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Summary Aims To determinate the topographical distribution of key diagnostic histological features of lymphocytic colitis (LC) and collagenous colitis (CC) and to establish what correlations may exist between the histological findings and the causes and severity of MC. Patients and methods Patients with MC were included in a prospective multicentre French study from September 2010 to October 2012. MC was diagnosed by performing total colonoscopy with multiple biopsies of the rectum and colon collected in separate jars and analyzed separately for each site (descending and sigmoid colon, transverse colon, ascending colon). CC was defined as a subepithelial collagen layer > 10 μm thick and LC as an intraepithelial lymphocyte (IEL) count > 20 lymphocytes per 100 epithelial cells without any associated thickening of the subepithelial collagen. Results Ninety-five patients, 69 with LC 26 and with CC, were included in the analysis. The sensitivity of the biopsies for diagnosing MC was maximum in the transverse colon and minimum in the rectum. Rectal and left colonic biopsies resulted in the diagnosis of CC and CL in 93% and 94% of cases, respectively. All the remaining cases of MC were diagnosed by performing additional biopsies beyond the splenic flexure. In patients with LC, a higher rate of IELs was associated with the absence of abdominal pain (P = 0.01) and a shorter duration of diarrhea (P = 0.001). In patients with CC, a lower level of collagen thickness in the basement membrane was associated with the presence of an autoimmune disease (P = 0.02). Conclusion More than 90% of cases of microscopic colitis were diagnosed in this study by performing rectal and left colonic biopsies.

Resume Introduction Les tumeurs pigmentees mammaires sont rares. Nous rapportons le troisieme cas d’adenocarcinome mammaire pigmente primitif du mamelon chez un homme, simulant cliniquement un melanome. Observation Un patient consultait pour un nodule infiltre pigmente indolore du mamelon droit, sans masse palpable sous-jacente. Apres exerese de la lesion, l’examen histologique montrait une proliferation tumorale maligne dermique se prolongeant en profondeur le long des canaux galactophores, formant des cavites canaliculaires. Le stroma fibreux peri-lesionnel etait riche en pigment melanique libre ou intra-macrophagique. Il s’agissait donc d’un adenocarcinome mammaire pigmente primitif simulant cliniquement un melanome. Discussion La pigmentation melanique de l’adenocarcinome mammaire que nous rapportons pourrait relever de trois mecanismes : un transfert de melanosomes a partir des melanocytes situes dans l’epiderme surmontant la tumeur, correspondant a l’areole mammaire naturellement hyperpigmentee ; une synthese directe de melanine par les cellules carcinomateuses, traduisant leur differenciation melanocytaire, suggerant ainsi l’existence d’un adenocarcinome mammaire metaplasique a differenciation melanocytaire ; la synthese de melanine par des melanocytes epidermiques ayant migre dans la tumeur, qui nous semble ici l’hypothese la plus plausible. Conclusion L’adenocarcinome mammaire, quoique rare chez l’homme, peut etre revele par une lesion cutanee pigmentee mamelonnaire et peut poser un probleme de diagnostic differentiel clinique avec un melanome primitif ou une metastase de melanome.

Resume Le mesotheliome desmoplastique est une variante inhabituelle du mesotheliome malin. Il est caracterise par une fibrose dense rendant le diagnostic difficile. L’evolution clinique est souvent rapide avec des metastases frequentes essentiellement viscerales. Les metastases osseuses restent rares avec peu de cas rapportes dans la litterature. Nous rapportons l’observation clinique d’un patient âge de 58 ans, dont le diagnostic d’un mesotheliome desmoplastique a ete pose et dont l’evolution etait marquee par la survenue de metastases vertebrales et le deces dans l’annee. Notre but a travers cette observation est de faire le point sur les criteres histologiques et immunohistochimiques clefs pour poser un diagnostic correct d’un mesotheliome desmoplastique avec une revue de la litterature.

BACKGROUND: Non-organ-specific autoantibodies (NOSAs) are frequently found in the sera of patients with Hepatitis C Virus (HCV) infection. However, no conclusive answers have been produced concerning the clinical relevance of these antibodies. AIM: To determine whether a relationship might exist between the presence of NOSA and the severity of liver disease in chronic hepatitis C. METHODS: 186 treatment-naive chronic hepatitis C patients were studied consecutively for autoantibodies. Liver biopsies were analyzed according to the Metavir score. RESULTS: NOSAs were present in 75 patients (40%). Anti-nuclear antibodies were found in 32% of patients (speckled pattern), anti-smooth muscle in 15% without F-actin specificity, anti-mitochondria in 0.5%, and anti-LKM1 in 0.5%, respectively. No liver-cytosol1 or soluble liver antigen antibodies were detected. There was a highly significant correlation between the positivity of NOSA and the degree of inflammation and hepatocellular injury (p = 0.001) and also with the degree of fibrosis (p < 0.0001). The presence of NOSA was associated with higher aspartate aminotransferase, gamma-glutamyl-transpeptidase, gamma-globulin and immunoglobulin G levels. By contrast, no differences were observed regarding age, gender, route of infection, duration of disease, HCV genotypes or viral load. CONCLUSION: NOSAs were associated with the most severe forms of chronic HCV infections.

Les lésions génitales masculines dues à Schistosoma haematobium sont rares dans nos régions. Pourtant les travaux de Chaker en 1889 et de Lortet et Vialleton qui ont décrit les premières lésions des vésicules séminales en sont le témoignage. Nous rapportons un cas de prostatite bilharzienne de découverte anatomo-pathologique chez un patient de 65 ans après résection transurétrale de prostate. African Journal of Urology Vol. 14 (1) 2008: pp. 59-62

Summary Background The purpose of this study was to evaluate the incomplete excision rate of nasal basal cell carcinomas (BCC) resected with different margins to demonstrate that 3-mm surgical margins could be used as safety margins to reduce esthetic consequences with a low risk of incomplete excision. Methods All patients with BCC of the nose excised from January 1st 2008 to December 31st 2011 were included. Data were analyzed and reviewed retrospectively. Tumors were treated with different surgical margins of excision: 3 mm, 4 mm, and 5 mm. The primary outcome variable was the rate of incomplete excision. Other study variables were the histologic subtype, size, and recurrent lesions. Results Of the 132 patients, 115 were included corresponding on with 127 BCC. Median age was 75.5 (64–83) and sex ratio M:F = 1.05. Of the 127 BCC, 80 were aggressive histologic subtype (63%), and 11 were recurrent (8.7%). The overall rate of incomplete excision was 17.3% ( n = 22). Of these 22, 17 (77.3%) were of an aggressive subtype. The incomplete excision rates within the groups were 12.5% ( n = 4), 22.2% ( n = 10), and 16% ( n = 8), respectively within the group with 3-, 4- and 5-mm surgical margins. No significant difference was observed between the groups ( P = .519). The incomplete excision rate was not independently associated with the surgical margins, histologic subtype and recurrent type ( P > .05). Conclusion Three-millimeters margins could possibly be used to treat nasal BCC in chosen cases. Regarding the high rate of incomplete excision, reconstruction should be performed after receiving the pathologic report.

International audience; STUDY OBJECTIVE: The aim of the study was to assess diagnosis value of tumor markers for differential diagnosis between mesothelioma and other pleural tumors. DESIGN AND METHODS: Prospective study of 85 patients attending our hospital with malignant pleural effusion. The diagnostic approach involved routine pleurocentesis followed by pleural needle. When precise diagnosis was not achieved, thoracoscopy with pleural biopsies was performed. Carcinoembryonic antigen (CEA), hyaluronic acid, tissue polypeptide antigen and cyfra 21 to 1 were measured in serum and pleural fluid. RESULTS: By using receiver operating characteristics curves and area under curves, the best diagnostic characteristics were obtained with pleural and serum CEA concentrations. The area under the curve was larger for pleural ACE than for serum ACE. The sensitivity and specificity of a pleural CEA level exceeding 3 ng/mL for ruling out the diagnosis of mesothelioma were 100% and 77%, respectively. CONCLUSION: A CEA level above 3 ng/mL in pleural fluid eliminated the diagnosis of mesothelioma, whereas the other markers were not sufficiently discriminant. However, despite a negative predictive value of 100% at a cutoff of 3 ng/mL, CEA assay in pleural fluid only avoids a small number of diagnostic thoracoscopies.

But de la presentation Les papillomes exophytiques representent 30 a 50 % des papillomes des fosses nasales. Ils sont reconnus comme secondaires aux papillomavirus 6 et 11(HPV). Aucune forme floride n’est decrite dans la litterature. L’objectif est de decrire la prise en charge des papillomes exophytiques, y compris florides, de mettre en evidence d’eventuels facteurs de risque et de codifier leur therapeutique. Materiel et methodes Il s’agit d’une etude retrospective incluant tous les patients ayant un papillome exophytique sur une periode de 10 ans. Pour chaque sujet a ete analyse : (1) le symptome ayant amene a la consultation ; (2) les antecedents ; (3) l’extension de la lesion au moment du diagnostic ; (4) le (ou les) traitement(s) realise(s) ; (5) l’analyse histologique avec la recherche de papillome inverse associe, de stigmates d’infection a HPV ou bien de dysplasie ; (6) l’apparition de recidive et leur prise en charge. Resultats Treize patients (8 hommes, 5 femmes), d’âge 35,9± 9 ans ont ete inclus. Le mode de decouverte le plus frequent etait l’obstruction nasale (6 cas, 40 %) suivi des decouvertes fortuites lors d’endoscopies (3 cas, 23 %), des epistaxis (2 cas, 15 %) et les decouvertes de tumefaction (2 cas, 15 %). 8 patients avaient des antecedents de traumatisme ou de deviation septale, d’exposition a la poussiere ou de prise de drogues ou medicaments par voie nasale. La localisation initiale predominait sur le septum anterieur (6 cas, 40 %) et le vestibule nasal (5 cas, 33 %). Les formes etaient bifocales pour 2 patients et florides pour 3 patients. Le traitement initial etait chirurgical pour 12 patients. Histologiquement il existait 2 associations au papillome inverse, 4 prelevements dysplasiques et des stigmates d’infection virale a 6 reprises. La recidive survenait dans les 3 mois chez 3 patients (1 traite par azote liquide et 2 des patients ayant une forme floride). La reprise chirurgicale associee a une phototherapie au laser diode pour 2 cas a permi 1 guerison. Conclusion Les papillomes uni ou bifocaux sont d’exerese simple et la recidive rare. Les formes florides posent des problemes therapeutiques. La confirmation des serotypes HPV 6 et 11, identiques a ceux de la papillomatose laryngee, pourrait permettre d’appliquer aux formes florides les traitements de cette derniere, a ce jour mieux etudies.