[Immunohistochemical analysis of mismatch repair proteins in colorectal adenomas]

The deficiency of mismatch repair system is one of the main pathways in colorectal cancer. This system consists mainly of four proteins: MLH1, MSH2, MSH6 and PMS2. Colorectal cancer develops in the majority of cases from precancerous lesions called adenomas. Only few studies have reported on the deficiencies of these proteins in adenomas. In this study we used immunohistochemistry staining in colorectal adenomas to assay functional status of MLH1, MSH2, MSH6, and PMS2 proteins. 102 adenomas from 93 patients were collected in our institution during six years [2007-2012]. The immunohistochemical technique was performed with 4 antibodies: MLH1, MSH2, MSH6 and PMS2. The loss of expression was retained if adenomatous cells were not stained with positive internal control. Staining was considered as abnormal if nucleus of adenomatous cells showed low nuclear staining and / or heterogeneous one, while positive internal control had normal staining. Loss of expression of MSH2 and MSH6 in adenomatous cells was found in only 1 case which was a tubular adenoma 3mm high-grade dysplasia. Abnormal staining of the adenomatous cells was noted in 23 cases [22.5%] for MSH2 and in 8 cases [7.8%] for MSH6. No cases showed loss of expression of MLH1 and PMS2. Abnormal expression of MSH2 and MSH6 was not correlated with sex of patients, the location of the adenoma, its grade of dysplasia and its histological type. Loss of Mismatch repair proteins expression is a rare event in adenomas. However, the abnormal expression levels are higher in our study compared to those reported in the literature. This could reflect a higher rate of microsatellite instability in our patients. Multicenter and larger studies with molecular biology techniques are needed

[Solid pseudopapillary tumors of the pancreas: a pediatric case report]

Solid pseudopapillary tumors of the pancreas are extremely rare and mostly seen in young females. It is often diagnosed incidentally or during investigations of gastrointestinal complaints. Report of a pediatric case of this tumor. We report the case of a 15-year old teenager who presented with painful abdominal tumefaction. Imaging findings were a 12 cm solid and cystic mass originating from the tail of the pancreas. A distal pancreatectomy with splenectomy was performed. Pathologic examination concluded to solid pseudopaprillary tumor. Evolution was favorable with no recurrence 18 months after surgery. Histological examination confirms the diagnosis and allows, with the help of immunohistochemical study, to rule out some differential diagnoses such as pancreatoblastoma, acinar tumors and endocrine tumors. Prognosis of solid pseudopapillary tumors of the pancreas is excellent after radical resection and recurrences are rarely seen

[Small cell carcinoma of the urinary bladder]

Pancreatic pseudocysts [PC] are a common complication of both acute and chronic pancreatitis. Most pancreatic pseudocysts are located within the head and the body of the pancreas, but 20%of them are extrapanereatic [pleura, mediastinum, pelvis and spleen]. The location of a pseudocyst in the liver is an exceptional event, only thirty three cases are reported in the literature. This article aimed to report a new case of PC located in the liver combined with a systematic review of reported cases published in peer-reviewed journals. A new case of PC located in the liver was reported. An extensive electronic search of the relevant literature since 1990 was carried out using Medline. We retained only the articles reporting one or several cases. When the article was unavailable, we considered the relevant abstracts which should report clinical patterns and therapeutic modalities. Reviews of the literature, systemic reviews, letters to editors and incomplete abstracts were excluded. A descriptive analysis of the collected sample including our case was performed. Morphological, therapeutic and outcome variables were reported. Tile analysis of 22 cases reported in the literature and our observation provided the following data: 17 men and 6 women with a mean age of 51 +/- 3,2 years. Seventeen patients presented an acute pancreatitis, complicating a chronic pancreatitis in seven cases, alcoholic in six cases, biliary in three cases and traumatic in one case, Six patients presented a chronic pancreatitis. The PC was located in the left lobe of the liver in 5 cases, in the right lobe in 6 cases and interested the two lobes in 5 eases. The lesion was unique in patients and multiple in 13 patients. Fifteen patients were treated by Ultrasound or CT guided percutaneous drainage. Four patients were managed surgically. Three patients had no specific treatment. One patient was successfully treated by endoscopic transpapiltary drainage. The evolution was favourable for alt patients except in three patients who died. Pancreatic pseudocyst located in the liver is an exceptional event, commonly following acute pancreatitis, rising in older male, involving the left lobe of the liver and treated by percutaneous drainage

Prognostic value of the immunohistochemical expression of: KI67, p53, pcna and bcl2 in the superficial tumors of the bladder

To study a serie of superficial tumors of the bladder and to assess the prognostic significance of p53, Ki67, PCNA and bc!2 in these tumors. We studied 59 bladder tumors: 43 pTa and 16 pTl. All Patients had cystoscopy 3 months after the resection and tumors that did not recur had a minimum follow up of 5 years. Age more than 65 years [p = 0,001], multifocality [p=0,022] and tumoral size > 3 cm [p = 0,022] were correlated with the recurrence. The expression of p53 was correlated with the recurrence in the year following the tumoral resection [p = 0,035]. That of of Ki67 was correlated with the histological grade [p = 0,03] and stage [p=0,002]. Our results suggest to practise regular endoscopic controls during the first year following the resection of the primitive tumor if it expresses p53. The immunohistochemical expression of Ki67 being correlated with the grade, this marker could help to better classify the tumors of intermediate grade

[Pelvic ganglioneuroma. Report of a case]

Ganglioneuroma is a rare benign tumor. It is the most mature of neurogenic tumors. We report a case of a pelvic ganglioneuroma diagnosed in 24-year-old pregnant women who presented with an urinary infection. Echographic examination suggested an ovarian mass. At surgical operation, the tumor was close to the sacrum. A total resection of the tumor was performed. Pathological examination proved it as a ganglioneuroma. Sixteen months later, the patient is free from disease

[Prognostic value of clinicopathologic factors in superficial bladder: a retrospective analysis of 59]

To study, through a series of superficial bladder tumors, the prognostic factors of recurrence and tumoral progression. this is a retrospective study of a series of 59 urothelial tumors of the bladder at stage pTa or pTl. The following parameters were considered: age, sex, treatment, stage and grade. The chi square test was used in search of a correlation between the different parameters and the course [recurrence and progress] of the disease. A multivariate analysis was undertaken by integrating factors correlated with the course. Thirty two tumors [54%] had recurred versus 27 [46%] without recurrence. Light tumors [25%] progressed in grade and 4 [12,5%] had become infiltrative. Age beyond 65 years. tumoral size > 3 cm and rnultifocality were predictive factors of recurrence with a relative risks of 2.36, 3,28 and 3,88 respectively. In a multivariate analysis, these factors remained significant with adjusted relative risks respectively of 1,36, 1,6 and 1,7