[ spindle cell myoepithelioma of parotid gland: a case report]

Background: Myoepthelioma is a rare salivary gland tumor which is usually located in parotid gland and in minor salivary glands

Case report :We report a case of myoepithelioma arising in an accessory paritid gland in a 47-yearold woman who presented with a slowly expanding subcutaneous nodule on the left cheek, that was within the parotid gland at surgical resection . This tumor was composed of spindle cells. Immunophenotypical characterization demonstrated its myoepithelial nature

Conclusion: In the subcutaneous tissue, this unusual neoplasm may be confused with soft tissue tumors showing spindle cell features

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

[Adenoid cystic carcinoma of the parotid with facial nerve invasion]

Adenoid cystic carcinoma comprises approximately 10% of all epithelial salivary neoplasms and most frequently involves the parotid. Perineural invasion is a common feature but intraneural invasion and spread is less common. The authors report a case of parotid adenoid cystic carcinoma with invasion and spread via the facial nerve with an emphasis on radiologic features. We report a case of a 47-year-old man presenting with a right submandibular mass evolving for 4 years. On physical examination, the mass was firm painless, well delineated. There was no facial paralysis. The magnetic resonance imaging [MRI] examination showed a right parotid gland solid mass located in the deep lobe of the parotid gland with mastoid bony involvement.The mass was heterogenously enhanced. High resolution non contrast computed tomographie [CT] scan of the temporal bone showed in the axial and coronal cuts, a widening of the mastoid segment of the facial canal with involvement of the facial nerve. Pathologic examination of the resected specimen revealed histological features of adenoid cystic carcinoma with intra neural invasion of the mastoid segment of the facial nerve. The surgical margins were free. The evolution was favourable 5 years later. This study confirms that multiplanar approach of MRI allows rapid detection of adenoid cystic carcinoma. The influence of intraneural invasion and spread on survival remains controversial

[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

[Cytologic study of 8827 PAP smear with cytosistologic confrontation]

Cervical cancer is the second female cancer. Currently, pap smears represent the most effective tool for screening of neoplastic cervical lesions and their precursors. The objective of this study is to deal with epidemiology, cytology and histology of all cervical lesions and to evaluate pap smears reliability in cervical cancer screening. Our study included 8827 pap smears collected during three years [2003-2005]. Results of pap smears were reported according to the 2001 Bethesda system. A comparative cytohistologic study was performed in 342 cases. For statistical analysis, we used Chi 2 test and considered differences as significant for a p value less than 0,05. The mean age of our patients was 41 years. Pap smears were normal in 269 cases [3,1%], inflammatory in 8070 cases [9]4%] and showed epithclial cell defects in 46 cases [0,5%]. A cytohistologic accord was found in 944%of cases. Pap smear was more sensitive in detecting high grade squamous lesions [50 to 100%] than those of low grade [33,3 to 66,6%]. Pap smear is the most useful tool for screening of preneoplastic cervical lesions which tend to be mole and more a pathology of young females. Its sensibility and specificity are better in detecting high grade intraepithelial lesions

[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