Epidemiology and subtype distribution of lymphoid neoplasms from a single institution in Lebanon between 2010 and 2014

The 2008 WHO classification is the gold standard for classifying hematopoietic neoplasms. Our study reviewed 1256 cases between the years 2010 and 2014. It aimed to establish a descriptive status of lymphoma cases in Lebanon. Hodgkin lymphomas [HL] accounted for 21% of all cases whereas non-Hodgkin lymphomas [NHL] accounted for 79%. In NHL, mature B-cell neoplasms accounted for 85% and mature T-cell neoplasms accounted for 9%. For mature B-cell neoplasms, the majority of cases [48%] were diffuse large B-cell lymphomas [DLBCL]. Within T-cell lymphomas, anaplastic lymphoma [ALCL 40%] was the most prevalent. The distribution within subtypes confirmed the findings of two previous Lebanese studies. Our figures of HL are higher than in Eastern and Western countries. This could probably be related to EBV infection among other etiologies. Our NHL figures are close to the Western world. Westernization of the way of life of the Lebanese society could explain this result

Gastric Adenocarcinoma Secondary to Primary Gastric Diffuse Large B-cell Lymphoma

Despite the decreasing incidence and mortality from gastric cancer, it remains a major health problem worldwide. Ninety percent of cases are adenocarcinomas. Here, we report a case of gastric adenocarcinoma developed after successful treatment of prior primary gastric diffuse large B-cell lymphoma (DLBCL). Our patient was an elderly man with primary gastric DLBCL in whom complete remission was achieved after R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone plus rituximab) chemotherapy. Helicobacter pylori infection persisted despite adequate treatment leading to sustained chronic gastritis. The mean time to diagnose metachronous gastric carcinoma was seven years. We believe that a combination of many risk factors, of which chronic H. pylori infection the most important, led to the development of gastric carcinoma following primary gastric lymphoma. In summary, patients who have been successfully treated for primary gastric lymphoma should be followed up at regular short intervals. H. pylori infection should be diagnosed promptly and treated aggressively.

B-type natriuretic peptide modulates the action potential and the L-type calcium current in adult rat heart muscle cells

Natriuretic peptides seem to be a potent regulator of cell Ca[2+] signaling in their action on the cardiovascular system. It was therefore the aim of this study to investigate the effect[s] of B-type natriuretic peptide [BNP] on the action potential and the L-type calcium current [I[cal]] in the rat left ventricular myocytes. Perforated and whole cell patch clamp technique was used to record action potential [AP] and I[cal] in current and voltage clamp mode, respectively. At the concentration tested of 10[-7] M, BNP significantly increased the action potential duration at 50% and at 90% of repolarization by 16.85% and 16.39% respectively, and the phase II slope of the AP by 52.5% ; reduced the I[cal] amplitude with a 16.17% decrease in the peak amplitude ; reduced [16.51%] the inactivation time course of current decay; increased the V[0.5] activation of the L-type calcium channel by 32.84% and decreased V[0.5] inactivation by 34.39%. These data suggest that BNP modulates cardiomyocyte function by reducing I[cal] and modifying the AP. This study may show a novel facet to evaluate the paracrine/autocrine effect of BNP on the normal heart function

effects of methyl methacrylate monomer on testosterone level in male rats. An experimental study

Methyl methacrylate [MMA] is commonly used in medicine and dentistry. The adverse effects of MMA are well described in the literature. Animal studies have largely confirmed the risks reported in clinical observations. There is no study indicating direct implication of MMA on male fertility mechanism. The purpose of this study was to determine whether MMA is able to modify the testosterone level. The target population consisted of 60 male Sprague-Dawley rats. They were closed in colony cages and divided into five groups: The first group [n = 15] designated as the control group and four experimental groups [n = 45]. Experiments were conducted by exposing the four experimental groups to MMA with water at different concentrations [4%, 8%, 16% and 32%] administered per os. The exposure duration was eight months. Blood was obtained before and at the end of the exposure and the measurement of the testosterone level was made by EIA test. The exposure of rats at a moderate concentration of MMA [16%] showed an increase in testosterone level of 60% [p = 0.003] while the other groups showed a decrease of testosterone level. The control group showed a decrease of 44.8% [p = 0.001], the rats exposed at 4% showed a decrease of 67.7% [p = 0.000], those exposed at 8% showed a decrease of 4.32% [p = 0.35], the rats exposed at 32% showed a decrease of 71.7% [p = 0.002]. Despite the fact that MMA at low concentration was rapidly hydrolyzed in blood due to the nonspecific carboxylesterase and metabolized at high concentration by the liver, its effects on testosterone level were significant. These preliminary results showed an interference of the MMA with the testosterone hormonal equilibrium that could be an interesting target for further investigations

Toxic effects of methyl methacrylate monomer on male genital tissue in vitro study in rats

Methyl methacrylate [MMA], a widely used monomer in dentistry and medicine has been reported to cause abnormalities or lesions in several organs. Experimental and clinical studies have documented that monomers may cause a wide range of adverse health effects such as irritation to skin, eyes, and mucous membranes, allergic dermatitis, stomatitis, asthma, neuropathy, disturbances of the central nervous system, liver toxicity, and fertility disturbances. The purpose of this study was to determine whether MMA mixed with water at four different concentrations is able to affect the histological structure of testicular tissues and seminal vesicle on male rats. The target population consisted of 60 male Sprague-Dawley rats. They were housed in colony cages and divided into five groups: The first group [n = 15] designated as the control group and four experimental groups [n = 45]. Experiments were conducted by exposing the four experimental groups to MMA administered per os mixed with water at different concentrations [4%, 8%, 16%, 32%]. The exposure duration was eight months. The testicles and the seminal vesicles were then extracted, dissected, fixed in Bouin liquid fixative and were submitted to the pathology laboratory [National Institute of Pathology] for histopathological examination. Seven out of 10 rats to which the MMA was administrated at a concentration of 32% showed partial seminal vesicle atrophy. The seminal vesicles in the remaining rats showed normal histology in all specimens. Testis, epididymis and vas deferens showed normal histology in all rats. The data in this study showed that MMA administered at high concentration is associated to seminal vesicle atrophy. These findings let us suggest that this effect could be the result of either a direct effect of MMA on testosterone levels [as shown in our first study], or through its possible action on other organs involved in testosterone metabolism and seminal vesicle trophicity such as the hypophysis

Periarterite noueuse: complications digestives et cardio-vasculaires a propos d'un cas

Polyarteritis nodosa [PAN] is a necro-tizing systemic vasculitis involving the wall of small and medium sized arteries. The histologic aspect is defined by the presence of fibrinoid necrosis and an infiltrate rich in neutrophil polynuclears in the artery wall and rare granulomas. Clinical manifestations are misleading, and more often the symptoms of the disease are retrospectively related to the PAN. The gastrointestinal involvement carries a poor prognosis. We report a clinical case of severe PAN concerning a 46-year-old woman revealed by an acute alithi-asic cholecystitis, needing a cholecystectomy. A number of complications occurred during the evolution and we noticed the occurrence of cutaneous ulcers, a number of ischemic accidents like a necrosis of toes of right leg, a minimal myocardial infarction, a pneu-matosis of the small intestin. Three months later, under treatment by prednisone and cyclophosphamide, the patient developped an ischemic perforation of the Despite an urgent surgery a rapid and fatal evolution was observed. A discussion of the case and a review of the literature will be presented

Human papillomavirus testing as an adjunct to cytology evaluation in cervical specimens of selected and consecutively screened Lebanese women: a prospective clinical study

Cervical cancer is the second leading cancer in women worldwide, with 85-100% of cervical cancers being HPV DNA positive. Our study aimed at evaluating the use of HPV DNA testing as an adjunct to the routine cervical cytology evaluation of Lebanese women. Cervical cytology evaluation and testing for human papillomavirus [HPV], as well as high-risk HPV were performed on two groups of women. One group consisted of 274 healthy women attending gynecology clinics for routine evaluation, while the other included 199 women selected based on a high-risk lifestyle and/or abnormal findings at cytology. HPV and HR-HPV DNA were 4 and 10 times higher, and HPV was 4 to 5 times more frequent at all age groups in selected, compared to healthy women. HPV infection decreased in healthy women with age but did not decrease in selected women. HPV positive-normal cytology decreased with age in both groups. Although HR-HPV detection decreased with age in healthy women, it doubled in selected women. In addition, more severe cytology was associated almost uniquely with selected women. HR-HPV detection and advanced cytology lesions correlated well and were mutually predictive. The overall sensitivity, specificity, positive and negative predictive values of HPV testing for squamous intraepithelial lesions were [85.5%], [90.95], [67.8%] and 96.5%, respectively. Based on these findings, we recommend implementing HPV screening as an adjunct to routine cervical cytology in selected Lebanese women older than 30 years of age

carcinome adenoide kystique du sein. A propos d'un cas

We report a case of adenoid cystic carcinoma of the breast in a 62-year-old lady. This tumor is a rare histologic form of breast cancer, associated with a favorable prognosis, and a special clinical behavior. It is mainly diagnosed on morphological grounds, by identifying two populations of neoplastic basaloid myoepithelial and epithelial cells with extracellular deposits of eosinophilic basement membrane-like substance. Lymph node metastases are rare. Partial or simple mastectomy is an adequate treatment. Axillary lymph node dissection may not be necessary

Tumeurs stromales gastriques: presentation de deux cas avec etude immunohistochimique. revue de la litterature

GSTs are uncommon mesenchymal tumors of the stomach. The evaluation of malignancy is difficult and their histogenesis is controversial. Recently a relationship to the pacemaker interstitial cells of Cajal [ICC] has been suggested because GSTs, like the ICC express CD117 [C-K1T protein]. Some authors, like Miettinen in one of his studies, consider the CD117 positivity as part of the definition of GSTs. The purpose of this paper is to present two cases of GST with immunohistochemical study confirming the diagnosis of GST; the immunoreactivity of these two tumors is positive for CD117 and negative for protein S-100, actine and desmin. A review of the clinicopathologic, the immunohistochemical features, the prognostic factors and novelties in treatment will be presented

Cohorte de 23 patients Libanais porteurs d'un syndrome de Gougerot - Sjogren primitif

Gougerot-Sjogren Syndrome is a autoimmune disease in Lebanon. A retrospective study including 23 patients selected according to european criteria allowed to evaluate glandular and extra glandular mainfestations, to correlate histological, clinical and biological results, to place the histological of the minor salivary glands in the general diagnostic frame and to relate epidemiological characteristics linked to the family aspect of the syndrome

Value of duodenal endoscopic markers of villous atrophy

Several endoscopic aspects of duodenal mucosa have been described in patients with villous atrophy [VA] and celiac disease. We assessed the accuracy of three endoscopic markers in patients referred for duodenal biopsy.methods: From January 1992 to June 2000 all patients undergoing upper gastrointestinal [UGI] endoscopy by a single operator [n = 4102], had the second part of the duodenum examined, without any magnification technique or addition of vital dye staining, for the presence of three markers of VA, [1] reduction or loss of Kerkring's folds, [2] scalloped configuration of the duodenal folds, and [3] mosaic appearance of the mucosa.Biopsy samples were taken from those in whom the mucosa was abnormal [n = 51], and from those in whom it Was normal but where biopsy was indicated [n = 230].None of the 230 endoscopically normal controls had VA. Seven out of 51 patients [14%] with an abnormal mucosa had a normal histology, the remaining 44 [86%] had some degree of VA confirmed at histology, partial VA in 11 patients [25%] and subtotal or total VA in 33 patients [75%]. 63% of the patients with only one endoscopic marker had VA confirmed at histology whereas the coexistence of more than one marker was always associated with histological villous atroluphy. The overall sensitivity, specificity, positive and negative predictive values of the endoscopic markers were respectively, 100%, 97%, 86%, and 100%.mg 44 [86%] had some degree of VA confirmed at histology, partial VA in 11 patients [25%] and subtotal or total VA in 33 patients [75%]. 63% of the patients with only one endoscopic marker had VA confirmed at histology whereas the coexistence of more than one marker was always associated with histological villous atrophy. The overall sensitivity, specificity, positive and negative predictive values of the endoscopic markers were respectively, 100%, The appearance of the second part of the duodenal mucosa as assessed during routine UGI endoscopy, is a sensitive and specific indicator of the presence of VA on biopsy, and should alert the endoscopist to the possibility of a celiac disease