Background: Prostate cancer, the most common male cancer, represents a real public health problem in terms of its frequency and severity in different countries around the world. It disproportionately affects people of...Background: Prostate cancer, the most common male cancer, represents a real public health problem in terms of its frequency and severity in different countries around the world. It disproportionately affects people of African descent wherever they live in the world [1]. To the best of our knowledge, its extent and particularities in the African environment are not well known. Objective: To determine the epidemiological and histopathological profile of prostate cancer in the CUK anatomopathology department. Methodology: This is a retrospective study conducted at the University Clinics of Kinshasa Anapathology Department from January 1, 2015 to December 31, 2022, a period of 8 years. Word processing and tables were entered using the Hp brand computer, with Microsoft Office WORD 2016 software. Data analysis was performed with SPSS version 22.0 software. Results were presented in tables and figures. Results: Prostate was diagnosed in 132 cases, i.e. 1.58% of all CUK laboratory analyses and 8% of cancers diagnosed. The age group most affected was 66-75 years, i.e. 59% of all subjects. Adenocarcinoma was the most frequent histological type, and biopsy dominated in 111 cases (84.1%). Conclusion: Prostate cancer is a real public health problem. Worldwide, and in the Democratic Republic of Congo, it is the most frequently diagnosed cancer in men, and the leading cause of cancer-related death in men. In the DRC, because of the delay in consulting our patients and the weakness of systematic screening, patients are seen at an advanced stage of the disease. Treatment is multidisciplinary, involving surgery, radiotherapy and chemotherapy (including targeted therapies). Patient awareness and screening campaigns will help to considerably reduce the delay in diagnosis and the morbidity and mortality associated with prostate cancer.展开更多
BACKGROUND New markers are needed to improve the effectiveness of serological screening for atrophic gastritis.AIM To develop a cost-effective method for serological screening of atrophic gastritis with a high level o...BACKGROUND New markers are needed to improve the effectiveness of serological screening for atrophic gastritis.AIM To develop a cost-effective method for serological screening of atrophic gastritis with a high level of sensitivity.METHODS Of the 169 patients with atrophic gastritis,selected by the visual endoscopic Kimura-Takemoto method,165 showed histological mucosal atrophy using the updated Kimura-Takemoto method.All 169 patients were examined for postprandial levels of gastrin-17(G17)and pepsinogen-1(PG1)using Gastro-Panel®(Biohit Plc,Helsinki,Finland).RESULTS We used the histological standard of five biopsies of the gastric mucosa,in accordance with the Kimura-Takemoto classification system to assess the sensitivity of G17 in detecting gastric mucosal atrophy.We also compared the morphofunctional relationships between the detected histological degree of gastric mucosal atrophy and the serological levels of G17 and PG1,as the markers of atrophic gastritis.The sensitivity of postprandial G17 was 62.2%for serological levels of G17(range:0-4 pmol/L)and 100%for serological G17(range:0-10 pmol/L)for the detection of monofocal severe atrophic gastritis.No strong correlation was found between the levels of PG1 and degree of histological atrophy determined by the Kimura-Takemoto classification system to identify the severity of mucosal atrophy of the gastric corpus.In the presented clinical case of a 63-year-old man with multifocal atrophic gastritis,there is a pronounced positive long-term dynamics of the serological marker of atrophy-postprandial G17,after five months of rennet replacement therapy.CONCLUSION Serological screening of multifocal atrophic gastritis by assessment of postprandial G17 is a cost-effective method with high sensitivity.Postprandial G17 is an earlier marker of regression of atrophic gastritis than a morphological examination of a gastric biopsy in accordance with the Sydney system.Therefore,postprandial G17 is recommended for dynamic monitoring of atrophic gastritis after treatment.展开更多
Background: The management of breast cancer increasingly requires molecular classification based on immunohistochemistry. As breast cancer is a heterogeneous disease characterized by the accumulation of multiple molec...Background: The management of breast cancer increasingly requires molecular classification based on immunohistochemistry. As breast cancer is a heterogeneous disease characterized by the accumulation of multiple molecular alterations that give each tumour its own phenotype and evolutionary potential, immunohistochemistry, as a complementary technique to morphological examination, determines the status of hormone receptors and on protein in tumour cells, which are predictive and prognostic markers of breast cancer. This technique is often little used in the Democratic Republic of Congo (DRC), as this study shows. The under-use of this technique due to a lack of equipment and/or human skills explains the paucity of epidemiological data available to date. Objective: Determine the immunohistochemical profile of breast cancer. Methodology: This is a retrospective study carried out in the Anapath Department of the NGANDA Hospital from January 1, 2020 to December 31, 2022, i.e. a 3-year period. Result: A total of 736 patients were registered in the hospitalization register of the Oncology Department of CH NGANDA for the period corresponding to the present study. Breast cancer was diagnosed in 110 patients, representing 14.9% of all cases. The mean age of the patients was 58.4 ± 8.2 years, with extremes ranging from 30 to 76 years. Breast nodules were the most common reason for diagnosis in 56.3% of cases, with Luminal A dominating in 17.3%. Conclusion: Breast cancer is a major public health problem. Worldwide, it is the most frequently diagnosed cancer in women and the leading cause of cancer-related death in women. In the Democratic Republic of Congo, because of the delay in consulting our patients and the weakness of systematic screening, patients are seen at an advanced stage of the disease. Treatment is multidisciplinary, involving surgery, radiotherapy, chemotherapy (including targeted therapies) and hormone therapy. Patient awareness and screening campaigns will contribute to a considerable reduction in the delay in diagnosis and the morbidity and mortality associated with breast cancer.展开更多
Introduction: Glomerular damage during Gougerot-Sjgren syndrome is much rarer than interstitial damage, and is essentially extra-membranous and membrano-proliferative glomerulonephritis. Observation: We report the cas...Introduction: Glomerular damage during Gougerot-Sjgren syndrome is much rarer than interstitial damage, and is essentially extra-membranous and membrano-proliferative glomerulonephritis. Observation: We report the case of a 44-year-old woman with primary Sjgrens syndrome, confirmed by clinical dryness syndrome, positive anti-SSA and anti-SSB antibodies, and a salivary gland biopsy revealing grade 4 lymphocytic sialadenitis according to CHISHOLMs classification. Later, the patient developed nephrotic syndrome, along with hypertension. Renal function remained normal with a creatinine level of 9.3 mg/l, and hematuria was absent. Only antinuclear antibodies tested positive, while anti-PLA2R antibodies were negative. A renal biopsy was performed, which was complicated on the same day by hemodynamic instability with hematuria. Renal CT scan with contrast injection revealed a posterior perirenal hematoma without contrast extravasation. Additionally, bilateral renal vein thrombosis was incidentally discovered, suggesting extramembranous glomerulonephritis. The patients hemodynamic status stabilized after fluid resuscitation with isotonic saline solution (0.9%), without the need for blood transfusion. Renal biopsy confirmed extramembranous glomerulonephritis with interstitial fibrosis and minimal tubular atrophy. The initial etiological assessment was negative. The patient was started on oral corticosteroids, angiotensin-converting enzyme inhibitors, and therapeutic anticoagulation for renal vein thrombosis. The patients condition improved, with the disappearance of the syndrome and spontaneous regression of the hematoma. Discussion: The association of nephrotic syndrome and renal vein thrombosis primarily suggests glomerulopathy, in particular extra-membranous glomerulonephritis. Sjgrens syndrome can be associated with extra-membranous glomerulonephritis without being its direct cause. Like, it is possible that it is a cause of glomerulonephritis, essentially extra membranous and membrano-proliferative. Conclusion: Sjgrens syndrome is generally underestimated cause of glomerulonephritis, which should be considered in cases of extra-membranous glomerulonephritis.展开更多
Context and Justification: The sigmoido-jugular junction connects two structures of different compositions and has a complex organization. The sinusoidal portion of its endothelium contains muscle cells in adults. Is ...Context and Justification: The sigmoido-jugular junction connects two structures of different compositions and has a complex organization. The sinusoidal portion of its endothelium contains muscle cells in adults. Is this the same presentation observed in fetuses? Objective: To describe the sigmoido-jugular junction in fetuses. Materials and Methods: Over a period of seven months, a histochemical and immunohistochemical study was conducted on 30 sigmoido-jugular junctions taken from 15 fetuses aged at least 32 weeks of gestation. These fetuses were obtained following expulsion due to intrauterine death, after informed consent from the parents. Results: Three portions can be identified: sigmoid, junctional, and jugular. Histochemical preparations revealed the existence of two constant layers and a third layer present only at the jugular level. From the inside out, the layers are as follows: 1) Inner Layer (Endothelium): This layer is clearer from the junction and reveals the presence of smooth muscle cells at the sigmoid level in immunohistochemistry. 2) Outer Layer: At the sigmoid and junctional levels, this layer consists of collagen fibers and becomes median at the jugular level, where it is composed of elastic and muscular collagen fibers. 3) Third Layer: Present only at the jugular level, this layer corresponds to the adventitia. Conclusion: The architecture of the sigmoido-jugular junction in fetuses, which is identical to that in adults, excludes the metaplastic hypothesis regarding endothelial smooth muscle cells in the sigmoid portion. Instead, it favors their role in regulating encephalic venous drainage.展开更多
Kyoto global consensus reports that the current ICD-10 classification for gastritis is obsolete.The Kyoto classification of gastritis states that severe mucosal atrophy has a high risk of gastric cancer,while mild to ...Kyoto global consensus reports that the current ICD-10 classification for gastritis is obsolete.The Kyoto classification of gastritis states that severe mucosal atrophy has a high risk of gastric cancer,while mild to moderate atrophy has a low risk.The updated Kimura-Takemoto classification of atrophic gastritis considers five histological types of multifocal corpus atrophic gastritis according to stages C2 to O3.This method of morphological diagnosis of atrophic gastritis increases sensitivity by 2.4 times for severe atrophy compared to the updated Sydney system.This advantage should be considered when stratifying the high risk of gastric cancer.The updated Kimura-Takemoto classification of atrophic gastritis should be used as a reference standard(gold standard)in studies of morphofunctional relationships to identify serological markers of atrophic gastritis with evidence-based effectiveness.The use of artificial intelligence in the serological screening of atrophic gastritis makes it possible to screen a large number of the population.During serological screening of atrophic gastritis and risk stratification of gastric cancer,it is advisable to use the Kyoto classification of gastritis with updated Kimura-Takemoto classification of atrophic gastritis.展开更多
Background: The incidence of cervical cancer in Belgium is 11.1 per 100,000. With the introduction of cervical cytology screening and more recently anti-HPV vaccination, this rate has been decreasing for almost 20 yea...Background: The incidence of cervical cancer in Belgium is 11.1 per 100,000. With the introduction of cervical cytology screening and more recently anti-HPV vaccination, this rate has been decreasing for almost 20 years. Despite this, some patients are missed by the screening and prevention system and cervical cancer is still diagnosed at an advanced stage. Recurrences by splenic metastases are rare and are most often found at autopsy. Case Study: We describe the case of a 41-year-old caucasian patient with a single splenic recurrence after radiotherapy, chemotherapy, brachytherapy, and surgery for a poorly differentiated adenocarcinoma of the cervix grade 3 at an initial stage IIB according to FIGO. This recurrence happens 3 years after the initial treatment. After monitoring this asymptomatic lesion, the size increase results in laparoscopic splenectomy. Histology demonstrates a splenic metastasis recurrence of adenocarcinoma of endocervical origin. Conclusion: The spleen is a rare metastatic site in cervical cancer. Splenectomy followed by chemotherapy is the therapy most often found in the literature, which is however poor in this regard.展开更多
Prostate cancer is a public health problem in Senegal. It is one of the most common cancers in men and can be detected early by PSA measurement and confirmed by the pathological study which specifies the histological ...Prostate cancer is a public health problem in Senegal. It is one of the most common cancers in men and can be detected early by PSA measurement and confirmed by the pathological study which specifies the histological type and evaluates the histoprognostic scores (Gleason and pTNM). We did not find any anatomopathological study highlighting a link between the PSA t rate and histoprognostic Gleason scores in Senegal. Objective: We carried out this work aimed at determining whether there is a correlation between the PSA t rate and the histoprognostic Gleason score, in our context. Methodology: This is a retrospective, descriptive and analytical study conducted from January 2013 to October 2021, based on histologically proven prostate cancer cases with a specified PSA level, diagnosed in the pathological anatomy and cytology laboratory of Aristide Le Dantec hospital. Results: We identified 654 cases of prostate cancer. The average age was 68.59 ± 5.8 years with extremes of 40 years to 92 years. More than half of our cohort presented a clinical stage T2c, i.e. 56.94%. The average prostate volume on ultrasound was 81.81 ± 66 cc. The median PSA t was 110.5 ng/ml, with extremes ranging from 2 ng/ml to 74,770 ng/ml. Prostatic adenocarcinoma was the only histological type found in our patients. There was a predominance of Gleason score 6 (PICU grade group 1) observed in 35.17% of patients. Well-differentiated cancers were predominant and represented 35.17%. There was a statistically significant positive correlation between PSA t level and Gleason score (Spearman’s Rho = 0.305, p = 0.000). Conclusion: This study shows that in the Senegalese population, in patients with prostate cancer, the higher the PSA t level rises above normal, the higher the Gleason score tends to be.展开更多
This review describes current approaches to the management of patients with cirrhotic ascites in relation to the severity of its clinical manifestations. The PubMed database, the Google Scholar retrieval system, the C...This review describes current approaches to the management of patients with cirrhotic ascites in relation to the severity of its clinical manifestations. The PubMed database, the Google Scholar retrieval system, the Cochrane Database of Systematic Reviews, and the reference lists from related articles were used to search for relevant publications. Articles corresponding to the aim of the review were selected for 1991-2018 using the keywords:“liver cirrhosis,”“portal hypertension,”“ascites,”“pathogenesis,”“diagnostics,” and “treatment.” Uncomplicated and refractory ascites in patients with cirrhosis were the inclusion criteria. The literature analysis has shown that despite the achievements of modern hepatology, the presence of ascites is associated with poor prognosis and high mortality. The key to successful management of patients with ascites may be the stratification of the risk of an adverse outcome and personalized therapy. Pathogenetically based approach to the choice of pharmacotherapy and optimization of minimally invasive methods of treatment may improve the quality of life and increase the survival rate of this category of patients.展开更多
BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was ...BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was developed to overcome theselimitations.AIMTo compare the morphological classification of atrophic gastritis between theKimura-Takemoto system and the Updated Sydney system.METHODSA total of 169 patients with atrophic gastritis were selected according to diagnosisby the visual endoscopic Kimura-Takemoto method. Following the UpdatedKimura-Takemoto classification system, one antrum biopsy and five gastriccorpus biopsies were taken according to the visual stages of the Kimura-Takemoto system. The Updated Kimura-Takemoto classification system was thenapplied to each and showed 165 to have histological mucosal atrophy;theremaining 4 patients had no histological evidence of atrophy in any biopsy. The Updated Kimura-Takemoto classification was verified as a referencemorphological method and applied for the diagnosis of atrophic gastritis. Addingone more biopsy from the antrum to the six biopsies according to the Updated Kimura-Takemoto classification, constitutes the updated combined Kimura-Takemoto classification and Sydney system.RESULTSThe sensitivity for degree of mucosal atrophy assessed by the Updated Sydneysystem was 25% for mild, 36% for moderate, and 42% for severe, when comparedwith the Updated Kimura-Takemoto classification of atrophic gastritis formorphological diagnosis. Four types of multifocal atrophic gastritis wereidentified: sequential uniform (type 1;in 28%), sequential non-uniform (type 2;in7%), diffuse uniform (type 3;in 23%), diffuse non-uniform (type 4;in 24%), and"alternating atrophic – non-atrophic" (type 5;in 18%). The pattern of the spread ofatrophy, sequentially from the antrum to the cardiac segment of the stomach,which was described by the Updated Kimura-Takemoto system, washistologically confirmed in 82% of cases evaluated.CONCLUSIONThe Updated Sydney system is significantly inferior to the Updated Kimura-Takemoto classification for morphological verification of atrophic gastritis.展开更多
Plexiform angiomyxoid myofibroblastic tumor(PAMT) is a rare benign mesenchymal tumor of stomach. Rarity of this kind of tumors and scarce review articles may cause underrecognition of this entity and pose a real diagn...Plexiform angiomyxoid myofibroblastic tumor(PAMT) is a rare benign mesenchymal tumor of stomach. Rarity of this kind of tumors and scarce review articles may cause underrecognition of this entity and pose a real diagnostic challenge to gastroenterologists, pathologists and surgeons when encountering such patients and differentiating PAMT from other gastric intramural tumors. We report a case of 28-year-old woman, who presented with epigastric pain after meals, iron-deficiency anaemia and weight loss. Upper gastrointestinal endoscopy revealed submucosal tumorlike elevated lesion in the anterior wall of the antrum with intact overlying mucosa. Endoscopic ultrasound showed a 3-cm hypoechoic homogenous mass, originating from the third layer of the gastric wall. Endoscopic ultrasound-guided fine needle aspiration was not informative. Endoscopic buttonhole biopsy was performed to obtain specimens. Following this, the unexpected prolapse of the tumor occurred into the lumen of the stomach, causing gastric outlet obstruction- the biopsy was obtained. Pathomorphological features suggested the diagnosis of PAMT. Gastric resection of the Billroth I type was performed. Diagnosis was confirmed by histological analysis of the surgical specimen.展开更多
BACKGROUND In metastatic colorectal cancer(mCRC),the anti-vascular endothelial growth factor drug bevacizumab(BVZ)plus chemotherapy significantly improves progression-free survival compared to chemotherapy(CT)alone.Th...BACKGROUND In metastatic colorectal cancer(mCRC),the anti-vascular endothelial growth factor drug bevacizumab(BVZ)plus chemotherapy significantly improves progression-free survival compared to chemotherapy(CT)alone.This benefit is not,however,observed in all patients.While increased chemokine CXCL5 gene expression promoting angiogenesis has been proposed as a prognostic mCRC biomarker,few studies have examined its relationship with drug efficacy.This study sought to analyze tumor CXCL5 gene expression in six patients with different efficacy of BVZ-containing CT in terms of the tumor response to treatment.CASE SUMMARY We report six cases of stage IV KRAS-mutated mCRC.Patients were given first line treatment with BVZ-containing chemotherapy in University Hospital of Fuenlabrada.The six patients differed in terms of primary tumor location(right/left side),tumor burden(mostly hepatic and peritoneal disease)and clinical disease course.Before treatment onset,total RNA was isolated from paraffinated tumor biopsy specimens and CXCL5 gene expression quantified through conventional RT-qPCR procedures.Our main finding was that CXCL5 expression levels were several times higher in three patients with lower progression free survival(under 6 mo)from the start of treatment.CONCLUSION A higher expression of CXCL5 was observed in the three patients showing worse tumor response to treatment.展开更多
Cystic hepatic neoplasms are rare tumors,and are classified into two separate entities:mucinous cystic neoplasms(MCNs)and intraductal papillary mucinous neoplasms of the bile duct(IPMN-B).We report the case of a 56-ye...Cystic hepatic neoplasms are rare tumors,and are classified into two separate entities:mucinous cystic neoplasms(MCNs)and intraductal papillary mucinous neoplasms of the bile duct(IPMN-B).We report the case of a 56-year-old woman who presented with abdominal pain and jaundice due to the presence of a large hepatic multilocular cystic tumor associated with an intraductal tumor.Partial hepatectomy with resection of extrahepatic bile ducts demonstrated an intrahepatic MCN and an intraductal IPMN-B.This is the first report of the simultaneous occurrence of these two histologically distinct entities in the liver.展开更多
Sarcoidosis is a multisystem chronic inflammatory condition of unknown etiology that has the potential to involve every tissue in the body.Sarcoidosis in the gastrointestinal system,and particularly the colon,is very ...Sarcoidosis is a multisystem chronic inflammatory condition of unknown etiology that has the potential to involve every tissue in the body.Sarcoidosis in the gastrointestinal system,and particularly the colon,is very rare.Here,we report the case of a 57-yearold man with no previous diagnosis of sarcoidosis who presented with new onset of abdominal pain and constipation.A colonoscopy revealed that the abdominal pain was caused by an obstructing lesion in the cecum-ascending colon and lacked a clear histologic diagnosis.Radiologic investigation revealed concentric wall thickening of the cecum-ascending colon with multiple satellite lymphadenopathies,highly suggestive of a malignancy.The patient underwent a laparotomy and a right hemicolectomy was performed.A diagnosis of colonic sarcoidosis was made after the resected specimen was examined.Additionally,a chest computed tomography scan revealed lung involvement with atypical radiologic features in the absence of respiratory symptoms.Only histologic examination of the surgical specimen can yield a diagnosis of gastrointestinal sarcoidosis due to the non-specificity of endoscopic and radiologic findings.展开更多
Pulmonary artery intimal sarcoma(PAIS) is a rare tumor with a very poor prognosis. Clinical and radiological findings usually mimic thromboembolic disease, leading to diagnostic delays. The treatment of choice is surg...Pulmonary artery intimal sarcoma(PAIS) is a rare tumor with a very poor prognosis. Clinical and radiological findings usually mimic thromboembolic disease, leading to diagnostic delays. The treatment of choice is surgery, and adjuvant chemotherapy and radiotherapy have limited results. We report the case of a 48-year-old male patient, initially suspected with pulmonary thromboembolism. The angio-CT revealed a filling defect in the pulmonary artery trunk. The patient underwent surgery, resulting in with complete resection of the mass with a diagnosis of PAIS. The tumor progressed rapidly in the lung, requiring surgery of multiple lung metastases. The patient was treated with stereotactic body radiation therapy(SBRT) on two occasions for new pulmonary lesions. In the last follow-up(4 years after initial diagnosis), the patient was disease-free. In conclusion, SBRT proved to be an alternative treatment to metastasectomy, allowing palliative chemotherapy to be delayed or omitted, which may result in improved quality of life.展开更多
AIM: To investigate neurofibromatosis type 2(NF2) gene mutation at mRNA levels in sporadic orbitocranial meningioma and its association with progesterone receptor(PR) mR NA expression.METHODS: This was a case-control ...AIM: To investigate neurofibromatosis type 2(NF2) gene mutation at mRNA levels in sporadic orbitocranial meningioma and its association with progesterone receptor(PR) mR NA expression.METHODS: This was a case-control study. Thirty-four sporadic meningioma patients with no familial NF2-related meningioma history were recruited. They were interviewed for their obstetric, gynecologic, and contraception history. PR investigation was performed with real-time polymerase chain reaction(PCR). NF2 mutation was investigated using Qbiomarker Somatic Mutation PCR Assay at NF2 mRNA level after its cDNA extraction(four mRNA mutation cytoband coordinates for nucleotide change: c.634 C>T/p.Q212, c.655 G>A/p.V219 M, c.784 C>T/p.R262 and c.1228 C>T/p. Q410). RESULTS: After mutation analysis at mRNA level, NF2 gene mutation was found in 35.29% patients. Non-mutation group was strongly associated with exogenous hormonal exposure(non-mutation vs mutation: 95.5% vs 83.3%, P<0.001). PR mR NA was found significantly lower in nonmutation group(P=0.033) which presumed as long term exogenous progesterone exposure. However, mutation group was associated with higher rate of progression to gradeⅡ(mutation vs non-mutation, 18.2% vs 5%, P<0.001) and was associated more in fibrous and anaplastic tumor tissue.CONCLUSION: NF2 mutation-meningioma is associated with higher grade of meningioma. Non NF2 mutationmeningioma is strongly associated with exogenous progesterone exposure and lower PR expression.展开更多
BACKGROUND Pituitary apoplexy represents one of the most serious,life threatening endocrine emergencies that requires immediate management.Gonadotropin-releasing hormone agonist(GnRHa)can induce pituitary apoplexy in ...BACKGROUND Pituitary apoplexy represents one of the most serious,life threatening endocrine emergencies that requires immediate management.Gonadotropin-releasing hormone agonist(GnRHa)can induce pituitary apoplexy in those patients who have insidious pituitary adenoma coincidentally.CASE SUMMARY A 46-year-old woman,with a history of hypertension and menorrhagia was transferred to our hospital from a secondary care hospital after complaints of headache and vomiting,with loss of consciousness 5 min after an injection of GnRHa.The drug was prescribed by her gynecologist due to the presence of uterine myomas.The clinical neurological examination revealed right cranial nerve III palsy,ptosis and movement limitation of the right eye.Our first clinical consideration was a pituitary apoplexy.Blood hormonal analysis revealed mild hyperprolactinemia and high follicle stimulating hormone level;PTH and calcium was high with glomerular filtration rate mildly to moderately decrease.A computed tomography scan,revealed an enlarged pituitary gland(3.5 cm)impinging upon the optic chiasm with bone involvement of the sella.Following contrast media administration,the lesion showed homogeneous enhancement with high-density focus that suggests hemorrhagic infarction of the tumor.Transsphenoidal endoscopic surgery was perfomed and adenomatous tissue was removed.Immunohistochemistry was positive for luteinizing hormone(LH)and follicular-stimulating hormone(FSH).A solid hypoechoic nodule(14 mm x 13 mm x 16 mm)was found in the caudal portion of the right thyroid lobe after a parathyroid ultrasound.A genetic test of Multiple Endocrine Neoplasia type 1(MEN1)was negative.A right lower parathyroidectomy was performed and the pathologic study showed the presence of an encapsulated parathyroid carcinoma of 1.5 cm.A MEN type 4 genetic test was performed result was negative.CONCLUSION This case demonstrates an uncommon complication of GnRH agonist therapy in the setting of a pituitary macroadenoma and the casual finding of parathyroid carcinoma.It also highlights the importance of suspecting the presence of a multiple endocrine neoplasia syndrome and to carry out relevant genetic studies.展开更多
<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</str...<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Rhabdomyosarcoma (RMS) is the most common soft tissue tumor in children, with the head and neck location accounting for up to 40% of cases. The embryonal and alveolar histologic variants are more commonly seen in pediatric patients. The treatment is multimodal and the prognosis of this clinical entity is always gloomy.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">We report the case of nasopharyngeal rhabdomyosarcoma in a 7-year-old boy child with a good response to early post-therapy.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Case</span></b></span></span><span><span><b><span style="font-family:;" "=""> </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Presentation</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The patient was diagnosed with nasopharyngeal RMS revealed by a congested nose, ptosis and bilateral blindness, and who received induction chemotherapy followed by concurrent radiotherapy followed by adjuvant chemotherapy. The evolution is marked by a good clinical course but persistence of bilateral blindness</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The RMS nasopharyngeal often presents with nonspecific symptoms. Multimodal therapy should be performed including surgery, chemotherapy and radiotherapy.</span></span></span>展开更多
BACKGROUND Primary liver cancer is common in West Africa due to endemic risk factors.However,epidemiological studies of the global burden and trends of liver cancer are limited.We report changes in trends of the incid...BACKGROUND Primary liver cancer is common in West Africa due to endemic risk factors.However,epidemiological studies of the global burden and trends of liver cancer are limited.We report changes in trends of the incidence of liver cancer over a period of 28 years using the population-based cancer registry of Bamako,Mali.To assess the trends and patterns of liver cancer by gender and age groups by analyzing the cancer registration data accumulated over 28 years(1987-2015)of activity of the population-based registry of the Bamako district.METHODS Data obtained since the inception of the registry in 1987 through 2015 were stratified into three periods(1987-1996,1997-2006,and 2007-2015).Age-standardized rates were estimated by direct standardization using the world population.Incidence rate ratios and the corresponding 95%confidence intervals(CI)were estimated using the early period as the reference(1987-1996).Joinpoint regression models were used to assess the annual percentage change and highlight trends over the entire period(from 1987 to 2015).RESULTS Among males,the age-standardized incidence rates significantly decreased from 19.41(1987-1996)to 13.12(1997-2006)to 8.15(2007-2015)per 105 person-years.The incidence rate ratio over 28 years was 0.42(95%CI:0.34-0.50),and the annual percentage change was-4.59[95%CI:(-6.4)-(-2.7)].Among females,rates dropped continuously from 7.02(1987-1996)to 2.57(2007-2015)per 105 person-years,with an incidence rate ratio of 0.37(95%CI:0.28-0.45)and an annual percentage change of-5.63[95%CI:(-8.9)-(-2.3)].CONCLUSION The population-based registration showed that the incidence of primary liver cancer has steadily decreased in the Bamako district over 28 years.This trend does not appear to result from biases or changes in registration practices.This is the first report of such a decrease in an area of high incidence of liver cancer in Africa.This decrease may be explained by the changes and diversity of diet that could reduce exposure to aflatoxins through dietary contamination in this population.展开更多
The purpose of this study was to determine the thickness of skin and fat folds in Kyrgyz women of various ages, taking into account their somatotypological profile. Using the method of complex anthropometry, including...The purpose of this study was to determine the thickness of skin and fat folds in Kyrgyz women of various ages, taking into account their somatotypological profile. Using the method of complex anthropometry, including the determination of the values of 21 anthropometric parameters, the physical status of 1028 Kyrgyz women of different age groups was studied youth (16 - 20 years old 310 girls), mature age (1st period, 21 - 35 years old 308 women;2nd period, 36 - 55 years 410 women) living in Osh, Kyrgyzstan. For somatotyping, we used the scheme of constitutional diagnostics. Seven somatotypes distinguished within three constitutional groups. The subcutaneous fat was measured by caliperometry. Statistical processing carried out using the statistical programs Microsoft Excel and the STATISTICA package (v. 6.0). To determine the reliability of the differences between the indicators, the Student’s test was used (p < 0.05). The results demonstrate that within each somatotype there are broad changes in the studied anthropometric indicator. Thus, the thickness of the skin and fat folds is the smallest in women of asthenic, athletic and stenoplastic (p < 0.05), and the largest in representatives of the euriplastic and pycnic somatotypes (p < 0.05). Thus, indicators of physical status in adolescence and adulthood in women have a pronounced somatotypological specificity. These materials on the physical development and constitutional and typological characteristics of the studied population of women applicable for a personalized approach in the context of a relative norm.展开更多
文摘Background: Prostate cancer, the most common male cancer, represents a real public health problem in terms of its frequency and severity in different countries around the world. It disproportionately affects people of African descent wherever they live in the world [1]. To the best of our knowledge, its extent and particularities in the African environment are not well known. Objective: To determine the epidemiological and histopathological profile of prostate cancer in the CUK anatomopathology department. Methodology: This is a retrospective study conducted at the University Clinics of Kinshasa Anapathology Department from January 1, 2015 to December 31, 2022, a period of 8 years. Word processing and tables were entered using the Hp brand computer, with Microsoft Office WORD 2016 software. Data analysis was performed with SPSS version 22.0 software. Results were presented in tables and figures. Results: Prostate was diagnosed in 132 cases, i.e. 1.58% of all CUK laboratory analyses and 8% of cancers diagnosed. The age group most affected was 66-75 years, i.e. 59% of all subjects. Adenocarcinoma was the most frequent histological type, and biopsy dominated in 111 cases (84.1%). Conclusion: Prostate cancer is a real public health problem. Worldwide, and in the Democratic Republic of Congo, it is the most frequently diagnosed cancer in men, and the leading cause of cancer-related death in men. In the DRC, because of the delay in consulting our patients and the weakness of systematic screening, patients are seen at an advanced stage of the disease. Treatment is multidisciplinary, involving surgery, radiotherapy and chemotherapy (including targeted therapies). Patient awareness and screening campaigns will help to considerably reduce the delay in diagnosis and the morbidity and mortality associated with prostate cancer.
文摘BACKGROUND New markers are needed to improve the effectiveness of serological screening for atrophic gastritis.AIM To develop a cost-effective method for serological screening of atrophic gastritis with a high level of sensitivity.METHODS Of the 169 patients with atrophic gastritis,selected by the visual endoscopic Kimura-Takemoto method,165 showed histological mucosal atrophy using the updated Kimura-Takemoto method.All 169 patients were examined for postprandial levels of gastrin-17(G17)and pepsinogen-1(PG1)using Gastro-Panel®(Biohit Plc,Helsinki,Finland).RESULTS We used the histological standard of five biopsies of the gastric mucosa,in accordance with the Kimura-Takemoto classification system to assess the sensitivity of G17 in detecting gastric mucosal atrophy.We also compared the morphofunctional relationships between the detected histological degree of gastric mucosal atrophy and the serological levels of G17 and PG1,as the markers of atrophic gastritis.The sensitivity of postprandial G17 was 62.2%for serological levels of G17(range:0-4 pmol/L)and 100%for serological G17(range:0-10 pmol/L)for the detection of monofocal severe atrophic gastritis.No strong correlation was found between the levels of PG1 and degree of histological atrophy determined by the Kimura-Takemoto classification system to identify the severity of mucosal atrophy of the gastric corpus.In the presented clinical case of a 63-year-old man with multifocal atrophic gastritis,there is a pronounced positive long-term dynamics of the serological marker of atrophy-postprandial G17,after five months of rennet replacement therapy.CONCLUSION Serological screening of multifocal atrophic gastritis by assessment of postprandial G17 is a cost-effective method with high sensitivity.Postprandial G17 is an earlier marker of regression of atrophic gastritis than a morphological examination of a gastric biopsy in accordance with the Sydney system.Therefore,postprandial G17 is recommended for dynamic monitoring of atrophic gastritis after treatment.
文摘Background: The management of breast cancer increasingly requires molecular classification based on immunohistochemistry. As breast cancer is a heterogeneous disease characterized by the accumulation of multiple molecular alterations that give each tumour its own phenotype and evolutionary potential, immunohistochemistry, as a complementary technique to morphological examination, determines the status of hormone receptors and on protein in tumour cells, which are predictive and prognostic markers of breast cancer. This technique is often little used in the Democratic Republic of Congo (DRC), as this study shows. The under-use of this technique due to a lack of equipment and/or human skills explains the paucity of epidemiological data available to date. Objective: Determine the immunohistochemical profile of breast cancer. Methodology: This is a retrospective study carried out in the Anapath Department of the NGANDA Hospital from January 1, 2020 to December 31, 2022, i.e. a 3-year period. Result: A total of 736 patients were registered in the hospitalization register of the Oncology Department of CH NGANDA for the period corresponding to the present study. Breast cancer was diagnosed in 110 patients, representing 14.9% of all cases. The mean age of the patients was 58.4 ± 8.2 years, with extremes ranging from 30 to 76 years. Breast nodules were the most common reason for diagnosis in 56.3% of cases, with Luminal A dominating in 17.3%. Conclusion: Breast cancer is a major public health problem. Worldwide, it is the most frequently diagnosed cancer in women and the leading cause of cancer-related death in women. In the Democratic Republic of Congo, because of the delay in consulting our patients and the weakness of systematic screening, patients are seen at an advanced stage of the disease. Treatment is multidisciplinary, involving surgery, radiotherapy, chemotherapy (including targeted therapies) and hormone therapy. Patient awareness and screening campaigns will contribute to a considerable reduction in the delay in diagnosis and the morbidity and mortality associated with breast cancer.
文摘Introduction: Glomerular damage during Gougerot-Sjgren syndrome is much rarer than interstitial damage, and is essentially extra-membranous and membrano-proliferative glomerulonephritis. Observation: We report the case of a 44-year-old woman with primary Sjgrens syndrome, confirmed by clinical dryness syndrome, positive anti-SSA and anti-SSB antibodies, and a salivary gland biopsy revealing grade 4 lymphocytic sialadenitis according to CHISHOLMs classification. Later, the patient developed nephrotic syndrome, along with hypertension. Renal function remained normal with a creatinine level of 9.3 mg/l, and hematuria was absent. Only antinuclear antibodies tested positive, while anti-PLA2R antibodies were negative. A renal biopsy was performed, which was complicated on the same day by hemodynamic instability with hematuria. Renal CT scan with contrast injection revealed a posterior perirenal hematoma without contrast extravasation. Additionally, bilateral renal vein thrombosis was incidentally discovered, suggesting extramembranous glomerulonephritis. The patients hemodynamic status stabilized after fluid resuscitation with isotonic saline solution (0.9%), without the need for blood transfusion. Renal biopsy confirmed extramembranous glomerulonephritis with interstitial fibrosis and minimal tubular atrophy. The initial etiological assessment was negative. The patient was started on oral corticosteroids, angiotensin-converting enzyme inhibitors, and therapeutic anticoagulation for renal vein thrombosis. The patients condition improved, with the disappearance of the syndrome and spontaneous regression of the hematoma. Discussion: The association of nephrotic syndrome and renal vein thrombosis primarily suggests glomerulopathy, in particular extra-membranous glomerulonephritis. Sjgrens syndrome can be associated with extra-membranous glomerulonephritis without being its direct cause. Like, it is possible that it is a cause of glomerulonephritis, essentially extra membranous and membrano-proliferative. Conclusion: Sjgrens syndrome is generally underestimated cause of glomerulonephritis, which should be considered in cases of extra-membranous glomerulonephritis.
文摘Context and Justification: The sigmoido-jugular junction connects two structures of different compositions and has a complex organization. The sinusoidal portion of its endothelium contains muscle cells in adults. Is this the same presentation observed in fetuses? Objective: To describe the sigmoido-jugular junction in fetuses. Materials and Methods: Over a period of seven months, a histochemical and immunohistochemical study was conducted on 30 sigmoido-jugular junctions taken from 15 fetuses aged at least 32 weeks of gestation. These fetuses were obtained following expulsion due to intrauterine death, after informed consent from the parents. Results: Three portions can be identified: sigmoid, junctional, and jugular. Histochemical preparations revealed the existence of two constant layers and a third layer present only at the jugular level. From the inside out, the layers are as follows: 1) Inner Layer (Endothelium): This layer is clearer from the junction and reveals the presence of smooth muscle cells at the sigmoid level in immunohistochemistry. 2) Outer Layer: At the sigmoid and junctional levels, this layer consists of collagen fibers and becomes median at the jugular level, where it is composed of elastic and muscular collagen fibers. 3) Third Layer: Present only at the jugular level, this layer corresponds to the adventitia. Conclusion: The architecture of the sigmoido-jugular junction in fetuses, which is identical to that in adults, excludes the metaplastic hypothesis regarding endothelial smooth muscle cells in the sigmoid portion. Instead, it favors their role in regulating encephalic venous drainage.
文摘Kyoto global consensus reports that the current ICD-10 classification for gastritis is obsolete.The Kyoto classification of gastritis states that severe mucosal atrophy has a high risk of gastric cancer,while mild to moderate atrophy has a low risk.The updated Kimura-Takemoto classification of atrophic gastritis considers five histological types of multifocal corpus atrophic gastritis according to stages C2 to O3.This method of morphological diagnosis of atrophic gastritis increases sensitivity by 2.4 times for severe atrophy compared to the updated Sydney system.This advantage should be considered when stratifying the high risk of gastric cancer.The updated Kimura-Takemoto classification of atrophic gastritis should be used as a reference standard(gold standard)in studies of morphofunctional relationships to identify serological markers of atrophic gastritis with evidence-based effectiveness.The use of artificial intelligence in the serological screening of atrophic gastritis makes it possible to screen a large number of the population.During serological screening of atrophic gastritis and risk stratification of gastric cancer,it is advisable to use the Kyoto classification of gastritis with updated Kimura-Takemoto classification of atrophic gastritis.
文摘Background: The incidence of cervical cancer in Belgium is 11.1 per 100,000. With the introduction of cervical cytology screening and more recently anti-HPV vaccination, this rate has been decreasing for almost 20 years. Despite this, some patients are missed by the screening and prevention system and cervical cancer is still diagnosed at an advanced stage. Recurrences by splenic metastases are rare and are most often found at autopsy. Case Study: We describe the case of a 41-year-old caucasian patient with a single splenic recurrence after radiotherapy, chemotherapy, brachytherapy, and surgery for a poorly differentiated adenocarcinoma of the cervix grade 3 at an initial stage IIB according to FIGO. This recurrence happens 3 years after the initial treatment. After monitoring this asymptomatic lesion, the size increase results in laparoscopic splenectomy. Histology demonstrates a splenic metastasis recurrence of adenocarcinoma of endocervical origin. Conclusion: The spleen is a rare metastatic site in cervical cancer. Splenectomy followed by chemotherapy is the therapy most often found in the literature, which is however poor in this regard.
文摘Prostate cancer is a public health problem in Senegal. It is one of the most common cancers in men and can be detected early by PSA measurement and confirmed by the pathological study which specifies the histological type and evaluates the histoprognostic scores (Gleason and pTNM). We did not find any anatomopathological study highlighting a link between the PSA t rate and histoprognostic Gleason scores in Senegal. Objective: We carried out this work aimed at determining whether there is a correlation between the PSA t rate and the histoprognostic Gleason score, in our context. Methodology: This is a retrospective, descriptive and analytical study conducted from January 2013 to October 2021, based on histologically proven prostate cancer cases with a specified PSA level, diagnosed in the pathological anatomy and cytology laboratory of Aristide Le Dantec hospital. Results: We identified 654 cases of prostate cancer. The average age was 68.59 ± 5.8 years with extremes of 40 years to 92 years. More than half of our cohort presented a clinical stage T2c, i.e. 56.94%. The average prostate volume on ultrasound was 81.81 ± 66 cc. The median PSA t was 110.5 ng/ml, with extremes ranging from 2 ng/ml to 74,770 ng/ml. Prostatic adenocarcinoma was the only histological type found in our patients. There was a predominance of Gleason score 6 (PICU grade group 1) observed in 35.17% of patients. Well-differentiated cancers were predominant and represented 35.17%. There was a statistically significant positive correlation between PSA t level and Gleason score (Spearman’s Rho = 0.305, p = 0.000). Conclusion: This study shows that in the Senegalese population, in patients with prostate cancer, the higher the PSA t level rises above normal, the higher the Gleason score tends to be.
文摘This review describes current approaches to the management of patients with cirrhotic ascites in relation to the severity of its clinical manifestations. The PubMed database, the Google Scholar retrieval system, the Cochrane Database of Systematic Reviews, and the reference lists from related articles were used to search for relevant publications. Articles corresponding to the aim of the review were selected for 1991-2018 using the keywords:“liver cirrhosis,”“portal hypertension,”“ascites,”“pathogenesis,”“diagnostics,” and “treatment.” Uncomplicated and refractory ascites in patients with cirrhosis were the inclusion criteria. The literature analysis has shown that despite the achievements of modern hepatology, the presence of ascites is associated with poor prognosis and high mortality. The key to successful management of patients with ascites may be the stratification of the risk of an adverse outcome and personalized therapy. Pathogenetically based approach to the choice of pharmacotherapy and optimization of minimally invasive methods of treatment may improve the quality of life and increase the survival rate of this category of patients.
文摘BACKGROUND The Updated Sydney system for visual evaluation of gastric mucosal atrophy viaendoscopic observation is subject to sampling error and interobserver variability.The Kimura-Takemoto classification system was developed to overcome theselimitations.AIMTo compare the morphological classification of atrophic gastritis between theKimura-Takemoto system and the Updated Sydney system.METHODSA total of 169 patients with atrophic gastritis were selected according to diagnosisby the visual endoscopic Kimura-Takemoto method. Following the UpdatedKimura-Takemoto classification system, one antrum biopsy and five gastriccorpus biopsies were taken according to the visual stages of the Kimura-Takemoto system. The Updated Kimura-Takemoto classification system was thenapplied to each and showed 165 to have histological mucosal atrophy;theremaining 4 patients had no histological evidence of atrophy in any biopsy. The Updated Kimura-Takemoto classification was verified as a referencemorphological method and applied for the diagnosis of atrophic gastritis. Addingone more biopsy from the antrum to the six biopsies according to the Updated Kimura-Takemoto classification, constitutes the updated combined Kimura-Takemoto classification and Sydney system.RESULTSThe sensitivity for degree of mucosal atrophy assessed by the Updated Sydneysystem was 25% for mild, 36% for moderate, and 42% for severe, when comparedwith the Updated Kimura-Takemoto classification of atrophic gastritis formorphological diagnosis. Four types of multifocal atrophic gastritis wereidentified: sequential uniform (type 1;in 28%), sequential non-uniform (type 2;in7%), diffuse uniform (type 3;in 23%), diffuse non-uniform (type 4;in 24%), and"alternating atrophic – non-atrophic" (type 5;in 18%). The pattern of the spread ofatrophy, sequentially from the antrum to the cardiac segment of the stomach,which was described by the Updated Kimura-Takemoto system, washistologically confirmed in 82% of cases evaluated.CONCLUSIONThe Updated Sydney system is significantly inferior to the Updated Kimura-Takemoto classification for morphological verification of atrophic gastritis.
文摘Plexiform angiomyxoid myofibroblastic tumor(PAMT) is a rare benign mesenchymal tumor of stomach. Rarity of this kind of tumors and scarce review articles may cause underrecognition of this entity and pose a real diagnostic challenge to gastroenterologists, pathologists and surgeons when encountering such patients and differentiating PAMT from other gastric intramural tumors. We report a case of 28-year-old woman, who presented with epigastric pain after meals, iron-deficiency anaemia and weight loss. Upper gastrointestinal endoscopy revealed submucosal tumorlike elevated lesion in the anterior wall of the antrum with intact overlying mucosa. Endoscopic ultrasound showed a 3-cm hypoechoic homogenous mass, originating from the third layer of the gastric wall. Endoscopic ultrasound-guided fine needle aspiration was not informative. Endoscopic buttonhole biopsy was performed to obtain specimens. Following this, the unexpected prolapse of the tumor occurred into the lumen of the stomach, causing gastric outlet obstruction- the biopsy was obtained. Pathomorphological features suggested the diagnosis of PAMT. Gastric resection of the Billroth I type was performed. Diagnosis was confirmed by histological analysis of the surgical specimen.
基金Supported by University Hospital of Fuenlabrada,Universidad Europea de Madrid(project numbers 2015/UEM12 and2016/UEM13)Fundación de la Universidad Europea(project numbers FGUE001804 and FGUE001805).
文摘BACKGROUND In metastatic colorectal cancer(mCRC),the anti-vascular endothelial growth factor drug bevacizumab(BVZ)plus chemotherapy significantly improves progression-free survival compared to chemotherapy(CT)alone.This benefit is not,however,observed in all patients.While increased chemokine CXCL5 gene expression promoting angiogenesis has been proposed as a prognostic mCRC biomarker,few studies have examined its relationship with drug efficacy.This study sought to analyze tumor CXCL5 gene expression in six patients with different efficacy of BVZ-containing CT in terms of the tumor response to treatment.CASE SUMMARY We report six cases of stage IV KRAS-mutated mCRC.Patients were given first line treatment with BVZ-containing chemotherapy in University Hospital of Fuenlabrada.The six patients differed in terms of primary tumor location(right/left side),tumor burden(mostly hepatic and peritoneal disease)and clinical disease course.Before treatment onset,total RNA was isolated from paraffinated tumor biopsy specimens and CXCL5 gene expression quantified through conventional RT-qPCR procedures.Our main finding was that CXCL5 expression levels were several times higher in three patients with lower progression free survival(under 6 mo)from the start of treatment.CONCLUSION A higher expression of CXCL5 was observed in the three patients showing worse tumor response to treatment.
文摘Cystic hepatic neoplasms are rare tumors,and are classified into two separate entities:mucinous cystic neoplasms(MCNs)and intraductal papillary mucinous neoplasms of the bile duct(IPMN-B).We report the case of a 56-year-old woman who presented with abdominal pain and jaundice due to the presence of a large hepatic multilocular cystic tumor associated with an intraductal tumor.Partial hepatectomy with resection of extrahepatic bile ducts demonstrated an intrahepatic MCN and an intraductal IPMN-B.This is the first report of the simultaneous occurrence of these two histologically distinct entities in the liver.
文摘Sarcoidosis is a multisystem chronic inflammatory condition of unknown etiology that has the potential to involve every tissue in the body.Sarcoidosis in the gastrointestinal system,and particularly the colon,is very rare.Here,we report the case of a 57-yearold man with no previous diagnosis of sarcoidosis who presented with new onset of abdominal pain and constipation.A colonoscopy revealed that the abdominal pain was caused by an obstructing lesion in the cecum-ascending colon and lacked a clear histologic diagnosis.Radiologic investigation revealed concentric wall thickening of the cecum-ascending colon with multiple satellite lymphadenopathies,highly suggestive of a malignancy.The patient underwent a laparotomy and a right hemicolectomy was performed.A diagnosis of colonic sarcoidosis was made after the resected specimen was examined.Additionally,a chest computed tomography scan revealed lung involvement with atypical radiologic features in the absence of respiratory symptoms.Only histologic examination of the surgical specimen can yield a diagnosis of gastrointestinal sarcoidosis due to the non-specificity of endoscopic and radiologic findings.
文摘Pulmonary artery intimal sarcoma(PAIS) is a rare tumor with a very poor prognosis. Clinical and radiological findings usually mimic thromboembolic disease, leading to diagnostic delays. The treatment of choice is surgery, and adjuvant chemotherapy and radiotherapy have limited results. We report the case of a 48-year-old male patient, initially suspected with pulmonary thromboembolism. The angio-CT revealed a filling defect in the pulmonary artery trunk. The patient underwent surgery, resulting in with complete resection of the mass with a diagnosis of PAIS. The tumor progressed rapidly in the lung, requiring surgery of multiple lung metastases. The patient was treated with stereotactic body radiation therapy(SBRT) on two occasions for new pulmonary lesions. In the last follow-up(4 years after initial diagnosis), the patient was disease-free. In conclusion, SBRT proved to be an alternative treatment to metastasectomy, allowing palliative chemotherapy to be delayed or omitted, which may result in improved quality of life.
文摘AIM: To investigate neurofibromatosis type 2(NF2) gene mutation at mRNA levels in sporadic orbitocranial meningioma and its association with progesterone receptor(PR) mR NA expression.METHODS: This was a case-control study. Thirty-four sporadic meningioma patients with no familial NF2-related meningioma history were recruited. They were interviewed for their obstetric, gynecologic, and contraception history. PR investigation was performed with real-time polymerase chain reaction(PCR). NF2 mutation was investigated using Qbiomarker Somatic Mutation PCR Assay at NF2 mRNA level after its cDNA extraction(four mRNA mutation cytoband coordinates for nucleotide change: c.634 C>T/p.Q212, c.655 G>A/p.V219 M, c.784 C>T/p.R262 and c.1228 C>T/p. Q410). RESULTS: After mutation analysis at mRNA level, NF2 gene mutation was found in 35.29% patients. Non-mutation group was strongly associated with exogenous hormonal exposure(non-mutation vs mutation: 95.5% vs 83.3%, P<0.001). PR mR NA was found significantly lower in nonmutation group(P=0.033) which presumed as long term exogenous progesterone exposure. However, mutation group was associated with higher rate of progression to gradeⅡ(mutation vs non-mutation, 18.2% vs 5%, P<0.001) and was associated more in fibrous and anaplastic tumor tissue.CONCLUSION: NF2 mutation-meningioma is associated with higher grade of meningioma. Non NF2 mutationmeningioma is strongly associated with exogenous progesterone exposure and lower PR expression.
基金Supported by FIS del Instituto de Salud Carlos Ⅲ(FEDER from E.U.),Spain,No.PI13/00322 and PI16/00884
文摘BACKGROUND Pituitary apoplexy represents one of the most serious,life threatening endocrine emergencies that requires immediate management.Gonadotropin-releasing hormone agonist(GnRHa)can induce pituitary apoplexy in those patients who have insidious pituitary adenoma coincidentally.CASE SUMMARY A 46-year-old woman,with a history of hypertension and menorrhagia was transferred to our hospital from a secondary care hospital after complaints of headache and vomiting,with loss of consciousness 5 min after an injection of GnRHa.The drug was prescribed by her gynecologist due to the presence of uterine myomas.The clinical neurological examination revealed right cranial nerve III palsy,ptosis and movement limitation of the right eye.Our first clinical consideration was a pituitary apoplexy.Blood hormonal analysis revealed mild hyperprolactinemia and high follicle stimulating hormone level;PTH and calcium was high with glomerular filtration rate mildly to moderately decrease.A computed tomography scan,revealed an enlarged pituitary gland(3.5 cm)impinging upon the optic chiasm with bone involvement of the sella.Following contrast media administration,the lesion showed homogeneous enhancement with high-density focus that suggests hemorrhagic infarction of the tumor.Transsphenoidal endoscopic surgery was perfomed and adenomatous tissue was removed.Immunohistochemistry was positive for luteinizing hormone(LH)and follicular-stimulating hormone(FSH).A solid hypoechoic nodule(14 mm x 13 mm x 16 mm)was found in the caudal portion of the right thyroid lobe after a parathyroid ultrasound.A genetic test of Multiple Endocrine Neoplasia type 1(MEN1)was negative.A right lower parathyroidectomy was performed and the pathologic study showed the presence of an encapsulated parathyroid carcinoma of 1.5 cm.A MEN type 4 genetic test was performed result was negative.CONCLUSION This case demonstrates an uncommon complication of GnRH agonist therapy in the setting of a pituitary macroadenoma and the casual finding of parathyroid carcinoma.It also highlights the importance of suspecting the presence of a multiple endocrine neoplasia syndrome and to carry out relevant genetic studies.
文摘<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Rhabdomyosarcoma (RMS) is the most common soft tissue tumor in children, with the head and neck location accounting for up to 40% of cases. The embryonal and alveolar histologic variants are more commonly seen in pediatric patients. The treatment is multimodal and the prognosis of this clinical entity is always gloomy.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">We report the case of nasopharyngeal rhabdomyosarcoma in a 7-year-old boy child with a good response to early post-therapy.</span></span></span><span><span><span style="font-family:;" "=""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Case</span></b></span></span><span><span><b><span style="font-family:;" "=""> </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Presentation</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The patient was diagnosed with nasopharyngeal RMS revealed by a congested nose, ptosis and bilateral blindness, and who received induction chemotherapy followed by concurrent radiotherapy followed by adjuvant chemotherapy. The evolution is marked by a good clinical course but persistence of bilateral blindness</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The RMS nasopharyngeal often presents with nonspecific symptoms. Multimodal therapy should be performed including surgery, chemotherapy and radiotherapy.</span></span></span>
文摘BACKGROUND Primary liver cancer is common in West Africa due to endemic risk factors.However,epidemiological studies of the global burden and trends of liver cancer are limited.We report changes in trends of the incidence of liver cancer over a period of 28 years using the population-based cancer registry of Bamako,Mali.To assess the trends and patterns of liver cancer by gender and age groups by analyzing the cancer registration data accumulated over 28 years(1987-2015)of activity of the population-based registry of the Bamako district.METHODS Data obtained since the inception of the registry in 1987 through 2015 were stratified into three periods(1987-1996,1997-2006,and 2007-2015).Age-standardized rates were estimated by direct standardization using the world population.Incidence rate ratios and the corresponding 95%confidence intervals(CI)were estimated using the early period as the reference(1987-1996).Joinpoint regression models were used to assess the annual percentage change and highlight trends over the entire period(from 1987 to 2015).RESULTS Among males,the age-standardized incidence rates significantly decreased from 19.41(1987-1996)to 13.12(1997-2006)to 8.15(2007-2015)per 105 person-years.The incidence rate ratio over 28 years was 0.42(95%CI:0.34-0.50),and the annual percentage change was-4.59[95%CI:(-6.4)-(-2.7)].Among females,rates dropped continuously from 7.02(1987-1996)to 2.57(2007-2015)per 105 person-years,with an incidence rate ratio of 0.37(95%CI:0.28-0.45)and an annual percentage change of-5.63[95%CI:(-8.9)-(-2.3)].CONCLUSION The population-based registration showed that the incidence of primary liver cancer has steadily decreased in the Bamako district over 28 years.This trend does not appear to result from biases or changes in registration practices.This is the first report of such a decrease in an area of high incidence of liver cancer in Africa.This decrease may be explained by the changes and diversity of diet that could reduce exposure to aflatoxins through dietary contamination in this population.
文摘The purpose of this study was to determine the thickness of skin and fat folds in Kyrgyz women of various ages, taking into account their somatotypological profile. Using the method of complex anthropometry, including the determination of the values of 21 anthropometric parameters, the physical status of 1028 Kyrgyz women of different age groups was studied youth (16 - 20 years old 310 girls), mature age (1st period, 21 - 35 years old 308 women;2nd period, 36 - 55 years 410 women) living in Osh, Kyrgyzstan. For somatotyping, we used the scheme of constitutional diagnostics. Seven somatotypes distinguished within three constitutional groups. The subcutaneous fat was measured by caliperometry. Statistical processing carried out using the statistical programs Microsoft Excel and the STATISTICA package (v. 6.0). To determine the reliability of the differences between the indicators, the Student’s test was used (p < 0.05). The results demonstrate that within each somatotype there are broad changes in the studied anthropometric indicator. Thus, the thickness of the skin and fat folds is the smallest in women of asthenic, athletic and stenoplastic (p < 0.05), and the largest in representatives of the euriplastic and pycnic somatotypes (p < 0.05). Thus, indicators of physical status in adolescence and adulthood in women have a pronounced somatotypological specificity. These materials on the physical development and constitutional and typological characteristics of the studied population of women applicable for a personalized approach in the context of a relative norm.
