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Background Cellular angiofibroma represents a newly described, site specific tumor. Histologically, CAF is a benign mesenchymal neoplasm characterized by two principal components: bland spindle cells and prominent small to medium-sized vessels with mural hyalinization. The indolent nature of the lesion is underscored by the uniformity of its constituent stromal cells, and their lack of nuclear atypia. Characterization by immunohistochemistry is helpful distinguishing Cellular angiofibroma from other mesenchymal lesions. Case presentation We report the case of a 37-year-old woman, presenting with a painless nodule involving the vulva. This lesion had gradually increased in size; a simple excision was performed, and follow up was unremarkable. Gross examination showed a well circumscribed, firm tumor measuring 3× 3 × 2,5 cm. Histologically, the tumor was composed of uniform, short spindle-shaped cells, proliferating in an edematous to fibrous stroma and numerous small to medium-sized thick-walled vessels. A panel of immunohistochemical stains was performed, and confirmed the diagnosis of Cellular angiofibroma. Conclusion In this report we aim to describe the clinical, pathological and immunohistochemical features of this rare entity through a literature review, and to discuss other vulvar mesenchymal lesions.

La biopsie radioguidée constitue une alternative à la biopsie chirurgicale invasive et à la cytologie pour le diagnostic des tumeurs pédiatriques. L'intérêt de notre étude est d’évaluer la valeur diagnostique des biopsies radioguidées examinées au laboratoire d'anatomopathologie de l'hôpital d'Enfants de Rabat (HER). L’étude a porté sur 78 biopsies radioguidées recueillies dans notre laboratoire entre janvier 2008 et décembre 2011. l’âge moyen des patients était de 5 ans et 10 mois avec une prédominance masculine (65,4%). La tumeur était abdominale dans 80% des cas, thoracique dans 15% cas, thoracique et abdominale dans 2,5% et sacrée dans 1,2%. Les biopsies étaient écho-guidées dans 90% des cas et scannoguidées dans 10% des cas. Le diagnostic histopathologique était posé dans 89% des cas. L'immuno-histochimie a été indiquée dans 35% des cas. Les diagnostics les plus fréquents étaient: tumeurs neuroblastiques (42 cas), lymphomes non hodgkiniens (10 cas), rhabdomyosarcomes (6 cas), autres (sarcome d'Ewing, néphroblastomes, tumeur myofibroblastique inflammatoire, maladies de Hodgkin, leucémie aiguë, hépatoblastome et ostéosarcome). Dans notre série, la biopsie radioguidée a permis un diagnostic histopathologique certain dans 89% des cas. Elle nécessite une étroite collaboration entre clinicien, radiologue et anatomopathologiste pour discuter son indication, afin de diminuer le nombre de biopsies peu ou non représentatives.

Study of histological and clinical correlations of 30 cases of renal amyloidosis AA diagnosed between November 2010 and December 2012.The main causes associated with amyloidosis AA were represented by chronic infectious diseases (60%). Nephrotic syndrome and renal failure were observed in 94% and 73% respectively. The distribution of amyloid deposits: 90% of patients had a glomerular form and 10% had a vascular form. Inflammatory reaction associated with AA renal amyloidosis was present in 50% of cases. This inflammation was observed near amyloid deposits associated with a deposition of immunoglobulin chains and/or complement factors.Our study confirms the predominance of AA amyloidosis complicating chronic infectious diseases, especially tuberculosis. Our data point out a relationship between the morphology of renal AA amyloidosis, its clinical presentation and prognosis.

We present two cases of renal lymphoma revealed by acute renal failure (ARF), which remains a rare clinical entity. Case 1 was a 29-year-old man with an ARF. The diagnosis was a primitive kidney immunophenotype B lymphoma. The patient died after three courses of chemotherapy due to rapid spread lymphoma. The second case was a high-grade renal lymphomatous infiltration, with an unusual computer tomography image of two large kidneys compressing the stomach. Death happened early before initiating therapy. In both cases the diagnosis has been established by renal pathology. Early diagnosis is a key component of therapeutic success, however, the rapid spread of lymphoma worsened renal and vital prognosis.

Sclerodermic renal crisis is defined as a severe arterial hypertension or rapidly progressive glomerulonephritis in a sclerodermic patient, associated with anuria due to no other cause but systemic sclerodermia. It constitutes a rare and dangerous complication. The renal prognosis can be effectively improved by converting enzyme inhibitors, allowing a better arterial hypertension control. However, the associated mortality remains high, a follow up must be instaured in order to prevent the apparition of renal lesions in all sclerodermic patients. We report a case of rapidly progressive renal failure with hypertension in a patient with no previous problems, which preceded the development of scleroderma diffuse cutaneous form. The biopsy showed a microangiopathy in the context of scleroderma renal crisis. The evolution was marked by the presence of chronic renal insufficiency which necessitated the dialysing start.

Ethylene glycol is present predominantly in antifreeze,and in industrial solvents. Accidental ingestion of ethylene glycol is relatively rare, but may be potentially lethal. It results in a depression of the central nervous system, a severe metabolic acidosis and an acute renal failure by tubular precipitation of calcium oxalate crystals. We report a case of ethylene glycol poisoning by through skin absorption.A 38-year-old man, working in a cement factory, with a history of cutaneous psoriasis for 10 years, was admitted to our hospital due to acute nausea, vomiting and diffuse abdominal pain, followed by generalized convulsive status epilepticus and worsening of his mental status. Biologic analysis showed severe metabolic acidosis and acute renal failure which required hemodialysis. On renal biopsy, there were intratubular crystals of calcium oxalate. Cerebral magnetic resonance imaging showed posterior encephalitis. Evolution was marked by normalization of renal function at two weeks and improvement of the mental status. Retrospectively, the patient's history-taking revealed that he manipulated ethylene glycol without gloves.Cutaneous contact with ethylene glycol may cause poisoning in presence of skin lesions. The triad neurologic involvement, renal failure due to oxalate crystals deposits and metabolic acidosis leads to the diagnosis of ethylene glycol intoxication. In the case of acute renal failure with oliguria, haemodialysis is the treatment of choice. It allows the removal of the toxic substance and its metabolites with correction of the metabolic acidosis. The precocity of the treatment may improve the prognosis.

Giant cell fibroblastoma (GCF) is a rare neoplasm occurring mostly in children. It has a tendency to recur locally after treatment. We report a new case noticed in an five year-old child who developed recurrence a first time three years later with the picture of GCF and at a second time with the picture of dermatofibrosarcoma protuberans 17 months later.

The aim of the study is to look retrospectively for gene alterations and evaluate apoptosis in rhabdomyosarcomas (RMSs) from 40 children including 24 patients not previously treated. Histological subtype was botryoid in 1 case, spindle cell in 2 cases, embryonal in 22 cases, alveolar in 10 cases, and undetermined in 5 cases. Gene expression was evaluated immunohistochemically for p53 tumor suppressor gene, MDM2 oncogene, and bcl-2 gene. N-myc amplification was detected by in situ hybridization. Apoptotic cells and bodies were recognized morphologically and stained by 3-OH end labeling. Intranuclear accumulation of p53 protein was obvious (25% of tumor cells) in two recurrent embryonal RMSs. Expression of the MDM2 gene was intense (80% of tumor cells) in a recurrent and metastatic embryonal RMS. Amplification of the N-myc gene was obvious (about 20% of tumor cells) in an alveolar RMS metastatic at diagnosis. Expression of the bcl-2 gene was intermediate (25-75% of tumor cells) in 26% of cases and high (75% of tumor cells) in 10% of cases either embryonal or alveolar. The percentage of tumor cells showing morphologically recognizable apoptosis was 0.2-7.5% (mean 2.9%). There was no correlation between apoptosis and histological subtype, bcl-2 expression, or previous treatment.