Aggressive nasal-type natural killer/-T-cell lymphoma associated with Epstein barr virus presenting as testicular tumor

Testicular lymphoma is a lethal disease with a median survival of approximately 12 to 24 months. Nasal-type natural killer/T-cell lymphoma of the testis is exceptional whether as a primary or secondary tumor. The authors report on the comprehensive histopathologic, immunohistochemical and molecular analysis of a case of primary testicular nasal type NK/T cell lymphoma and review the features of previously reported cases. We report a case of primary nasal-type natural killer/T-cell lymphoma of testis in a 28-year-old male. The histopathological examination of the surgical specimen, showed a large lymphoma cells with angioinvasion expressing CD 3 [cytoplasmic], CD2, CD8, CD43, CD45, CD45Ro, CD56, T-cell intracellular antigen-1, perforine, Mib1 and granxyme. In situ hybridation for Epstein-Barr-virus-encoded mENA was positive. Polymerase chain reaction study of formalin-fixed tissue showed lack of T-cell receptor gene rearrangements. The initial stage was I [EA] of Ann Arbor. This lymphoma was refractory to chemotherapy. The patient developed lymph node metastases in the out iliac and in the subclavicular region two months later. He died of disease after eight months. This study confirms that testicular NK/T-cell lymphoma deserves to be distinguished from the other testicular lymphomas. In fact, this lymphoma tends to occur at young age, to disseminate early, to have an aggressive course, and is strongly associated with EBV

[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

[Clinical and therapeutic results of a retrospective study about 62 cases of epithelial ovarian carcinomas]

To report retrospectively the therapeutic results and prognostic factors of epithelial ovarian carcinomas throughout a series of 62 patients treated between 1993 and 2002. Patients were treated with primary surgery classified as optimal [complete], sub-optimal or minimal. Adjuvant ciplatin based poly chemotherapy [6 cycles] was indicated in FIGO stage Ic or more. Patients with minimal surgery received 3 or 4 cycles of chemotherapy followed by an interval debulking surgery. Overall survival was calculated according to Kaplan-Meier and univariate analysis done by the Log-Rank test for the following factors: age group, surgical excision, stage, histological type and presence or not of ascitis at diagnosis. Fifty five patients were operated. The excision was optimal, suboptimal and minimal in respectively 19,3%, 33.8% and 40.3% of the cases. Adjuvant or neoadjuvant chemotherapy was given to 50 patients [93,5%]. Interval debulking surgery was complete in 7 among 13patients. At the first evaluation, 14/58 patients were in complete response. The 3 and 5 years overall survival rates were respectively of 25% and 13%. Advanced stage was the only pejorative prognostic factor [P= 0.0002]. Incomplete surgery [minimal] and chemotherapy without taxanes based chemotherapy were associated with poor outcome in our patients. Our study confirmed the importance of disease stage as a prognostic factor

[Fibrocystic mastopathy and Cancer of the breast. About 111 cases]

Objective: Our aim was to identify the predictive factors of degeneration of the fibrocystic mastopathy

Methods: This work is a retrospective survey of I 1 1 observations of isolated fibrocystic mastopathies or associated to a breast cancer among 542 women admitted for tumor of the breast during one period of 13 active years from 1991 to 2003. The diagnosis has been gotten by anatomo-pathologic exam in 95, 5% [106cas] on the operative piece and 4,5% [Scas] on a material of biopsy

Results: The fibrocystic mastopathy represented 30 % of the set of the benign tumors of the breast. They were associated to a breast cancer in 45 cases [40,5%]. The isolated benign fibrocystic mastopathy was observed in 66 cases with a middle age of 37 years. whereas the shapes associated to a breast carcinoma were noted in 45 cases. The middle age was 53 years. The non proliferative fibrocystic mastopathy is the most frequent histological type and repre-sent 54,6 % of the cases. The proliferative form with atypies was observed at 21 women [46,8%]. The carcinoma the more frequently associated to the fibrocystic mastopathy was the infiltrating canalled carcinoma in 91% of cases, with a pre-dominance of the 11 rank [SBR]

Conclusion: The discovery of a mastopathy must search a luteal failure and risk factors of breast cancer notably a proliferative shape of mastopathy with atypies

[Breast cancer and pregnancy: a study of 3 cases]

Cancer is rare during pregnancy. Breast cancer is the most common cancer in pregnant women. We report 3 cases of breast cancer associated with pregnancy.The mean age was of 34 years. Cancer was detected during the second trimester of pregnancy in two patients. They were treated with mastectomy followed by 6 courses of adjuvant chemotherapy. The first course was given before delivery. Loco regional radiotherapy was given after the end of chemotherapy. The third patient presented with a bilateral breast cancer which was discovered 2 months after delivery. The patient was treated with mastectomy of the left breast and conservative surgery of the right one, associated with adjuvant chemotherapy and radiotherapy. Two patients died the course of the disease. Twenty months later, the third patient is still alive, free of all symptoms and signs. Based on our findings and through a review of literature, we try to determine the epidemiological and clinical features of this association as well the outcome of therapy and eventual prognosis