ABSTRACT
It is a rare tumor characterized by a good prognosis even in metastatic cases. Its etiopathogenesis is still controversial and the anatomopathological progress permits for the best comprehension of these tumors. It's a case revealed by an abdominal pain witch the diagnosis was done by a histological study aided by an immunohistochemistry analysis of the excised tumnor. This pathology represents 0.7 to 2.7% of all cases of the exocrine tumors of the pancreas, with a female predominance and the average age is 22 years old. The clinical picture is not specific and may be discovered by chance. The diagnosis is based on histological study. It shows a tumoral proliferation of a pseudopapillary shape composed of small sized cells adherent to the fibrovascular axes. The differential diagnosis between these tumors and essentially the neuroendocirne tumors is based on the immunohistochemistry analysis. The treatment is essentially surgical with a good prognosis even with metastatic cases. The diagnosis of solid pseudo-papillary tumor of the pancreas bases on histological study aided by an immunohistochemistry analysis. Its good prognosis justifies a surgical radical treatment. The visible increase of its incidence is the likely consequence of a better knowledge of this pathology
ABSTRACT
It is a very rare affection even in our country which is a tuberculous endemic country. The physipathological mechanism is still controversial, lithiasis plays a role in supporting the tuberculous localization in the gallbladder which decreases the vesicular resistance against bacillus of Koch. It is about a case of tuberculosis of the gallbladder of an operated patient for chronic lithiasis cholecystitis which appears to have a direct relation with the vesicular lithiasis. Its diagnosis depends on the histological examination of the piece of cholecystoctomy. This pathology represents 1% of the digestive turberculosis localization. Its clinical signs are not specific. The biological assessment shown the presence of blooc lymphocytosis which is in favor of a possible tuberculosis, but rarely found. The only certitude diagnosis is the anatomopathological examination of the excised piece of cholecystoctoy by finding the evidence of the epitheloidal and granulomatous inflammation and cellular overgrowth with caseous necrosis. The physiopathological mechanism is still discussed. The presence of calculus resulting in disappearance of biliary acids and provokes a non specific inflammatory reaction to the vesicular mucosa which decreases the vesicular resistance against bacillus of Koch. This possibility shows an increase in frequency in the developed countries due to the emerging of AIDS. The impact of the lithiasis on the appearance of this specific inflammation is possible but remains discussed. Its treatment is medico-surgical