[Clinicopathologic characteristics of low grade primary gastric non-Hodgkin's lymphomas: experience from a single center]. / Caractéristiques clinico-pathologiques des lymphomes gastriques primitifs de bas grade de malignité.

AIM: To report the clinicopathological data and the treatment outcomes in patients with primary gastric low grade non-Hodgkin's lymphoma. METHODS: We carried out a retrospective analysis of 16 consecutive patients (median age 46 and range 28-75 years) who presented to our department with histopathological diagnosis of primary gastric low grade non-Hodgkin's lymphoma. We analyzed clinical manifestations, endoscopic features, pathological features,Helicobacter pylori infection and treatment. RESULTS: Common symptoms included abdominal pain (87.5%),vomiting (62.5%), and gastrointestinal bleeding (25%). Endoscopic appearances were mainly ulcers and ulcerations (93.75%).Endoscopic biopsy confirmation rate reached 87.5% when biopsies were repeated. Helicobacter pylori detection rate was 75%. A total of 9 patients received surgeries. Three patients had chemotherapy and 8 patients had Helicobacter pylori eradication therapy. The range of follow-up was 2-74 months with a median of 27 months. A complete remission was obtained in 12 cases, whereas 1 patient died and 3 were lost of view. CONCLUSION: Eradication therapy may be offered as an initial treatment option in patients with low-grade gastric lymphoma.

[Association of Sjögren's syndrome and Plummer Vinson syndrome]. / Association d'un syndrome de Gougerot Sjögren et d'un syndrome de Plummer Vinson.

Dysphagia is a common complaint of patients with Sjogren's syndrome, but its mechanism remains a subject of controversy. The association of Sjogren's syndrome with Plummer-Vinson syndrome remains uncommon. We report a 56-year-old women who presented both disorders. The diagnosis of the Plummer-Vinson syndrome was based on the classic triad of dysphagia, iron-deficiency anaemia and oesophageal webs. The diagnosis of Sjogren's syndrome was based on the presence of three Fox criteria. This association should incite us to search for common immuno-genetic pathogenic factors between these two syndromes.

[Monoclonal gammopathy and primary colonic mantle cell lymphoma]. / Une gammapathie monoclonale associée à un lymphome colique primitif à cellules du manteau.

The association of a monoclonal gammopathy (MG) with a B cell non-Hodgkin's lymphoma (NHL) is a well-known phenomenon. It has been recognized in many subtypes of primary gastrointestinal lymphoma but its association with primary colonic mantle cell lymphoma has never been yet described. We report a 65-year-old man who presented with an exudative ascites and constipation. Serum electrophoresis showed a monoclonal peak in the gamma region of 45g/L and immunoelectrophoresis confirmed the presence of monoclonal gammopathy of IgM kappa type. Bone marrow aspirate was normal. Radiologic and endoscopic investigations evidenced a primary colonic mantle cell lymphoma. Although the association of an MG with an NHL and, in particular, to a primitive digestive location appears a rare phenomenon, endoscopic investigations in patients with MG appears legitimate in the presence of any digestive sign.

[Imaging in the screening and diagnosis of hepatocellular carcinoma in cirrhosis liver in Tunisia. A series of 30 cases]. / L'imagerie dans le dépistage et le diagnostic du carcinome hépatocellulaire sur foie de cirrhose en Tunisie. A propos de 30 cas.

UNLABELLED: The aim of our study is to expose a practical screening and diagnosis strategy of HCC occuring in cirrhosis liver, which is nowadays a health public matter in Tunisia. METHODS: HCC routine screening in cirrhosis liver has been conducted every 6 months using a combination of abdominal sonography and serum alpha-foetoprotein levels. PCUS, CT scan or MRI have been performed each time a focal liver lesion was discovered in US, or in case of elevated serum alpha-foetoprotein levels. 30 cases of HCC were identified. RESULTS: US has shown a unique nodule in 46% of the cases, multiple nodules in 50% of them. No lesion has been discovered in 4% of the cases. Nodule size ranged from 8 to 140 mm. Heterogenous hyperechoic pattern was the most frequent one (41%). Hypervascular doppler feature was authentified in 20% of the cases. Serum alpha-foetoprotein levels had respectively a sensitivity and a specificity of 14% and 44% in lesions inferior to 3 cm, 62% and 80% in lesions superior to 3 cm. Typical arterial enhancement of HCC was depicted in 1 case for PCUS, in 76% for CT scan and 60% for MRI. CONCLUSION: Combination of abdominal sonography and serum alpha-foetoprotein levels practiced every 6 months represent a good compromise between cost and effectiveness. Second intention imaging is based on CT scan in Tunisia because of its availability compared to MRI. PCUS is becoming in the near future the best modality for lesion caracterization thanks to its safety and relative inexpensiveness.

[Menetrier's disease: a case report]. / Maladie de Menetrier: a propos d'un cas.

Menetrier's disease is an uncommon reason of hypertrophic gastropathy. The diagnosis is suspected when clinic, endoscopic and radiologic criteria are associated and is confirmed by histologic features which are a cryptric hyperplasia atrophy of gland of the fundus and an hypertrophy of the mucosa. The main complications of this disease are neoplasia and cachexia. The treatment of Menetrier's disease is first medical. Chirurgical treatment is indicated when bleeding or neoplasia occurred. In this paper, we report the case of patient who is 41 years old which, in spite of some therapeutic problems is in conformity with literature.

[Esophageal cancer with esophagotracheal fistula. Treatment by esophageal prosthesis. Report of two cases]. / Cancer de l'oesophage avec fistules oesotracheales. Traitement par protheses oesophagiennes. A propos de deux observations.

Esophageal cancer has a bad prognosis because of late diagnosis. The rate of Survival is very low. Palliative treatment is frequently made. The aim of the treatment is to allow feeding, and treat some complications likes breathing troubles. We report two cases of esotracheal fistulae secondary to esophageal cancer. The esophageal fistula was successfully treated by esotracheal prosthesis.

[Duplicate principal bile ducts. Two case reports]. / Duplicité de la voie biliaire principale. A propos de deux cas.

The duplicity of the way biliaire main is a rare abnormality. We report two observations revealed by episodes of angiocholite. The degrades cholangiopancreatography endoscopy allowed to wear diagnosis and to practise a therapeutic gesture.