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Introduction: pMCT is defined as a variant of papillary carcinoma that measures≤1 cm in diameter and which is characterized by an excellent prognosis. Recently, a proposal has been advanced to use the designation of papillary mirotumour (pMT) for pMCTs with no risk factors ., Aim: In this study, we aimed to reclassify pMCTs according to the Porto proposal(Pp) criteria., Methods: We have retrospectively collected cases of pMCT diagnosed in our pathology department over a period of 10years(2012-2022). Clinical and pathological parameters have been retrieved from the patient's medical records and pathological reports. We have evaluated all cases following the criteria of Pp. Cases that fulfilled all the criteria have been reclassified as pMT. We have briefly compared the clinical outcomes in both groups., Results: 29 cases of pMCT was found. Mean age of patients was 46,6 years-old (17-67) with a female predominance (sex ratio=0,45). 23 cases of pMCT were incidentally discovered. The tumor was located in the right thyroid lobe in 15cases. The mean size of the tumor was 5,2mm. Multifocality was observed in 5 cases. A total of 17 cases could be classified as pMT according to the Pp. Only one patient developed pulmonary metastasis and local recurrence; however it was related to the papillary carcinoma firstly diagnosed in his contralateral lobe. Clinical outcome was also good in the group of papillary microcarcinoma (pMC) with no recurrence or distant metastasis., Conclusion: According to the Pp,>50% of pMCT could be reclassified as pMT which could reduce the psychological impact and overtreatment. Further studies with large sample size and molecular analysis are however needed in order to definitively validate and generalize the use of Porto proposal.

Introduction: Ep-CAM, is a cell adhesion glycoprotein located on the basolateral cell membrane surface and in the cytoplasm of most normal epithelial cells. It has also been described to be expressed in several malignancies such as lung, digestive, prostate and renal carcinomas suggesting it has a potential role in carcinogenesis.  In thyroid carcinoma, Ep-CAM expression has rarely been studied especially in papillary thyroid carcinoma., Objective: We sought to describe and compare the immunohistochemical expression of MOC31 in papillary thyroid carcinoma and in non invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)., Methods: We have retrospectively collected 33 cases of PTC diagnosed in the pathology department of the Security forces hospital during a period of 13 years (2008-2021). We have microscopically reviewed all cases and reclassified 9 of 33 cases as NIFTP.  An immunohistochemical  automated study have been performed with MOC-31 antibody.  The immunostaining was considered positive when it was membranous and/or cytoplasmic. The intensity of staining was scored as weak (score 1), moderate (score 2), and strong (score 3). We have used an immunoscore for assessing level of expression of MOC31 as follows: 0 for <5% of positive cells, 1 for 5-30%, 2 for 31-50%, 3 for 51-70%.The total score resulted by summing the percentage score with the intensity score; the final score was varying from 0 to 7, considered low between 1-4 and high 5-7., Results: The mean age of patients was 45,2 years-old for PTC cases and 48,1 years-old for NIFTP cases. A net female predominance was found in both groups (male to female ratio of respectively 0,4 and 0,3). MOC31 expression was found in 19 cases of PTC with a percentage of positive cells varying from 5 to 90%. Percentage of positive cells was variable from 5 to 90%. The immunoscore for positive cells was: 0 in 5/24cases, 1 in 4/24cases, 3 in 9/24cases and 4 in 6/24cases. The intensity of staining was assessed score2 (moderate) in 8 cases and score 3 (high) in 7cases (Figure1-2). Final MOC31 staining score was low in 37,5% (9/24) and high in 62.5% (15/24). Patients with advanced pt2-pt3 stages mostly showed high score of MOC31 staining (61,5%).One case was associated with lymph node involvement and was of a high score. 6 cases showed vascular invasion and was of high MOC31 score. MOC31 was expressed in all NIFTP cases with variable proportion of positive cells (5%-80%). The immunoscore for positive cells was: 0 in 1/9cases, 1 in 2/9cases, 2 in 3/9cases, 3 in 1/9cases and 4 in 2/9cases. The intensity of staining was assessed score 1 (weak) in one case, score 2 (moderate) in 6 cases and score 3 (high) in one case (Figure3-4). The final combined score was low in 66,7 (6/9) and high in 33,3% (3/9)., Conclusion: Our study revealed different immunohistochemical profile of MOC31 in benign and malignant tumors. It has somewhat a diffuse and marked staining in the first group.  The changes of MOC31 location as well as its score of staining in PTC and NIFTP could hence be helpful in the differential diagnosis. Our findings also support the potential prognostic value of this molecule that deserves further investigations.

Social media are inevitably becoming part of our lives. The increasing popularity of these platforms revolutionized communication among healthcare workers and has irrevocably changed the terms of classic learning models. Pathologists all over the world are very active on social media making it a new pedagogical paradigm in pathology education. A virtual community of pathologists is constantly present especially on Twitter and Facebook for sharing and discussing interesting cases, reporting original scientific researcher's results, or simply energizing our field. Tunisian pathologists are not taking advantage of these platforms, some do not master the use of social media, others are reluctant about their use in the health field. However, it is of crucial importance for us Tunisian pathologists, especially in these times of social distancing due to SARS-COV2 pandemic, to join this virtual community and implement new ways of learning. This article aimed primary to assess the popularity of these platforms as a pedagogic tool among Tunisian pathologist. Secondly, we introduced the basic use and rules of social media, benefits and potential risks, and to provided tips for effective social media use in pathology.

Sweet syndrome (SS), also known as acute febrile neutrophilic dermatosis is a rare cutaneous disorder characterized by specific clinical, biological and microscopic findings. Although the exact cause of SS is still unknown, it may be triggered by infections, malignancies and drugs but also occurring after vaccinations such as bacille calmette guerin vaccination and influenza vaccine. While the recently discovered SARS COV2 vaccines are almost safe, many cutaneous and extracutaneous minor adverse effects are reported. We herein describe the fourth case of Sweet Syndrome induced by SARS-COV2 vaccine.

Urothelial bladder carcinoma (UBC) includes a large group of malignancies with a variable clinical behavior. Despite remarkable developments in recognition of bladder carcinogenesis and prognostic factors, the recurrence rate is still high. Thus, identification of novel biomarkers involved in tumor cell invasion and metastatic dissemination is a constant challenge., Aim: To assess the prognostic impact of CD44 standard (CD44s) expression in UBT., Methods: We assessed the immunohistochemical expression of CD44 in 38 samples of endoscopically resected UBT. Only membranous staining was considered positive. We analyzed topographic distribution of CD44s staining. Correlation of CD44s expression, clinicopathological features and disease progression was analyzed by Chi2 and Fisher tests. Kaplan-Meier analysis was used to investigate CD44s prognostic value., Results: The mean age of patients was 61,24 years with male to female ratio of 18/1. CD44s expression was positive in 33 cases (87%). There was no significant correlation between CD44 expression and the parameters:  age, gender, tumor size, focality, tumor site, stage, recurrence and tumor progression. CD44s loss of expression is, nevertheless, correlated with a high tumor grade. Topographic distribution of CD44s staining was associated with focality, grade and stage. Basal/parabasal staining expanded to the tumor layers in homogeneous "laminate" pattern used to be of better prognosis, compared to the heterogeneous "islets" or "dispersed" pattern., Conclusions: Our results highlighted the prognostic value of CD44 expression in UBT. Focusing especially on staining pattern offers a better understanding of bladder carcinogenesis mechanisms.

Mixed epithelial and stromal tumour (MEST) of the kidney, is a recently recognized and rare entity .We herein reported the case of a 56 years old post-menopausal woman who presented with right abdominal pain. Her physical examination was unremarkable. Ultrasonography revealed the presence of a right cystic renal mass in the interpolar region extending into the pelvis. The tumor was considered Bosniak 4 category and a right nephro-ureterectomy was performed. The histological examination of the tumor revealed a mixed tumor with both epithelial and stromal pattern.

Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêts

Background: Autoimmune gastritis present a risk of cancer related to atrophy and intestinal metaplasia. Two recent classifications OLGA (Operative Link on Gastritis Assessment) and OLGIM (Operative Link on Gastritic Intestinal Metaplasia assessment) have been proposed to reveal the high progressive risk forms (stages III and IV)., Aim: To evaluate the OLGA and OLGIM staging systems in chronic autoimmune gastritis., Methods: A descriptive single institution study of 30 cases of autoimmune gastritis. was performed over a 4-year period. The revaluation of atrophy and intestinal metaplasia, of gastric antrum and corpus, allowed to identify respectively the stages of OLGA and OLGIM systems., Results: Our autoimmune gastritis were at high-risk stages in 26,5% of cases  according to two classifications. 95% of low-risk gastritis acoording to OLGA staging presented moderete to severe corpus atrophy. A significant association was present between high-risk gastritis according to OLGA staging and neuroendocrine hyperplasia. Both OLGA and OLGIM systems showed a highly significant positive correlation between them with a mismatch at 2%., Conclusions: The OLGA and OLGIM staging systems in autoimmune gastritis, allow probably selection of high risk forms of chronic gastritis requiring convenable care.