Introduction: Tuberculosis is the leading cause of pericardial effusion in sub-Saharan African countries. The aim of this study was to describe the diagnosis and the surgical management of tuberculous pericardial effu...Introduction: Tuberculosis is the leading cause of pericardial effusion in sub-Saharan African countries. The aim of this study was to describe the diagnosis and the surgical management of tuberculous pericardial effusion in low-income country. Methods: This was a retrospective and descriptive study performed at Vascular Surgery Unit for 10 years-period (from January 2012 to December 2021), including all cases of drainage of pericardial effusion due to tuberculosis. Results: Sixty-seven cases were recorded, including 38 males (56.71%) and 29 women (43.28%). The average age was 35.47 years old. Patients lived in urban areas in 67.16% of cases. Thirteen patients (13.43%) had a previous history of pulmonary tuberculosis. The most common risk factors for tuberculosis infection were malnourishment (80.59%), indoor air pollution (77.61%) and close contact with tuberculosis patient (40.29%). The commonest symptom were dyspnea, (95.52%), chest pain (89.55%), fever (67.16%), tachycardia (95.52%) and cough (80.59%). Twenty-seven patients (39.02%) presented clinical signs of cardiac tamponade. Electrocardiogram showed sinus tachycardia (97.53%) with microvoltage (39.02%). Chest-X-ray showed cardiomegaly (100%) and pleural effusion (56.71%). Echocardiography showed moderate (43.28%) and large (56.71%) pericardial effusion. All patients underwent subxiphoid pericardial drainage. Mycobacterium tuberculosis detection via GeneXpert test of pericardial effusion were positive in 38.80% of patients. Pericardial biopsies confirmed the diagnosis of tuberculosis in 41.79%. The mortality rate was 8.95%. Conclusion: Subxiphoid pericardial drainage reduced thr risk of cardiac tamponade in patients with massive pericardial effusion. Histopathology of pericardial biopsies made a definitive diagnosis for tuberculosis.展开更多
Nodular lymphoid hyperplasia of the colon (NLHC) is an uncommon pathology in adults. The disease can be asymptomatic and discovered incidentally or symptomatic, which is often manifested by abdominal pain and motility...Nodular lymphoid hyperplasia of the colon (NLHC) is an uncommon pathology in adults. The disease can be asymptomatic and discovered incidentally or symptomatic, which is often manifested by abdominal pain and motility disorders (diarrhea, constipation). The clinical presentation can also be alarming with rectal bleeding and obstructive symptoms that may be misinterpreted as a neoplastic process. In this paper, we report the case of a 58-year-old female patient with a previous history of appendicetomy. She presented with persistent abdominal pain, chronic constipation and black colored stools, following Covid-19 infection. The physical examination was unremarkable. Colonoscopy examination found a bulging, non-ulcerated mass, measuring 3.5 cm in greatest dimension, located at the right colic angle. Thoraco-abdomino-pelvic computed tomography was performed and showed right colonic wall thickening and enhanced nodule formation. Furthermore, metastatic localization was not detected. After a multidisciplinary meeting, a laparotomy with right hemicolectomy was performed. Histopathological examination of the surgical specimen revealed nodular lymphoid hyperplasia with CD20+, CD5−, CD10+ and BCL2−phenotype on immunohistochemistry. Besides, lymphocytes in interfollicular area are CD3+ T cells. Patient outcome was favorable after surgery and no additional treatment was necessary. Nodular lymphoid hyperplasia of the colon is a benign process whose endoscopic appearance can sometimes raise suspicion of malignancy. The diagnosis can only be established by histological evaluation. Immunohistochemistry is also essential to confirm the diagnosis and to rule out low-grade lymphoma. Clinical evolution is often favorable. However, endoscopic follow-up is necessary in all cases.展开更多
Although COVID-19 clinical manifestations are mostly respiratory gastrointestinal manifestations may also be encountered in some instances. However, at the time of our writing, little is known about COVID-19, associat...Although COVID-19 clinical manifestations are mostly respiratory gastrointestinal manifestations may also be encountered in some instances. However, at the time of our writing, little is known about COVID-19, associated pathologic changes in the digestive system. We describe a case of COVID-19 disease with digestive manifestations that demonstrated specific pathologic changes in the gastrointestinal tract. Histological examination of endoscopic biopsy samples from duodenum was performed in combination with a review of the literature. According to our literature review, digestive histopathologic changes have been reported in 14 cases of COVID-19 patients. Pathological findings were generally nonspecific in all these cases and ranged from epithelial damage, lymphoplasmacytic and macrophages infiltrates, prominent endothelitis and ischemic enterocolitis. In our patient, histological features were more specific, characterized by several viral cytopathic effects associated with mucosal damage, numerous microthrombi and positive staining of ACE2 on various enterocytes. Histological analysis is not a practical option for the diagnosis of SARS-CoV-2 infections but could help to elucidate pathophysiology of the disease. Those changes may be specific in the GI tract and related clinical manifestations should not be overlooked. Furthermore, preventive measures for oral-fecal transmission should not be minimized.展开更多
Mesenchymal neoplasms arising in the digestive tract are rare compared to adenomas and carcinomas [1]. They include several entities with histomorphological similarity and immunohistochemistry helps to confirm the dia...Mesenchymal neoplasms arising in the digestive tract are rare compared to adenomas and carcinomas [1]. They include several entities with histomorphological similarity and immunohistochemistry helps to confirm the diagnosis [2]. Our goals are to study the epidemiological aspect of mesenchymal tumors, and to compare the histological diagnoses before and after the use of immunochemistry. This is a retrospective, descriptive, single-center study performed on all cases of mesenchymal tumors in gastrointestinal tract, diagnosed at the laboratory of Pathological Anatomy Unit of Joseph Ravoahangy Andrianavalona University Hospital from January 1, 2007 to December 31, 2018. We included 29 cases. The mean age was 43.28 years. The sex ratio was 1.07. After immunohistochemical examination, 24.14% of tumors changed diagnosis to GISTs which are the most common mesenchymal tumor involving the gastrointestinal tract. In all cases of mesenchymal tumors of the gastrointestinal tract GIST should first be ruled out before making other diagnoses. Histologic and immunophenotypic features are thereby essential. According to the literature review, if c-Kit and DOG-1 are negative, molecular biology must be used.展开更多
Chronic gastritis is a persistent inflammation of the gastric mucosa. The Sydney System is the most widely used classification of this disease but it does not allow a ranking of patients according to the evolutionary ...Chronic gastritis is a persistent inflammation of the gastric mucosa. The Sydney System is the most widely used classification of this disease but it does not allow a ranking of patients according to the evolutionary potential of the disease, unlike the classifications: “Operative Link On Gastritis Assessment” (OLGA) and “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM). Our goals are to apply and evaluate the three classifications: the Sydney System, OLGA and OLGIM and to draw possible correlations. This is a retrospective, descriptive, single-center study performed on all cases of chronic gastritis, diagnosed at the laboratory of Pathological Anatomy Unit of Joseph Ravoahangy Andrianavalona University Hospital from January 1, 2013 to December 31, 2017. A review and application of the three main classification systems was performed on each case. We included 298 cases. The mean age was 50.85 years. The sex ratio was 1.48. The high-risk stages according to the “Operative Link On Gastritis Assessment” (OLGA) system and the “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM) system were 0.67% and 2.68%, respectively. We observed a correlation between the two systems with discordance of 5%. The use of the two new systems allows the assessment of the progressive potential of gastritis in patients at risk of developing gastric cancer. For optimal effectiveness of both classifications, biopsies should be performed according to the Sydney System recommendations.展开更多
Lymphangioma is a rare benign tumor of the lymphatic vessels of hamartomatous nature. We report a case of lingual lymphangioma in a 2-year-old child, revealed by macroglossia. The radiology suspected the lesion. Anato...Lymphangioma is a rare benign tumor of the lymphatic vessels of hamartomatous nature. We report a case of lingual lymphangioma in a 2-year-old child, revealed by macroglossia. The radiology suspected the lesion. Anatomopathological examination confirmed the diagnosis of cystic lymphangioma, and determined its characteristics.展开更多
文摘Introduction: Tuberculosis is the leading cause of pericardial effusion in sub-Saharan African countries. The aim of this study was to describe the diagnosis and the surgical management of tuberculous pericardial effusion in low-income country. Methods: This was a retrospective and descriptive study performed at Vascular Surgery Unit for 10 years-period (from January 2012 to December 2021), including all cases of drainage of pericardial effusion due to tuberculosis. Results: Sixty-seven cases were recorded, including 38 males (56.71%) and 29 women (43.28%). The average age was 35.47 years old. Patients lived in urban areas in 67.16% of cases. Thirteen patients (13.43%) had a previous history of pulmonary tuberculosis. The most common risk factors for tuberculosis infection were malnourishment (80.59%), indoor air pollution (77.61%) and close contact with tuberculosis patient (40.29%). The commonest symptom were dyspnea, (95.52%), chest pain (89.55%), fever (67.16%), tachycardia (95.52%) and cough (80.59%). Twenty-seven patients (39.02%) presented clinical signs of cardiac tamponade. Electrocardiogram showed sinus tachycardia (97.53%) with microvoltage (39.02%). Chest-X-ray showed cardiomegaly (100%) and pleural effusion (56.71%). Echocardiography showed moderate (43.28%) and large (56.71%) pericardial effusion. All patients underwent subxiphoid pericardial drainage. Mycobacterium tuberculosis detection via GeneXpert test of pericardial effusion were positive in 38.80% of patients. Pericardial biopsies confirmed the diagnosis of tuberculosis in 41.79%. The mortality rate was 8.95%. Conclusion: Subxiphoid pericardial drainage reduced thr risk of cardiac tamponade in patients with massive pericardial effusion. Histopathology of pericardial biopsies made a definitive diagnosis for tuberculosis.
文摘Nodular lymphoid hyperplasia of the colon (NLHC) is an uncommon pathology in adults. The disease can be asymptomatic and discovered incidentally or symptomatic, which is often manifested by abdominal pain and motility disorders (diarrhea, constipation). The clinical presentation can also be alarming with rectal bleeding and obstructive symptoms that may be misinterpreted as a neoplastic process. In this paper, we report the case of a 58-year-old female patient with a previous history of appendicetomy. She presented with persistent abdominal pain, chronic constipation and black colored stools, following Covid-19 infection. The physical examination was unremarkable. Colonoscopy examination found a bulging, non-ulcerated mass, measuring 3.5 cm in greatest dimension, located at the right colic angle. Thoraco-abdomino-pelvic computed tomography was performed and showed right colonic wall thickening and enhanced nodule formation. Furthermore, metastatic localization was not detected. After a multidisciplinary meeting, a laparotomy with right hemicolectomy was performed. Histopathological examination of the surgical specimen revealed nodular lymphoid hyperplasia with CD20+, CD5−, CD10+ and BCL2−phenotype on immunohistochemistry. Besides, lymphocytes in interfollicular area are CD3+ T cells. Patient outcome was favorable after surgery and no additional treatment was necessary. Nodular lymphoid hyperplasia of the colon is a benign process whose endoscopic appearance can sometimes raise suspicion of malignancy. The diagnosis can only be established by histological evaluation. Immunohistochemistry is also essential to confirm the diagnosis and to rule out low-grade lymphoma. Clinical evolution is often favorable. However, endoscopic follow-up is necessary in all cases.
文摘Although COVID-19 clinical manifestations are mostly respiratory gastrointestinal manifestations may also be encountered in some instances. However, at the time of our writing, little is known about COVID-19, associated pathologic changes in the digestive system. We describe a case of COVID-19 disease with digestive manifestations that demonstrated specific pathologic changes in the gastrointestinal tract. Histological examination of endoscopic biopsy samples from duodenum was performed in combination with a review of the literature. According to our literature review, digestive histopathologic changes have been reported in 14 cases of COVID-19 patients. Pathological findings were generally nonspecific in all these cases and ranged from epithelial damage, lymphoplasmacytic and macrophages infiltrates, prominent endothelitis and ischemic enterocolitis. In our patient, histological features were more specific, characterized by several viral cytopathic effects associated with mucosal damage, numerous microthrombi and positive staining of ACE2 on various enterocytes. Histological analysis is not a practical option for the diagnosis of SARS-CoV-2 infections but could help to elucidate pathophysiology of the disease. Those changes may be specific in the GI tract and related clinical manifestations should not be overlooked. Furthermore, preventive measures for oral-fecal transmission should not be minimized.
文摘Mesenchymal neoplasms arising in the digestive tract are rare compared to adenomas and carcinomas [1]. They include several entities with histomorphological similarity and immunohistochemistry helps to confirm the diagnosis [2]. Our goals are to study the epidemiological aspect of mesenchymal tumors, and to compare the histological diagnoses before and after the use of immunochemistry. This is a retrospective, descriptive, single-center study performed on all cases of mesenchymal tumors in gastrointestinal tract, diagnosed at the laboratory of Pathological Anatomy Unit of Joseph Ravoahangy Andrianavalona University Hospital from January 1, 2007 to December 31, 2018. We included 29 cases. The mean age was 43.28 years. The sex ratio was 1.07. After immunohistochemical examination, 24.14% of tumors changed diagnosis to GISTs which are the most common mesenchymal tumor involving the gastrointestinal tract. In all cases of mesenchymal tumors of the gastrointestinal tract GIST should first be ruled out before making other diagnoses. Histologic and immunophenotypic features are thereby essential. According to the literature review, if c-Kit and DOG-1 are negative, molecular biology must be used.
文摘Chronic gastritis is a persistent inflammation of the gastric mucosa. The Sydney System is the most widely used classification of this disease but it does not allow a ranking of patients according to the evolutionary potential of the disease, unlike the classifications: “Operative Link On Gastritis Assessment” (OLGA) and “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM). Our goals are to apply and evaluate the three classifications: the Sydney System, OLGA and OLGIM and to draw possible correlations. This is a retrospective, descriptive, single-center study performed on all cases of chronic gastritis, diagnosed at the laboratory of Pathological Anatomy Unit of Joseph Ravoahangy Andrianavalona University Hospital from January 1, 2013 to December 31, 2017. A review and application of the three main classification systems was performed on each case. We included 298 cases. The mean age was 50.85 years. The sex ratio was 1.48. The high-risk stages according to the “Operative Link On Gastritis Assessment” (OLGA) system and the “Operative Link on Gastritis Intestinal Metaplasia Assessment” (OLGIM) system were 0.67% and 2.68%, respectively. We observed a correlation between the two systems with discordance of 5%. The use of the two new systems allows the assessment of the progressive potential of gastritis in patients at risk of developing gastric cancer. For optimal effectiveness of both classifications, biopsies should be performed according to the Sydney System recommendations.
文摘Lymphangioma is a rare benign tumor of the lymphatic vessels of hamartomatous nature. We report a case of lingual lymphangioma in a 2-year-old child, revealed by macroglossia. The radiology suspected the lesion. Anatomopathological examination confirmed the diagnosis of cystic lymphangioma, and determined its characteristics.
