[Primary glomerular nephropathies in southern Tunisia].
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Biomedical subjects
Publications and source records attributed to F Sellami.
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We report two cases of oligodendroglioma-like meningioma revealed by symptoms of increased intracranial pressure, progressive hemiparesia and partial epileptic seizures. Brain CT-scan or scintigraphy and carotid arteriography were suggestive of a convexity meningioma. One patient had received radiation treatment for scalp tinea capitis 25 years previously. In spite of complete surgical removal, the tumor recurred in both cases respectively 17 years and 18 months later. The two patients were operated again, and one underwent a complementary radiotherapy. Pathologic diagnosis was particularly difficult in the first case where the pattern at conventional histologic technics was that of oligodendroglioma. On the occasion of recurrence, immuno-histochemistry and ultrastructural studies were performed. The tumor was positive for epithelial membrane antigen (E.M.A) and cytokeratin, but was negative for glial fibrillary acidic (G.F.A.) protein, S 100 protein (S 100), neuron-specific enolase (N.S.E.), vimentin, anti-LEU-7 (N.H.K.1), and neurofilaments (N.F.). Electron microscopy showed closely adjacent cells with tonofilaments and numerous desmosomes. These findings permitted to establish the diagnosis of oligodendroglioma-like meningioma instead of oligodendroglioma. In the second case, the histologic pattern was also reminiscent of oligodendroglioma, but presence of few cellular whorls in some part of the tumor permitted the correct diagnosis. The pathogenesis of this atypical form of meningioma, its tendency for recurrence, and usefulness of radiotherapy are discussed and literature is reviewed.
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The authors report their experience of forty-two cases of xanthogranulomatous pyelonephritis. They point out the various difficulties of preoperative identification of such diseases by the imaging modalities. They also discuss the main pathogenic hypotheses proposed in the literature.
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The authors report a case of dual malformation: pulmonary (sequestration) and mediastinal (pericardial). This case is original in that clinically and at standard radiography sequestration was mistaken for hydatid cyst. The diagnosis was corrected after anatomico-pathologicale examination of the operative specimen.
A case of severe vesicoureteral malakoplakia with bilateral megaureter in a child is reported. On the basis of a review of the literature, we recall the main characteristics of this condition, particularly concerning pathologic findings and ethiopathogenesis, and underline the difficulty of therapeutic decisions, especially if surgery is considered.
The occurrence of Gougerot-Sjögren syndrome in a context of dysthyroidism is not a chance happening, as is reflected by the 37% rate of incidence. Routine labial biopsy, carried out in 59 cases of primary hypothyroidism due to atrophic thyroiditis, 20 of Basedow's disease and 4 of Hashimoto thyroiditis identified Gougerot-Sjögren syndrome (3-4 Chisholm grade) in 3 of the 59 cases of hypothyroidism i.e. in 5 percent, and in one Basedow case out of 20, i.e. 5 percent. Using Kaplan's criteria, the incidence of Gougerot-Sjögren syndrome rises to 22 percent in hypothyroidism and 30 percent in Basedow's disease. Consequently, the incidence of Gougerot-Sjögren syndrome is higher in Basedow disease than in primary hypothyroidism. Gougerot-Sjögren syndrome is seen particularly in dysthyroidism involving manifest and all-round clinical signs. This association does not seem to result from one disease being caused by the other, but the outcome of the onset of entities to which a genetically determined context predisposes the subject, as is shown by the prevalence of HLA DRW3 and HLA B8 groupings in Gougerot-Sjögren syndrome, in primary hypothyroidism, in Basedow's disease and in Hashimoto's thyroiditis.
Eight pediatric cases of the diffuse form of xanthogranulomatous pyelonephritis are reported. These patients were selected among 17 with destruction of one kidney. Clinical symptoms were suggestive of a tumor in some instances. However, an infectious etiology was strongly suggested by the presence of a renal lithiasis in seven cases (including five staghorn stones) and of a urinary tract infection in six cases (usually caused by a Proteus). Nephrectomy was performed in every case.
Three uncommon cases of malignant para-testicular tumors are described. The first one was a malignant mesothelioma discovered after cervical node biopsy, the second, a high grade lipoblastic liposarcoma and the third a malignant mesenchymoma with 4 components. The literature is reviewed with special regard to these 3 types.
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The authors report a case of malignant paratesticular mesothelioma with multiple metastasis.
The authors report a new case of accessory spleno-testicular fusion with scrotal pain. They point out the main features of this rare congenital anomaly and review data from the literature.
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The authors report a case of polycystic kidneys complicated by bilateral renal hypernephroma. This association has been rarely described and is probably frequently unrecognized because of the diagnostic difficulties. Angiography should be performed in all doubtful cases in order to obtain an early diagnosis so that the patients can benefit from modern therapeutic techniques. Polycystic kidneys is a familial hereditary disease capable, like other genetic diseases, of malignant transformation. Clinically undiagnosed partial forms of the disease can be the origin of certain cases of apparently primary renal cancer.