Giant gastric lipoma mimicking well-differentiated liposarcoma

Gastric lipoma is a rare tumor, accounting for only 5% of gastrointestinal tract lipomas and less than 1% of all gastric tumors. Histological diagnosis is usually easy. However, the tumor may sometimes undergo significant inflammatory changes leading to a difficult differential diagnosis with well-differentiated liposarcoma. Authors report the case of a 51-year-old man, presenting with epigastralgia of recent onset. Physical exam was unremarkable. Endoscopy revealed a large, ulcerated, submucosal, and antral tumor. CT scan showed an antral mass with fat attenuation. The patient underwent a total gastrectomy. Macroscopic examination identified in the antral wall a 9-cm, well-circumscribed, nodular lesion, with a greasy cut surface. On histological examination, the tumor was composed of a mature adipocytes proliferation, showing significant variation in cell size, associated to some lipoblasts. Nuclei were sometimes large, irregular, neither with hyperchromasia nor mitosis. Diagnosis of a well-differentiated liposarcoma was suspected and hybridization. The diagnosis of lipoma was made. Twelve months after surgery, the patient is doing well. In conclusion, differentiating benign from malignant fatty tumors is sometimes difficult in morphologic features. In these cases, cytogenetic procedures are the only means for an accurate diagnosis

[Chronic laryngitis in adults]

Chronic laryngitis is a lingering inflammation of the laryngeal mucosa, caused by specifc aetiology and often irritative factors. To discuss clinic and therapeutic aspects of the pathology. We report a retrospective study about 25 patients treated and followed for non specific chronic laryngitis over a period of 11 years [1994-2004]. The average age of the patients was 54, 2 years. Tobacco intoxication was noted in 72,7 of cases and Gastroesophageal reflux in 2 cases. The endoscopic examination of laryngeal lesions, realized in all cases, notes laryngeal keratosis in 88% of cases and congestive laryngitis in 12%. Histological analysis of the lesions reveals a dysplasia in 44% of cases. Clinical and endoscopic follow up of the patients discover malignant development in 5 patients. The treatment of chronic laryngitis is based on the suppression of etiologic factors and on laryngeal microsurgery with micro instruments and with laser techniques

[Prospective study of 420 biopsies realised in patients with duodenal ulcer with positive Helcobacter pylori]

It's a prospective study leaded between September 1997 and July 1999 [23 months] in 75 patients with duodenal ulcer and positif for Helicobacter pylori. All patients had a first endoscopy with antral, fundic and duodenal biopsies, followed one months later by a second control fibroscopy with biopsies of the same sites. A total of 420 biopsies was realized. Chronic gastritis was evaluated according to sydney system. Patients was divided by randomization in 4 groups. Every group was received a different therapeutic association. The results was conform to liberation concerning activity 80%, intestinal metaplasia 12%, inflammation 100%. Atrophy was observed in 56% of cases, this percentage is variable in literature; chronic gastritis was predominant in antre relatively to fundus [p< 0.005]. After treatment, a significative fall of Helicobacter pylori and activity and atrophy was established, contrariety to intestinal metaplasia and chronic inflammation witch are persisted. The prevalence of follicular gastritis was 57%. The better rate of ulcer cicatrisation and Helicobacter pylori eradication was respectively of 79% and 66% in group 1 treated by omeprazol, amoxicillin, metronidazol by comparison with the others 3 groups [p< 0.005]

[Gastrointhstinal stromal tumors. a study of 5 cases]

G1 stromal tumors are mesenchymatal tumors arising primarily from the digestive tract or from the omentum. Despite their rarity [less than I% of digestive tumors]. These tumors have become of current interest since the discovery of a treatment for metastatic and locally advanced tumors, the imatinib [Glivecr]. In this study we report 5 cases of stromal tumors. Patients were 42 years old an average. Abdominal mass was the revealing signal in 80% of cases, localisation was obtained by endoscopy and ultrasonography in 60% cases. Total resection of the tumor was performed in all patients. Immuno-histochemical examination confirmed the diagnosis of stromal tumors. Based on these cases and on a review of literature, we insist on the diagnostic difficulties of this rare pathology, while trying to determine the histological prognostic parameters and the latest therapeutic methods