Besma Laabidi

Amyloid goiter: First manifestation of systemic amyloidosis

Amyloidosis is an abnormal extracellular deposit, which can occur in several tissues. The mechanism is not clearly defined. In systemic amyloidosis, all the organs can be infiltrated, but amyloid goiter as the initial manifestation of systemic amyloidosis is an exceedingly rare condition. We report a rare case of a patient who presented an amyloid goiter as the first manifestation of systemic amyloidosis. This patient had a known Crohns disease. He developed a goiter without compressive complications. Histologic examination revealed a diffuse amyloid deposition surrounding thyroid follicles. The gland was enlarged with an eosinophilic and amorphic deposit. Confirmation of amyloid was made by the presence of congophilia and apple-green birefringence under polarized-light microscopy. An immunoreactivity was seen with AA protein. Amyloid goiter is a rare manifestation of amyloidosis. About 250 cases of amyloid goiter have been reported in the literature. The goiter enlarges rapidly and progressively, often becoming compressive like thyroid cancer. The prognosis depends on the treatment of the amyloidosis and the underlying chronic disease.

A rare highly aggressive tumor of the kidney: The pure epithelioid angiomyolipoma

Renal epithelioid angiomyolipoma (EAML) has been recognized as a mesenchymal tumor in the 2016 World Health Organization classification of renal tumors, and a member of the family of PEComas, which may occur sporadically or in association with tuberous sclerosis syndrome (TSC). EAML is considered a potentially malignant neoplasm, since one third of the reported cases of EAML developed metastatic lesions. The “pure” form of EAML is extremely rare. It is composed of predominant or pure epithelial component and has minimal to no adipocytic component. We herin report a case of pure EAML of the kidney.

Chromoblastomycosis: Report of a case from a non-endemic region

A 47-year-old man presented with a skin lesion, of 3 years duration, located in the right limb. The lesion gradually expanded to form a 20 cm violet-colored papule with an atrophic center (Fig. 1). The diagnosis of cutaneous tuberculosis was suspected. Cultures were negative. A deep skin biopsy revealed the presence of fungal elements within a granulomatous reaction (Figs. 2 and 3). There was no evidence of any immunodeficiency.

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.

Human papillomavirus detection using in situ hybridization and correlations with histological and cytological findings.

BACKGROUND AND OBJECTIVE The human papillomavirus (HPV) is the main causative agent of cancerous and precancerous lesions in cervical cancers. The infection detection is performed by cytological and histological examination. However, molecular testing for HPV infection remains necessary to distinguish nonspecific inflammatory lesions from HPV-related lesions. We aimed to compare cytological and histological diagnosis of HPV lesions and to confront histological findings with molecular detection of HPV by in situ hybridization (ISH). MATERIAL AND METHODS A total of 2399 pap smears were collected between 1997 and 2002. Twenty-nine of them presented with lesions indicative of HPV infection. Colposcopy and biopsy were performed on 23 of these 29 pap smears, with a comparison of the cytological and histological findings. Molecular testing for HPV by ISH was performed on 11 pap smears. RESULTS A 79% cytological and histological agreement was observed. ISH revealed the presence of the virus in seven case patients, amounting to a 63% histological and molecular agreement. Seven HPV genotypes were categorized (6-11-16-18-31-33-51). CONCLUSION HPV detection by ISH adds little to the diagnosis of HPV-associated lesions based on cytological and histological features. It, however, helps improve the specificity of the diagnosis and determine the viral genotype which, in turn, helps better define the lesion prognosis.