ABSTRACT
Schistosomiasis (also known as bilharziosis) is a parasitic infection still endemic in Madagascar. Its transmission is perpetuated by population lifestyles in tropical countries. A genital location is relatively rare; diagnosis is histological. This is a retrospective, descriptive study of genital schistosomiasis observed in the anatomic pathology laboratory of Sampan'asa luteriana ho an'ny fahasalamana and the Joseph Ravoahangy Andrianavalona University Hospital Center over the 6-year period from January 2010 through December 2015. We collected 13 cases. The mean age of the patients was 31.6 years and ranged from 4 to 48 years. Localization was cervical (n = 10), tubo-ovarian (n = 2), and vulvar (n = 1). Clinical signs were isolated bleeding or associated with other signs for cervical localization, suspicion of cyst for the vulva, and suspicion of mass for the ovary. The diagnosis was based on the presence of schistosome eggs in all cases, associated with tuberculoid granulomas (n = 9), eosinophilic polynuclear cells (n = 1), and giant cells (n = 2). We observed one case of squamous cell carcinoma that developed on cervical schistosomiasis. Schistosomiasis is a neglected tropical diseases. Malignant transformation is possible. A cervical hemorrhage is not synonymous with cancer but may reveal a specific inflammatory lesion. Histological examination is necessary for diagnosis.
Subject(s)
Reproductive Tract Infections/diagnosis , Reproductive Tract Infections/epidemiology , Schistosomiasis/diagnosis , Schistosomiasis/epidemiology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Madagascar/epidemiology , Middle Aged , Reproductive Tract Infections/parasitology , Retrospective Studies , Young AdultABSTRACT
Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a rare and unfamiliar clinicopathological entity characterized by cervical lymphadenopathy, often associated with systemic signs such fever and night sweats. We report the first three Malagasy cases of Kikuchi-Fujimoto disease, diagnosed at the Pathology Lab of Joseph Ravoahangy Andrianavalona Hospital, occurring in three female patients of 11, 19 and 35 years old. The clinical course mimicked lymphoma in one case and tuberculosis in two cases. In all cases, lymph node biopsy allowed the diagnosis and showed necrotizing lymphadenitis with acidophil necrosis, histiocyte inï¬ltrate, presence of plasmacytoid monocytes and multiple apoptotic cells. The three patients received a low-dose corticosteroid treatment. Clinical remission was achieved within a few weeks. This disorder must be included in the differential diagnosis of "lymph node enlargement" because its course and treatment differ dramatically from those of lymphoma and tuberculosis.
