[Extensive bone marrow necrosis as presenting manifestation of sickle cell disease in Africa]. / Necrose médullaire etendue en Afrique révélant une drépanocytose homozygote.

Extensive bone marrow necrosis is a rare but severe complication of sickle cell disease. A formerly healthy man was admitted for bone pain, fever, and jaundice with severe aregenerative anemia. Bone marrow aspiration and biopsy showed extensive bone marrow necrosis while hemoglobin electrophoresis demonstrated homozygotic sickle cell disease. Despite early onset of septic arthritis of the right shoulder, outcome after blood transfusion and nonspecific treatment was favorable. Six months later, hemoglobin level remained stable up to 97 g/L. This first African case report illustrates typical features and good prognosis of extensive bone marrow necrosis in sickle cell disease. Extensive bone marrow necrosis is a highly unusual presenting manifestation of sickle cell in an adult.

[Infectious crystalline keratopathy: a case report]. / Kératopathie cristalline infectieuse: à propos d'une observation.

We report a case of perforated infectious crystalline keratopathy in a 88-year-old woman. Corneal surgery like keratoplasty and topical corticosteroids are the main causative factors present in the rare reported cases. Clinically, the anterior layers of cornea exhibit slowly progressive stellate infiltrates. "Viridans streptococci" are the most common micro-organisms involved but their culture for identification is difficult. As compared to cultures, histologic examination is more sensitive for diagnosis, by showing clusters of bacteria in the corneal stroma with no inflammatory response.

[Hamartomatous adiposity of the thyroid]. / Adipose hamartomateuse de la thyroïde.

Report of one case of hamartomatous adiposity of the thyroid gland. Only eight cases have been reported. The lesion is composed of thyroid tissue and mature adipose elements. Previously reported cases are reviewed and the pathogenesis is discussed.

[Meningoradiculitis revealing an occult medulloblastoma-PNET in an adult]. / Méningo-radiculite révélant un médulloblastome-PNET occulte de l'adulte.

Neoplastic meningitis as the presentation of occult primitive neuroectodermal tumor (PNET) is occasionally described in children. We report the case of an 64 year old-man who presented a meningo-radiculopathy with progressive injury of the cauda equina and then the ocular motor nerves, revealing an occult medulloblastoma-PNET.

[Blue nevus of the scalp associated with a meningeal melanocytoma]. / Naevus bleu en plaque du cuir chevelu associé à un mélanocytome méningé.

INTRODUCTION: Headache opposite to a blue nevus of the scalp can reveal intra cranial melanotic lesions. CASE REPORT: A 25-year-old man caucasian was admitted to hospital for a first generalized tonic-clonic seizure. For six months, he has had episodic frontal-temporal right headache opposite to a blue pigmentary cutaneous congenital lesion in frontal territory (histology confirmed benign blue nevus). Neurologic examination noted a right congenital hereditary ophtalmoplegia. Cerebral MRI showed a right rolandic tumor with diffuse leptomeninge infiltration. This patient was operated of a meningeal melanocytoma with leptomeninges melanosis. DISCUSSION: The apparition of headache related to a blue nevus must lead to realize a cerebral MRI to look for a neuroectodermic hamartoma: melanotic tumor (in particular melanoma), or leptomeninges melanosis with high potential of degeneration. Meningeal melanocytoma is a rare benign spinal or intra cranial melanotic tumor.

[Helminth diagnosis in pathologic anatomy]. / Le diagnostic des helminthes en anatomie pathologique.

Most publications devoted to diagnosis of helminths emphasize characteristic parasitological features. Histological feature are seldom described in detail. The purpose of this study was to propose a diagnostic method suitable for use by histologists who, unlike parasitologists, do not visualize the whole worm but rather pieces randomly scattered over a slide. It is relatively easy to distinguish helminths which have smooth muscle, no respiratory or circulatory system, and no coelom from arthropods which have striated muscle, both respiratory and circulatory systems, and coelom. At the adult stage, roundworms or nemathelminths present an external cuticle that may have patterned markings. The visceral cavity is empty. Adults can dwell either in the intestine in which case they are oviparous (oxyuris, ascaris, Ancylostoma, Strongyloides stercoralis, Trichuris...) or in tissue in which case they are viviparous (filaria). Larva of some species can be found in tissues. Adult tape-worms are devoid of cuticle and have a mesenchymatous visceral cavity. Cestodes which are segmented and have no digestive tract (taenias) are readily distinguishable from trematodes which are not segmented and have a digestive tract (faciolasis) Some cestodes unable thrive in man can cause cyst formation (hydatidosis, sparganosis, cysticercosis, coenurosis). On the basis of symptoms and histological features, it is usually possible to diagnose the genus and even the species of the offending helminth provided that the parasite has not been excessively damaged and that a sufficient number of sections are available.

[Subcutaneous Dirofilaria repens dirofilariasis]. / Dirofilariose sous-cutanée à dirofilaria repens.

The authors describe a case of Dirofilaria repens subcutaneous dirofilariasis, in a resident of Corsica (France). Epidemiological and morphological features are related for various species of Dirofilariasis. These data, mainly based on clinical history, are usually sufficient to exclude other forms of subcutaneous filariosis, especially tropical.

[Pseudo-parasites in histology and cytopathology]. / Les pseudo-parasites en anatomie et cytologie pathologiques.

When interpreting smears and specimens, histologist and cytopathologists can be misled by images mimicking micro-organisms especially parasites such as protozoa, mycotic agents or helminths. Although some of these pitfalls are well-known, others can be problematic especially if nature of the contaminant is the same as that of the parasite that it mimics. False protozoa parasites can correspond either to exogenous agents such as spores, remnants of human cells, or inert exogenous particles. Pseudo-yeast images can be due to pollen, starch or soot but especially to cells such as macrophages, spermatozoids, and neurons or to various inert bodies such as pigments or calcifications. Pseudomycotic filaments can result from vegetable silk, asbestos bodies, radiate granules or fibrin. Curschmann's spirals and vegetable fibers can be confused with helminths and bacterial particles or pollen with helminth eggs.

[Lipoblastic meningioma. An uncommon benign tumor]. / Méningiome lipoblastique. Une tumeur bénigne surprenante.

Often mentioned and not much documented, the lipoblastic meningioma is an unusual extra-axial benign tumor. It has spontaneously hypodensity in CT and appears with a high signal in MRI in T1-weighted sequence. Its vascularisation is rich and shows a strong contrast intake. Its resection is known as easy and its prognosis is excellent. The authors report here the observation of a 65 year old women having a lipoblastic meningioma. Literature is gone through and differential diagnoses are considered.