[Precancerous lesions of the uterine cervix in Pointe-Noire, Congo]. / Lésions précancéreuses du cancer du col utérin a Pointe-Noire: analyse de situation.

The purpose of this study was to determine the cytological profile and risk factors for intraepithelial precancerous lesions of the uterine cervix in an urban community of Pointe-Noire, an industrialized seaport located in the southeast region of Congo-Brazzaville. A transverse study was carried out over a period of 18 months (January 2003 to July 2004) in the Center for the Study of Human and Animal Diseases (CSHAD) at the General Adolphe Sie Hospital in Pointe-Noire. A total of 1347 files of women benefiting from cervico-vaginal smears were included in the study. Testing was undertaken either at the request of the patient (voluntary screening) or at the request of a health care provider (physician, midwife or nurse) in relation with various gynecological problems. The relative frequency of intraepithelial lesions was estimated to be 15.36% including 9.17% of low-grade intraepithelial lesions (Ig IEL) and 6.19% of high-grade intraepithelial lesions (hg IEL). The mean age of patients with hg IEL was 42.25 years (range, 12 to 17). Study of the interval between actual age at the time of sample collection and age of first sexual relations showed that women presenting IEL had an interval of at least 20 years. This interval probably corresponds to the time necessary for the interaction between human papillomavirus (HPV) and epithelial cells of the uterine cervix to induce intraepithelial lesions that lead to development of cancer of the uterine cervix. Comparative analysis of the number of sexual partners between the group of women with normal smears and the group with smears showing hg IEL indicated a clear predominance of the mean number of partners in the latter group, i.e., 2 +/- 1,2 versus 5 +/- 1,8 (p < 0.05). Most IEL were observed in multigestational women who accounted for 75.39% with a mean of 6.21 for hg IEL. This preliminary study provides a sound factual basis in terms of epidemiological data on these precancerous lesions of the uterine cervix in the Kouilou department of Congo-Brazzaville. These data will serve as benchmarks and guidance for forthcoming screening campaigns for early detection of uterine cervix cancer.

[Primary mandibular tuberculosis]. / Tuberculose mandibulaire primitive.

CASE REPORT: A 42 year-old patient presented a chronic submandibular tumefaction. Antibiotics were not effective. Diffuse osteolysis was noted on the panoramic. The diagnosis was provided by biopsy. The patient was cured after 9 months of antituberculosis tritherapy. DISCUSSION: Mandibular tuberculosis osteitis is extremely rare. Clinical and radiological presentation is not specific. Diagnosis can be suggested by the chronic course and the epidemiologic context.

[Detection of glial fibrillary acidic protein in central nervous tumors using an immunohistochemical method. Preliminary study of 33 cases (author's transl)]. / Le diagnostic des tumeurs nerveuses centrales par un marqueur de la protéine gliofibrillaire acide. Etude préliminaire d'une série de 33 cas.

Thirty-two cases of human central nervous tumor and one experimental glioma were studied in fixed paraffin or epon embedded tissues using the peroxidase-antiperoxidase method. The present study confirms the usefulness of immunohistochemical methods for the diagnostic evaluation of neuro-epithelial neoplasms. The authors also include some prognostic and histogenetic comments about glial tumors.

[Collar-stud tumour composed of combined neurilemmona and haemangioma elements. Clinicopathological study of one case with mediastinal and intraspinal localization (author's transl)]. / Tumeur en sablier à contingent schwannoglial et hémangiomateux. A propos d'une observation anatomo-clinique a localisation médiastinale et intrarachidienne.

A mediastinal and intraspinal collar-stud tumour in a 77 year-old-woman is reported. The orginality of this study comes from the histologic findings of a combined neurilemmoma and angioma. The authors also include a brief review of literature and clinicopathological and histogenetic comments, about these combined tumours.

[Astrocytic origin of a granular cell tumor of the cerebral hemispheres. Preliminary study of a case (author's transl)]. / Origine astrocytaire d'une tumeur à cellules granuleuses intracérébrale. Etude préliminaire d'une observation.

A case of intracerebral granular cell tumor is described in a 64 year-old woman. The originality of this study comes from the histological and histochemical evidence of its astrocytic origin. The authors also include clinical, pathological and histogenetic comments about this tumor.

Extraneural metastases of astrocytomas and glioblastomas: clinicopathological study of two cases and review of literature.

Two cases of intracranial gliomas with extraneural metastases are described. Case 1, studied with biopsy material only, was a left malignant astrocytoma from the area of the rolandic fissure with right cervical lymph nodes metastases in a 43-year-old man. Case 2 was a left temporal malignant astrocytoma in a 21-year-old woman. Fifteen days after craniotomy, a left submandibular lymph node metastasis appeared. Forty days after surgery, a ventriculoperitoneal shunt was performed. Fifty-four days after surgery, the patient died. Autopsy revealed three liver metastases. Our review of the literature consists of 72 autopsy cases with extraneural deposits. Thos metastases occurred mainly in adults (63/72) and among men (46/72). The primary glioma was supratentorial in 67 cases. Metastases were mainly pulmonary and pleural. The majority of patients (82.8%) died within 2 years after onset of symptoms. In 8 of the cases, metastasis developed without any craniotomy and in 8 other cases, through a shunt.

[Nervous system and lymphomatoid granulomatosis. Clinical, pathological and nosological considerations (author's transl)]. / Granulomatose lymphomatoïde et système nerveux. Aspects anatomo-cliniques et problèmes nosologiques.

This paper describes the first French case of lymphomatoid granulomatosis (LYG) in 46-year-old male. Autopsy revealed bilateral pulmonary involvement and multiple central nervous system (CNS) localizations. The originality of this study is due to 1st the scarcity of reported cases of LYG in Europe 2nd a detailed neuropathological study permitting diagnosis of multifocal central nervous involvement by LYG. In the literature only 12 previous cases of LYG have histologically proven CNS lesions. These lesions correspond to; 8 instances of LYG, one progressive multifocal leukencephalopathy,, one post-therapeutic disseminated necrotizing leukoencephalopathy, one immunoblastic sarcoma and one case of LYG associated with histiocytic malignant lymphoma. This paper also evokes clinical, histological, ultrastructural and prognostic characteristics of LYG gathered from the available literature. From a nosological point of view the relationship of LYG with Wegener granulomatosis, polymorphic reticulosis and certain lymphomas is still, to this day, not clearly established.

[Carcinoïd heart disease: clinical, light and electron microscopic study (author's transl)]. / Cardiopathies carcinoïdes. Etude anatomo-clinique et ultrastructurale.

The authors report a clinical and pathological case of carcinoïd heart disease in a 70-years old man. The primary carcinoïd tumor was ileal with both hepatic and neighbouring lymph node metastases. The clinical history was dominated by a typical carcinoïd syndrom biologically confirmed and accompanied by a tricuspid insufficiency. An autopsy permitted to described with precision the topography and extent of the cardiac affection. The originality of this work is due to the ultrastructural study which has rarely been done. This study permitted us to make some clinical histopathological, histogenetic and pathogenetic comments.

[Vertebro-basilar dissecting aneurysm : an anatomo-clinical case study fibrodysplasia of the left vertebral artery (author's transl)]. / Hémodissection vertébro-basilaire : une observation anatomo-clinique avec fibrodysplasie de l'artère vertébrale gauche.

A new anatomo-clinical case of vertebro-basilar dissecting aneurysm in a 43 year old woman is reported. The originality of this study comes from the autopsic discovery of an intimal fibro-dysplasia at the origin of the dissection in the left vertebral artery. The authors also included anatomoclinical and pathogenic comments about both the lesions discussed.