rare cause of dysphagia in a pregnant woman: herpes simplex esophagitis

Herpes simplex esophagitis [HSE] has rarely been reported in immunocompetent individuals. In a search of Medline until October 2012, we found only one case of HSE in a pregnant female. We present the first case of HSE in a healthy 36-year-old female at 27 weeks gestation who recovered without antiviral therapy

[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

Cerebral gliosarcoma: clinico-pathologic study of 8 cases

Gliosarcomas are biphasic neoplasms composed of a glioblastoma admixed to a sarcomatous component with different lines of differentiation. Histogenesis of these tumors is still discussed. Our objective is to specify clinical and pathological characteristics of this rare noeoplasm and to discuss its histogenesis. Retrospective study of eight cases of gliosarcomas diagnosed between January 1998 and December 2004. Clinical, radiological, therapeutic and follow-up data were reviewed. Histological features and immunohistochemical results were also included in this review. Five patients were male, three women with a median age of 50.7 [range 31-74 years]. Symptoms were dominated by intracranial hypertension and paralysis. The most conmon location was parietal or temporo-parietal [5 cases: 62.5%]. Pathological exam including histochemical and immunohistochemical study confirmed the diagnosis of gliosarcoma in all cases. Sarcomatous component had features of fibrosarcoma in 5 cases, osteosarcoma in 2 cases and malignant fibrous histiocytoma in 1 case. All patients were treated by surgical excision [complete in five cases and partial in three cases]. Adjuvant radiotherapy was received in three cases. One patient was lost on follow-up. Two patients died from postoperative complications and the five remaining patients died with a medium follow up of 9 months [extremes: 2-24 months]. Clinical, radiological and follow-up features of gliosarcomas share great similarities with glioblastomas. Histopathological, histochemical and inmmnohistochemical studies are helpful in accuracy diagnosis. Recent cytogenetic and molecular data support a monoclonal origin for these tumors

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

[Polymorphous low grade adenocarcinoma: about two cases]

Polymorphous low-grade adenocarcinoma [APBG] is a variant of malignant tumour of minor salivary glands usually arising in the palate. Our aim is to discuss morphology, evolution and differential diagnosis of this rare tumour. The first case interested a 65-year-old-woman admitted for a two-months-history of a right submaxillary swelling. Examination found a tumour of the right side of the palate. A biopsy concluded to a pleomorphic adenoma. Giving that the mass enlarged, a surgical resection carrying off the thyroid with a bilateral neck dissection was performed. Diagnosis was an APBG partially resected with lymph node metastasis. The patient received adjuvant radiotherapy. Local recurrence appeared 28 months after treatment. The second case interested a 57-year-old-woman who consulted for a 12-year-history of a swelling of the lower lip. Clinical examination showed a painless nodule measuring 2 cm located in the mucosal side of the lower lip. An excisional biopsy was performed. Pathologic examination concluded to an APBG completely resected. The patient had no evidence of disease with a follow-up of 54 months. APBG is characterised by a morphologic diversity and a cytologic uniformity that may cause a diagnostic dilemma especially with adenoid cystic carcinoma and pleomorphic adenoma. Its aggressiveness is assessed by its local infiltrative growth pattern requiring a wide surgical excision

[Central neurocytoma: a study of five cases]

Central neurocytoma is a very rare brain tumour recently described. The diagnosis rests on the data provided by anatomopathological examination and immunohistochemestry. We report a retrospective study of five cases of neurocytoma diagnosed in the Pathological laboratories of Anatomy and Cytology of Habib Bourguiba and Fattouma Bourguiba Hospitals over a period of two years [1999/2000]; this study was based on clinical, radiological and anatomopathological data. It was about three women and two men with an average age of 29 years [17 to 49 years] The tumor was located in the side ventricles in three cases. Two differential diagnoses were often discussed: oligodendroglioma and ependymoma. Immunohistochemistry showed an expression of the synaptophysine in every case. The treatment was exclusively surgical and the course was favorable with an average follow up of 48 months; only one case of relapse was noted of 36 months after the diagnosis