Profil histo-épidemiologique des adénopathies cervicales chroniques au Congo - Brazzaville

Les adénopathies cervicales chroniques sont celles qui évoluent depuis plus de trois semaines de façon non résolutive. Elles posent un problème de diagnostic étiologique et peuvent annoncer une affection grave. Matériel et méthodes : Il s'est agi d'une étude descriptive et rétrospective allant du 01 juillet 2007 au 31 juillet 2017, soit une période de 10ans. Cette étude s'est déroulée dans les services d'ORL du CHU-B et de l'Hôpital Général Adolphe SICE. Résultats : Au total 100 cas d'adénopathies cervicales chroniques ont été colligés en 10 ans, soit une prévalence de 1,8%. Le sex-ratio était de 1,17 et la tranche d'âge la plus représentée était celle de 20 à 29 ans avec une moyenne d'âge de 30,8±15,8 ans. La plupart des patients avaient une poly-adénopathie cervicale et une fièvre comme signe associé (64% des cas). Les lésions histopathologiques en cause étaient la tuberculose ganglionnaire (49%), les lymphomes ganglionnaires (21%), les adénites réactionnelles (15%), les métastases des carcinomes (11%) l'histiocytose ganglionnaire (2%) et la maladie de CASTLEMAN (2%).Conclusion : La pathologie ganglionnaire cervicale au Congo reste dominée par la tuberculose, suivie des proliférations lymphoïdes malignes et réactionnelles. L'examen anatomo-pathologique standard est complété par une étude immunohistochimique pour un diagnostic étiologique plus précis

Kikuchi-Fujimoto's disease presenting as acute cerebellar ataxia

Kikuchi-Fujimoto disease (KFD) is a benign and self-limiting condition primarily affecting the cervical lymph nodes. Central nervous system involvement with acute cerebellar symptoms is a rare presentation in KFD. We report a 15-year-old girl presenting with intentional tremor, dysarthria and gait ataxia following episodes of recurrent fever and cervical lymphadenopathy. The diagnosis of KFD was made based on histopathology. Brain magnetic resonance imaging showed lesions in mid-pons and bilateral middle cerebellar peduncles. The patient's symptoms spontaneously resolved without any sequelae. A diagnosis of KFD should be considered when enlarged cervical lymphnodes are observed in patients with acute cerebellar symptoms. Selective inflammation of cerebellum and related structures by viral or immunological responses may be attributed to this rare presentation in KFD

Clinico-Pathological Pattern of Nasopharyngeal Carcinoma in Ilorin, Nigeria

Nasopharyngeal carcinoma is an uncommon tumour in Nigeria but the burden of the disease in terms of morbidity and mortality is very high. The aim of the study was to document the clinic-pathological characteristics of nasopharyngeal carcinoma in Ilorin, North central Nigeria. This was a retrospective review of all patients seen in ENT department, University of Ilorin Teaching Hospital with the diagnosis of nasopharyngeal carcinoma between January 1st 1999 and December 31st,2008. The patient's biodata, clinical presentation and histopathological findings are presented. The histopathological diagnosis was in accordance with the 1991 WHO classification. A total of 30 patients with histologically confirmed nasopharyngeal carcinoma seen during the study period accounted for 2% of the total cancers recorded in Ilorin cancer registry. There were 20 males and 10 females with a mean age of 48.7 ± 15.9 years. The commonest presenting complaint was cervical lymphadenopathy in 96.7% of patients followed by epistaxis (66.7%) and hearing loss (66.7%). Identifiable risk factors included regular intake of ungutted salted smoked fish (76.7%) and tobacco use (23.3%) with some having both risk factors. Histologically, undifferentiated carcinoma was the commonest (70%) followed by welldifferentiated keratinizing squamous cell carcinoma (20%) and differentiated nonkeratinizing squamous cell carcinoma (10%).Undifferentiated carcinoma was the commonest type of nasopharyngeal carcinoma reported from this study especially among males in the 4th and 5th decades of life. Identifiable risk factors included consumption of ungutted salted smoked fish with tobaccon usage. Early diagnosis with effective referral system and easy access to radiotherapy would improve the survival outcome in patients with the disease

Radiographic evaluation of lymphadenopathy in pulmonary tuberculosis in Northeastern; Nigeria

BACKGROUND: There is changing pattern of presentation of tuberculosis in the era of HIV Lymphadenopathy is one of the most important manifestations of tuberculosis, hence the need for the evaluation of its radiologic patterns. METHODS: A multi-centre retrospective study of chest radiographs of 116 adult patients diagnosed bacteriologically (positive sputum smear) as pulmonary tuberculosis was conducted in the University of Maiduguri Teaching Hospital, Maiduguri, and Federal Medical Centre Nguru, in Bomo and Yobe States, Nigeria, respectively between April 2003 and March 2004. Lymphadenopathy was assessed in all the radiographs. RESULTS: Of the one hundred and sixteen radiographs of patients analyzed, there were 83 (71.6%) males and 33 (28.4%) females with mean age of 37.99 +/- 14.11 years. A total of thirty eight patients (32.7%) presented with lymphadenopathy with the highest frequency in the left hilar region (12.9%). Bilateral hilar and paratracheal lymphadenopathy were the lowest with equal percentages (4.3%). Left, right and bilateral hilar enlargement were more common in males than females (p < 0.000) and more patients had left hilar (15) than right hilar (13) enlargement (p = 0.030). Only 3 (2.6%) out of all the patients presented with lymph node calcification. CONCLUSION: In conclusion, there is a rise in the prevalence of lymphadenopathy among pulmonary tuberculosis patients when compared to a previous study done in the pre-HIV era in Nigeria