[ tracheal adenoid cystic carcinoma]

Adenoid cystic carcinoma [CACC], also called cylindroma, are rare epithelial malignant tumors, their favorite seat is at the salivary glands [95% of cases], they represent 20 to 40% of tracheal carcinoma and 0,1% of respiratory tract cancers. Bronchial localization is rare, estimated only between 0.3 and 2%. This is a retrospective study ranging from 1997 to 2006 concerning five patients treated in the thoracic surgery department, for tracheal tumor and whose final histological diagnosis was in favor of adenoid cystic carcinoma [ACC]. All the patients had inspiratory dyspnea. Bronchoscopy showed a smooth tracheal tumor, the biopsy revealed a ACC. Four of our patients underwent resection of the tumor-by-end anastomosis and one patient was deceased prior to surgery. Adjuvant radiotherapy was indicated in one case. The short term, outcome was good, but local recurrence with lung and cervical lymph node metastases appeared after 6 years in one patient. The adenoid cystic carcinoma of the trachea is a rare tumor. Its diagnosis and surveillanse based on bronchial Bibroscopy combined with biopsy. CT better evaluates the scope and extent of the peri tracheal tumor. The therapeutic management is based mainly on surgery combined with radiotherapy. adenoid cystic carcinoma of the trachea are rare malignant tumors issues to think about before a lesion at this level

[Primary tuberculosis of the gallbladder]

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

Idiopathic granulomatous mastitis

The idiopathic granulomatous mastitis is a rare entity. Up till now there is no any theory that can explain this pathology, specially the auto-immune origin. So we can consider it as of unknown aetiology. It is often adopt a cancerous radio-clinical semiology, while the histological examination proves that it is of a benign nature. Its diagnosis depends on a multidisciplinary approach. It is of an exclusion diagnosis, which needs an adequate treatment, with a long course follow up. We report here a new idiopathic granulomatous mastitis case, through a review of literature, trying to present its epidemiologic and clinical aspects, discussing the diagnostical methods and the therapeutic difficulties

[Cancer kidney of adult: pathological study about 139 cases]

The cancer of the kidney accounts for 3% of all adult malignant tumors and have an increased incidence. This retrospective study, reports 139 cases colliged in the Ibn Sina hospital, between 1990 and 1999. It concerns 68 men, 72 women [range 19-88 years]. Most of patients [79.8%] have between 40 and 70 years. The diagnosis was assessed by the histological examination about surgical specimens in 132 cases, renal biopsy in six cases and renal cytopunction in one case. Clear cell carcinoma was more frequent [72%] in 100 cases, metastasis [20.3%] in 28 cases, tubulo-papillary tumors, sarcomatoide carcinoma and wilms tumor [2,1% each other] 3 cases, Bellini carcinoma and clear sarcoma [0,7% each other] one case. Furhman grade as a prognosis factor used in 103 cases that 65% had a high grade [III, IV]. The diagnosis is based by microscopic gross in all of case except in few cases, the immunohistochemistry study was necessary. We insist on the central role of pathologist in prognosis of cancer kidney in adults

Leiomyoma of the colon [report of a case]

Leiomyoma of the colon is an extremely rare tumor. Reports are those of sessil intraluminal lesions. We report a case of extraluminal leiomyoma of the transverse colon. The diagnosis is suspected at laparotomy and confirmation of the precise nature of the neoplasm by histologic examination