Résumé
Polyarteritis nodosa [PAN] is a necro-tizing systemic vasculitis involving the wall of small and medium sized arteries. The histologic aspect is defined by the presence of fibrinoid necrosis and an infiltrate rich in neutrophil polynuclears in the artery wall and rare granulomas. Clinical manifestations are misleading, and more often the symptoms of the disease are retrospectively related to the PAN. The gastrointestinal involvement carries a poor prognosis. We report a clinical case of severe PAN concerning a 46-year-old woman revealed by an acute alithi-asic cholecystitis, needing a cholecystectomy. A number of complications occurred during the evolution and we noticed the occurrence of cutaneous ulcers, a number of ischemic accidents like a necrosis of toes of right leg, a minimal myocardial infarction, a pneu-matosis of the small intestin. Three months later, under treatment by prednisone and cyclophosphamide, the patient developped an ischemic perforation of the Despite an urgent surgery a rapid and fatal evolution was observed. A discussion of the case and a review of the literature will be presented
Résumé
Barrett esophagus [BE] is intestinal metaplasia [MI] within the distal tubular esophagus. The BE results in replacement of the normal squamous-lined epithelium with a columnar type epithelium. This metaplastic lesion is a clearly defined risk factor for the development of esophageal adenocarcinoma [ADC]. In the western countries the incidence of adenocarcinoma of the lower esophagus and the gastro-esophagus junction have rapidly increased during the past twenty years. The 5-year survival is very poor. Although the relative risk of individuals in the United States with BE developing esophageal adenocarcinoma is very high, the absolute risk is extremely low due to the small number of cases. This lesion is caused by a persistent gastro-esophageal reflux. The nature of the reflux liquid is mixed acid and alkaline in the big majority of cases. A familial aggregation of BE and esophageal adenocarcinoma are present in 14% of patients with BE and esophageal adenocarcinoma. The diagnosis, the surveillance, the new tools of characterization of BE and the therapy remain an actual problem. We present 2 cases of endobrachyesophagus associated to an adenocarcinoma of the lower esophagus and a review of the main actual problem
Sujets)
Humains , Mâle , Femelle , Adénocarcinome , Jonction oesogastrique/anatomopathologie , Revue de la littérature , Oesophage de Barrett/thérapie , Oesophage de Barrett/physiopathologieRésumé
GSTs are uncommon mesenchymal tumors of the stomach. The evaluation of malignancy is difficult and their histogenesis is controversial. Recently a relationship to the pacemaker interstitial cells of Cajal [ICC] has been suggested because GSTs, like the ICC express CD117 [C-K1T protein]. Some authors, like Miettinen in one of his studies, consider the CD117 positivity as part of the definition of GSTs. The purpose of this paper is to present two cases of GST with immunohistochemical study confirming the diagnosis of GST; the immunoreactivity of these two tumors is positive for CD117 and negative for protein S-100, actine and desmin. A review of the clinicopathologic, the immunohistochemical features, the prognostic factors and novelties in treatment will be presented
Sujets)
Humains , Femelle , Cellules stromales , Revue de la littérature , Immunohistochimie , Tumeurs de l'estomac/chirurgieRésumé
We report the case of a 36-year-old male patient who was treated with combined radiotherapy and chemotherapy for Hodgkin's disease in 1972, and developed a colon cancer 18 years later. Development of second malignancy in Hodgkin's disease patients and its relationship with treatment modality are discussed
Sujets)
/complicationsRésumé
The gastric Leiomyoblastoma is a smooth muscle described in 1960 by Martin and in 1962 by Stout. These rare tumors are generally benign but may have a sarcomatous evolution in 11% of cases. They are characterized by the presence of large round or polygonal cells. Thin filaments are visible on electronic microscopy. Treatment of choice is the surgical resection