Angiosarcoma of the spleen. Case report and review of literature.

Angiosarcomatous tumours of the spleen are rather rare. We report such a tumor in a 46 year old male. The pathology is described as well as a review of the literature. The pathogenesis is unknown, the symptomatology indistinct but spontaneous rupture is a rare event. Definite diagnosis is only possible with exploratory laparotomy and splenectomy. The prognosis is poor.

Gastric pseudolymphoma.

The observation of a gastric pseudolymphoma is presented. Diagnostic, pathologic and therapeutic implications of this uncommon condition are discussed.

[Primary torsion of the greater omentum as a cause of acute abdomen]. / Primaire torsie van het omentum majus als oorzaak van een acuut abdomen.

The authors report one case of primary torsion of the greater omentum. The presenting symptoms are similar to those of an acute appendicitis. Diagnosis is rarely considered before laparotomy. The presence of sero-sanguineous peritoneal fluid should lead to careful exploration of the omentum, with resection of the involved segment.

Primary malignant melanoma of the gallbladder, metastatic to the common bile duct.

A primary malignant melanoma of the gallbladder, metastatic to the common bile duct, is reported. Both tumor sites were first visualized by abdominal sonography. The presence of the common bile duct metastasis was confirmed by endoscopic retrograde cholangiopancreatography. Histologic evidence is presented that the primary tumor did arise in the gallbladder and that the metastasis to the common bile duct most likely occurred as a consequence of mucosal implants from tumor cells that were shed in the bile.

[Malignant degeneration of the intestine in Crohn's disease]. / Maligne ontaarding van de darm bij ziekte van Crohn.

A woman suffering more than ten years with Crohn disease, makes one day a small intestinal obstruction. She undergoes a laparotomy in which a resection of 30 cm terminal ileum is done. Surprisingly the anatomo-pathologic diagnosis is adenocarcinoma between the Crohn's inflammatory lesions. Weedom and Greenstein have proven that Crohn disease and colon carcinoma are related in their follow-ups. But to find such a relationship between Crohn and carcinoma of the small intestine tumours is very small: +/- 0,3/100.000 in a year and so the cases in literature too. We have found 38 cases with enough information. This people with Crohn and carcinoma of the small intestine have an age of 43 years and more than 10 years Crohn symptoms before tumour was found. The tumours are localized in more than 70% in the ileum; 85% are adenocarcinoma. Such differences in localization, age and anatomopathology between Crohn's patients and a normal population let us presume that malign degeneration in Crohn disease is more than accidentally. A casual connection can't be given. For therapeutic use a resection is to prefer because many dysplasias are found in bypass segments.