[Non alcohol steatohepatitis: pathologic study of 9 cases]

Non alcohol steatohepatitis is an acquired chronic hepatopathy frequently of metabolic origin. Histopathologically, it is characterised by a steatosis associated with necrotic inflammatory lesions mimicking alcohol hepatitis. This disease is complicated by cirrhosis in 15 at 30% of cases and by hepatocellular carcinoma in 13% of cases. The aim of our study was to evaluate the clinico-epidemiological features of this disease and the histopathological degree of hepatic failure. 9 cases of non alcohol steatohepatitis are diagnosed in our hospital in 3 years between 2001 to 2004. The clinical features of patients were determined. The aspect and extent of steatosis was noted and the degree of the necrotical activity was evaluated by the Lee score. We observed strong women prevalence with a sex-ratio of 0,125 and a high frequency between 40 and 60 years. Obesity and diabetes are the most common metabolic disorders encountered in our series. In opposition to published cases, a hepatomegaly and signs of portal hypertension are the most frequent clinical lesions noted in our study. Histopathological evaluation of Lee score finds a mild to moderate activity and fibrosis in nearly all our cases. One case of cirrhosis is noted

[Primary synovialosarcoma: a case of unusual location]

Report a new case of primary Synovi alosarcoma. We report a case of a 16 year old girl, who presented with a tumefaction on the right clavicle evolving or 3 months. Various explorations carried out, in particular thoracic scanner and imagery by magnetic resonance, showed a multilocular cystic formation of the seat and the clavicle reaching the mediastinum. A pathological examination of the part [piece] highlighted a biphasic synovialosarcoma of grade III. This diagnosis was validated by the immunohistochemistry study and the detection of transcribed specific fusion of the synovialosarcoma, SYT-SSXI. The unusual locations of the primitive SS must be known because the diversity of their microscopic aspects may cause confusion in the diagnosis. The immunohistochemistry, and more recently the cytogenetic studies, helps to solve these problems of differential diagnosis

Digestive polyposis, a retrospective study of 20 cases

Three main polyposis syndromes are transmitted as an autosomal dominant disorder: familial adenomatous polyposis [FAP], juvenile polyposis syndrome [JPS] and Peutz-Jeghers syndrome. Evaluate this management of digestive polyposis. Our study included 20 patients which were collected in the departements of pathology surgery and garstroenterology of MT Maarmouri's Hospital, Nabeul city. We reported 15 cases of adenomatous polyposis with 2 family groups. We identified a family group of JPS with 3 members and 2 cases of Peutz-Jeghers syndrome. We found 11 cases of colonic adenocarcinoma out of the 15 patients affected by adenomatous polyposes. FAP is a generalized disorder involving the entire colorectum segment with numerous extra-colonic manifestations. The risk to develop colonic cancer is 100%. JPS is characterised by the development of numerous gastrointestinal juvenile polyps and occurs usually before 20 years old, the progression to cancer is rarely observed. Peutz-Jeghers syndrome consists in hamartomatous polyps associated to a characteristic mucosal pigmentation. The patients are usually young adults and have an increased incidence of cancer in extradigestive sites