Les mucocèles appendiculaires, problèmes diagnostiques et thérapeutiques: à propos de 26 cas

La mucocèle appendiculaire est une affection rare caractérisée par une dilatation de la lumière appendiculaire avec des altérations muqueuses linéaires, une hypersécrétion de mucus. Nous avons réalisé une étude rétrospective entre le mois de janvier 2000 et le mois Décembre 2014. Vingt six patients dont 16 hommes et 10 femmes ayant un âge moyen de 43 ans ont été colligés. Les douleurs abdominales étaient un symptôme constant. Quatre malades (15%) avaient une masse palpable au niveau de la fosse iliaque droite et un autre avait une ascite lors du diagnostic. Une complication à type d'occlusion intestinale aigue était révélatrice dans deux cas. Le diagnostic était évoqué en préopératoire par l'imagerie chez neuf (34%) patients. Une appendicectomie simple était réalisée chez 8 patients. Trois malades ont eu une résection iléo-caecale devant un aspect per opératoire de masse appendiculaire. Le geste était une hémi colectomie droite avec anastomose iléo transverse pour 5 patients, une résection iléo-caecale pour deux patients et une réduction tumorale associée à une évacuation de l'ascite dans un autre cas. L'examen anatomopathologique avait conclu à une mucocèle rétentionnelle bénigne, un cystadénome mucineux et à un cystadénocarcinome chez respectivement 15, 7 et 4 malades.Pan African Medical Journal 2015; 2

Gastrites chroniques à hélicobacter pylori: évaluation des systèmes OLGA et OLGIM

Helicobacter pylori (H pylori) gastritis presents 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 identify high-risk forms (stages III and IV). The aim of this study is to evaluate the OLGA and OLGIM staging systems in H pylori gastritis. A descriptive study of 100 cases of chronic H pylori gastritis was performed. The revaluation of Sydney System parameters of atrophy and intestinal metaplasia, of gastric antrum and corpus, allowed identifying respectively the stages of OLGA and OLGIM systems. The progressive risk of our H pylori gastritis was 6% according to OLGA staging and 7% according to OLGIM staging. Significant correlation was revealed between age and OLGA staging. High-risk gastritis according to OLGIM staging was significantly associated with moderate to severe atrophy. High-risk forms according to OLGA staging were associated in 80% of the cases to intestinal metaplasia. OLGA and OLGIM systems showed a highly significant positive correlation between them with a mismatch at 5% for H pylori gastritis. The OLGA and OLGIM staging systems in addition to Sydney System, allow selection of high risk forms of chronic gastritis requiring accurate observation.Keywords: Chronic gastritis, helicobacter pylori, atrophic gastritis, intestinal metaplasia, stagingPan African Medical Journal 2016; 2

Psoriasis with verrucous appearance: A case reporPsoriasis report

Psoriasis verrucosa is a rare clinical variant of psoriasis with peculiar histologic features. Only few cases have been reported in the literature. We herein report a rare case of psoriasis with verrucous appearance occurring in a 63 year-old woman who presented with verrucous and scaly erythematous plaque of the legs which was developed thirty years ago. The biopsy specimen showed regular psoriasiform epidermal hyperplasia with acanthosis, hyperkeratosis, and focal spongiosis with a superficial perivascular infiltrate. The patient was diagnosed with verrucous psoriasis. Recognition of this entity should preempt confusion with verruca vulgaris or other entities capable of producing wart-like epidermal changes

Kyrle disease: report of a Tunisian case

Kyrle disease is an uncommon perforating dermatosis which is commonly associated with systemic disorders such as diabete mellitus and renal failure. A 60-year-old man, with no past medical history, consulted for purpuric, infiltrated and crusted lesions of extremities, buttocks and scalp. A punch biopsy showed a hyperkeratotic horny plug invaginating the epidermis. The diagnosis of Kyrle disease was retained. The clinicopathological features of this disease and its therapeutic problems are discussed

Paratesticular Angiomyofibroblastoma-Like Tumor: Unusual Case of a Solidocystic Form

The angiomyofibroblastoma-like tumor of the male genital tract is a rare benign tumor. A total of 34 cases have been reported in the literature. We herein report an exceptional case of solidocystic form in its paratesticular location, in a 79-year-old man. Clinical examination objectified a right testicular induration. Macroscopic examination of the orchidectomy objectified a paratesticular solidocystic tumor formation. Microscopically, the solid area was composed of vessels with small caliber and turgidity of endothelial cells. These vessels were surrounded by clusters of epithelioid cells, sometimes having the appearance of giant cells. They were associated with spindle cells. The cystic area was uncoated. Immunohistochemically, the fusiform cells expressed Desmin and Smooth Muscle Actin. Endothelial cells and clusters of cells surrounding large vessels expressed CD34. The expression of receptors for estrogen and progesterone was negative. To our knowledge, this is the second solidocystic case of angiomyofibroblastoma-like tumor of male genital tract