[Abrikosoff's tumor: a clinicopathologic study of nine cases]

Abrikossoff's tumour or granular cell tumor or is a benign neurogenic tumour. It is ubiquitous with the most frequently affected site is the head and neck region. To report a series of granular cell tumors and to discuss its clinicopathologic features and histogenesis. We report a series of nine cases diagnosed between January 2004 and December 2006 in the Pathology Department of the University Hospital of Sfax. We have collected the clinical aspects and we have proceeded on a pathological, cytochemical [PAS and PAS diastasis] and immunohistochemical study. Nine cases of TCG are presented: 5 females and 4 males. The median age was 33.9 years [extremes: 7 and 53 years]. All tumours were unique. The most common localization was in the head and neck region [5 cases]. The diagnosis was suspected using standard histologic criteria and confirmed by immunohistochemistry: tumour cells expressed vimentine [90%], S100 protein [100%] and neuron specifique enolase [80%]. In all cases patients were treated by excisional resection and had a benign course with no evidence of recurrence [median follow up: 2 years]. Granular cell tumours are rare neoplasm which must be recognised because they demonstrate a benign behaviour after their surgical excision. Histological features of granular cell tumours are commonly characteristic but some times they can be misdiagnosed as malignant tumours especially when the biopsy is superficial. The staining for neurogen markers and PAS are useful tools

[Ewing sarcoma osseous and extra osseous: a clinicopathological study of 29 cases]

Ewing's sarcoma [ES] is a rare tumour accounting for 10% of primary malignant bone tumours in children and 3% of all childhood malignancies. ES belongs to a group of small round cell tumours. In this review, we will describe the main clinicopathological features of this rare tumour and discuss its prognosis. We report a retrospective study of 29 cases of ES, of which 4 were extraosseous, diagnosed over a period 11 years [January 1989 - December 1999]. Clinicopathological data were described. Hematoxylin-eosin staining and immunohistochemical study were reviewed. 12 patients were male and 17 were female [ratio: 0.8] with a median age of 16 years. 62.5% of tumours were located in flat bone and 33.3% in long bone. The medium size of the tumor was 10.6 cm [range:3-25cm]. 27.5% of patients presented with metastatic disease at time of diagnosis. Microscopically, tumour tissue was composed of round, small, blue cells with fine granular chromatin. Tumour cells strongly coexpressed CD99 and vimentin [100%]. Systemic treatment consisted of adjuvant chemotherapy [84.2%]. Local control was based on and surgery [57. 9%] or radiation therapy [36.8%]. A good response to chemotherapy was obtained in 37.5%; 13.7% of patients were alive without disease [medium follow up: 169 mois]; 34.5% of patients developed metastases [medium follow up: 23 months] and 10.3% developed recurrences [medium follow up :13 months]. Our study emphasizes two points: the great size of the tumor and the frequent location in flat bone which may explain the poor prognosis of Ewing sarcoma in our series despite the multidisciplinary treatment

[Scalp metastasis from small cell carcinoma of the rectum: an unusual case]

Cutaneous metastasis of rectal carcinoma is a rare event. It occurs in 4%of all patients with rectal cancer. Skin metastasis of rectal cancer are usually detected near the initial tumor. especially in the periumbilical region; but they rarely occur in the scalp. To report a new case of scalp metastases from rectal tumor. Our patient was a 63-year old male with a history small cell carcinoma of the rectum who subsequently developed s single nodule of the scalp of 4cm. Histopathological analysis revealed a small cell carcinoma infiltrating the dermis am subcutaneous tissue. The patient underwent palliative chemotherapy but his disease continued to progress. In contrast to the prior cases of scalp metastases reported in the literature, ours is the first documentation of such occurrence from rectal small cell carcinoma. The early diagnosis of skin metastases in these patients is very important because it can alter treatment

[Histological features of celiac disease in south Tunisia: a study of 114 paediatric cases]

To report the histological features of celiac disease in a paediatric population originating from south Tunisia. A retrospective study of a series of duodenal biopsies from 114 children with celiac disease diagnosed over a period of 6 years [from January 1999 to December 2004]. The diagnosis was confirmed by histological results, serological studies and clinical response to gluten free diet. The average age of patients was of 6.2 years [range 6 months-15 years]. Sex ratio was 0.71. Symptoms were dominated by chronic diarrhea [48%], weight loss [50%] and anemia [20.1%]. Histological findings showed an intraepithelial lymphocytosis [Marsh type 1] in 12.2% of cases, type 2 was present in 1.7% of cases and type 3 [villous atrophy] in 86% of cases. A treatment with a gluten-free diet was indicated for all patients, only the cases who haven't presented a clinical amelioration [11 cases] have beneficed a control biopsie; a villous atrophy was persistent in 80% of this patients. Histological features in duodenal biopsies for the diagnosis and the follow-up of patients with coeliac disease. This allows an appropriate treatment and prevents further complications