated by pneumonectomy.
Archives de Pédiatrie 03/2008; 15(2):142-4. · 0.30 Impact Factor
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A Ibn Sellam,
A Chaibainou,
A Achir,
A Allouch,
Z Bernoussi,
A Jahid, N Mahassini,
L Achachi,
M El Ftouh,
A Benosman,
M T El Fassy Fihry
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ABSTRACT: Giant-cell tumors of bone are rare primary neoplasms commonly encountered in young adults. Women are slightly more affected than men.
We report the case a 27 year old woman presenting with a twelve months history of painful and progressively growing thoracic mass in the right anterior chest wall. Physical examination found out a fixed thoracic mass in the right retro-mammary area measuring 8 x 6 centimeters. The overlying skin was normal. Chest roentgenogram demonstrated a large ill defined mass continuing the anterior arc of the fourth right rib. Computed tomography evidenced a well defined pathologic process originating from the fourth right rib without expansion of the surrounding soft tissue. Pulmonary functional tests were normal and other complementary investigations evidenced no abnormalities. Our patient first had a fine needle cytological biopsy that brought strong suspicion of Giant-cell tumor of the rib. She then underwent an "en bloc" resection of the tumor whose histopathologic analysis allowed a definitive diagnosis. The post-surgical follow up during 12 months showed no signs of tumor recurrence.
Through this observation the authors emphasize not only the rarity of the giant-cell tumors of bone but also its unusual costal localization (few cases reported till date). They focus on the importance of precocious screening and treatment and underline the value of the follow up in order to detect timely any sign of local recurrence or sarcomatous transformation. Finally, they report a current review of the literature.
Revue des Maladies Respiratoires 12/2006; 23(5 Pt 1):453-7. · 0.59 Impact Factor
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ABSTRACT: Thyroid sarcomatoid carcinoma is a rare and aggressive neoplasm composed of a follicular carcinoma which is contiguous or admixed with a pleomorphic spindle cell component. We report the case of a thyroid tumor reputed to have a poor outcome, in a 62-year-old woman. The radical thyroidectomy specimen was totally invaded. Results of immunoperoxidase staining for thyroglobulin and epithelial markers were positive in the areas of follicular carcinoma and negative in the sarcomatous component. The patient died a few days later due to septic shock. The epithelial and mesenchymal components of thyroid carcinosarcoma were both part of the neoplastic parenchyma and evolved from a single common stem cell, in agreement with the hypothesis that the tumors are of monoclonal origin. The definition of this tumor as its histogenesis and prognostic are discussed.
Annales d Endocrinologie 04/2006; 67(1):64-8. · 0.74 Impact Factor
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ABSTRACT: Primary sarcomas of the great vessels, that is, the aorta, pulmonary artery, and inferior vena cava, are rare. They can be classified according to the location of the sarcoma in the vessel wall and by their gross appearance. Most often they are leiomyosarcomas or fibrosarcomas.
We report here a case of an intimal sarcoma of the inferior vena cava. Histological and immunohistochemical findings confirmed the diagnosis for this 17-year-old girl and distinguished it from leiomyosarcoma and angiosarcoma, both of which have better prognoses.
Intimal sarcoma of the inferior vena cava is rare and difficult to diagnose before surgery or biopsy. Histologically, it is a poorly differentiated tumor with the worst prognosis among the primary vascular sarcomas. Pathologic findings and immunohistochemical staining are useful for a positive diagnosis.
La Presse Médicale 12/2005; 34(20 Pt 1):1515-7. · 0.67 Impact Factor
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Revue de Pneumologie Clinique 10/2004; 60(4):226-8. · 0.24 Impact Factor
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ABSTRACT: Pleural fibroma, or fibrous tumor of the pleura, is an uncommon entity which is characterized by slow proliferation of undifferentiated, intermediary or mature fibroblasts associated with collagen fibers forming a tumor stroma. We report a case in a 49-Year-old man who developed exercise-induced dyspnea and right chest pain. The thoracic CT scan revealed the presence of a mass in the right lung base composed of heterogeneous encapsulated tIssue. Tumor resection was performed leading to the histological diagnosis of pleural fibroma. Immunohistochemistry tests revealed positive vimetin and CD34, and negative cytokeratin uptake. These immunohistochemistry data contributed to the differential diagnosis with malignant pleural mesothelium. Pleural fibroma is a benign tumor in 80% of the cases. Prognosis is excellent. Local recurrence is exceptional and generally occurs after incomplete resection. Radial surgical treatment determines the prognosis and is required to prevent local recurrence. Other criteria of malignancy are not correlated with the clinical course of this type of tumor.
Revue de Pneumologie Clinique 07/2004; 60(3):171-4. · 0.24 Impact Factor
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ABSTRACT: The malignant tumors of the inferior vena cava are rare. Their prognosis is bad. We report two cases of a 17-year-old and 46-year-old woman presenting the one an intimal sarcoma of the inferior vena cava and the other a metastatic of adenocarcinoma whose primary tumor was not identified. The aortic wall was invaded in both patients. The ureter repulsed in first case, was invaded in second case. The treatment consisted on resection of the tumor including the aortic wall with vein closure in both patients, with right nephrectomy in second patient. In the two cases, a prosthetic reconstruction of the arterial integrity was attempted with aortobiiliac bypass. The two patients died after relapse tumorous to the 6th month in first patient and by multisystem organ failure 5th day post-operative in second. Through these two personal cases, we try to point out the difficult problem of diagnosis that put these tumors and their bad prognosis despite an improvement of treatment.
Archives des maladies du coeur et des vaisseaux 05/2004; 97(4):362-5. · 0.40 Impact Factor
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ABSTRACT: This report describes a case of hepatic alveolar echinococcosis. To our knowledge it is the first documented report of human alveolar echinococcosis in Morocco. Alveolar echinococcosis of the liver is a relatively rare, severe chronic parasitic disease. It is characterized by slow-growing cysts that progressively invade and destroy the liver parenchyma like liver cancer. The discussion presents an update of the clinical, histologic, and therapeutic features of alveolar echinococcosis based on the findings in this case report and a review of the literature.
Médecine tropicale: revue du Corps de santé colonial 02/2004; 64(4):379-80.
