Maha Driss

Expression patterns of Notch receptors and their ligands in human osteoarthritic and healthy articular cartilage

Notch pathway plays a pivotal role in cell fate determination. There is much interest surrounding its therapeutic potential, in osteoarthritis, but the expression profile of Notch-related molecules, as well as their relation with cartilage pathological parameters, remains unclear. The purpose of our study is to analyze the expression pattern of Notch family members, type II and type I collagen, in normal (healthy) and osteoarthritic human knee cartilage. Osteoarthritic cartilages were obtained from 3 patients undergoing a total knee replacement. Macroscopically normal cartilage was dissected from 3 human knees at the time of autopsy or surgery. Immunohistochemical staining was performed using Notch1,2,3 and 4, Delta, Jagged, type II collagen and type I collagen antibodies. In healthy cartilage, type II collagen was abundantly expressed while type I was absent. This latter increased proportionally to the osteoarthritic grade. Type II collagen expression remained intense in osteoarthritic cartilage. In healthy cartilage as well as in cartilage with minor lesions, Notch family members proteins were not or just weakly expressed at the surface and in the cells. However, Notch molecules were over-expressed in osteoarthritic cartilage compared to healthy one. This expression pattern was different according to the cartilage zone and the severity of OA. Our data suggest that Notch signaling is activated in osteoarthritic cartilage, compared to healthy cartilage, with a much more abundant expression in the most damaged areas.

Métastase placentaire d’un cancer du sein

Resume Les auteurs rapportent une observation originale de metastase placentaire d’un cancer du sein chez une femme âgee de 43 ans, G10 P10, enceinte a 33 semaines d’amenorrhee, qui presentait un carcinome canalaire infiltrant du sein droit metastatique (metastases pulmonaires, hepatiques et ovariennes bilaterales). L’extraction par cesarienne d’un nouveau-ne de sexe feminin en bonne sante apparente a ete realisee a 34 semaines d’amenorrhee. L’etude anatomopathologique du placenta a revele des metastases microscopiques du carcinome mammaire dans la chambre intervilleuse. La patiente est rapidement decedee de ses metastases. Les metastases placentaires des cancers primitifs de la mere sont rares dans la litterature. Leur diagnostic est essentiellement histologique. Elles sont de mauvais pronostic pour la mere. Si les metastases sont localisees a la chambre intervilleuse, le fœtus est habituellement indemne de la tumeur.

Cotyledonoid dissecting leiomyoma of the uterus associated with endosalpingiosis

Cotyledonoid dissecting leiomyoma (CDL) may create a diagnostic challenge. A 47-year-old woman underwent laparotomy for a large pelvic mass associated to vaginal bleeding. During operation, a bulky deep red mass protruding from the uterus and projecting into the pelvic cavity was discovered. Allowing to sarcoma- like appearance, a total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed with removal of the pelvic tumor extension. The diagnosis of cotyledonoid dissecting leiomyoma of the uterus associated with endosalpingiosis was performed. To the best of our knowledge, this association has never been encountered in the English literature.

Granulocytic sarcoma of the small intestine in a child without leukemia: report of a case with cytologic findings and immunophenotyping pitfalls.

BACKGROUND Granulocytic sarcoma is a rare tumor that is often misdiagnosed as it can be confused with lymphoma. It has unique cytologic features independent of the site of the tumor and can be identified on fine needle aspiration. CASE A 13-year old girl without a relevant medical history presented with an abdominal mass. Investigation revealed a tumor infiltrate in the small intestine and mesentery. The fine needle aspirate contained myeloid blasts with cytoplasmic granules. Immunohistochemistry on subsequent biopsy confirmed myeloid differentiation. There was no evidence of blood or bone marrow involvement suggestive of acute leukemia. The patient was well after 27 months of follow-up. CONCLUSION Granulocytic sarcoma should be included in the differential diagnosis of any small intestine infiltrate. Cytomorphology is accurate and efficient for the diagnosis in conjunction with complete immunocytochemistry study.

Mammary Dirofilariasis A Case Report

We report a case of a dirofilariasis manifesting as a breast nodule in a 32-year-old Tunisian woman. It appeared as a relatively well-circumscribed and slightly dense nodule on mammography and was hypoechogenic with enhanced through transmission on ultrasonographic examination. The patient was treated by surgical resection. Histopathologic analysis could identify viable female and male worms as Dirofilaria repens. Dirofilaria is rare in Tunisia and this is the second human case reported. The patient lived all her life in Tunisia and had never been abroad.

Primary Well Differentiated Liposarcoma: An Unusual Tumor in the Breast

A 43-year-old woman, presented with a tender mobile lump in the lower inner quadrant of the left breast. On examination, there was no local lymphadenopathy. Mammography showed a 20 mm, dense, well circumscribed lesion suggesting a fibroadenoma (Fig. 1). The lump was excised and no axillary dissection was made. Grossly, the specimen excised measured 35 · 25 · 15 mm, it was occupied by a well circumscribed, yellow, firm mass. No areas of necrosis were identified. At histological examination (Fig. 2), the tumor had well-defined margins. It was composed of an adipocytic proliferation presenting a variation in cell size with focal nuclear atypia and hyperchromasia. Scattered atypical, hyperchromatic stromal cells were noted in a fibrillary, collageneous stroma. Occasionally, a varying number of monovacuolated or multivacuolated lipoblasts were recognized. An arborizing Figure 2. Associated osteoclast-like giant cells (arrows). Figure 3. Tumor cells were synaptophysin positive whereas the osteoclast-link giant cells were negative (arrow).

Ascitic fluid cytology in malignant Brenner tumor: a case report.

BACKGROUND Peritoneal effiusion is rare in malignant Brenner tumors and has been found in only 10% of patients. CASE A 77-year-old woman presented with malignant Brenner tumor and ascites. The cytology of the ascitic fluid revealed many activated mesothelial cells intermingled with squamous tumoral cells. These cells were either isolated or arranged in small clusters. They were often round or oval with irregular and moderately hyperchromatic nuclei. CONCLUSION Presence of squamous cells in ascitic fluid associated with an ovarian tumor should raise the possible diagnosis of malignant Brenner tumor in addition to malignant transformed teratoma and secondary squamous carcinoma of the ovary.

L’histiocytofibrome bénin profond: À propos d’un cas

Bening fibrous histiocytoma is one of the most frequent benign tumors. Most tumors are found in the skin, particularly on the limbs. Tumor size is usually small. According to the WHO, a deep location is found for less than 1% of all benign fibrous histiocytomas. Most deep tumors occur in the subcutaneous tissue. Deep locations in other organs have also been reported. We report a case and discuss the pathological and clinical aspects of this rare tumor.

Acute Lymphoblastic Leukemia Relapse in the Breast: Fine Needle Aspiration Diagnosis of a Rare Presentation

Spindle cell rhabdomyosarcomas may pose a problem because of their resemblance to other spindle cell neoplasms, notably fibroblastic, smooth muscle and peripheral nerve sheath sarcomas. However, they should be sufficiently cellular, mitotically active and atypical, not to be confused with benign proliferations. Cytologically, smooth muscle spindle cells are described as having fragile or whiplike cytoplasm and fibroblastic tumors have spindle cells with broad or fibrillary cytoplasmic process. Long grass-like cytoplasmic processes that are skeletal muscle in nature have not been described in other spindle cell tumors.1 Besides cross striation, desmin supplemented with myogenin or MyoD1 stains can be useful to differentiate them.2-5 We recommend brushing and washing cytology and immunocytochemistry of sinus spindle cell rhabdomyosarcoma as a valuable method for further surgical planning in sinus tumors.

Plasmocytome cutané primitif

Resume Le plasmocytome cutane primitif (PCP) est un lymphome B cutane rare. Nous rapportons une observation de PCP chez une femme de 64 ans ayant presente un nodule de la joue gauche. Histologiquement, la lesion etait constituee essentiellement de cellules plasmocytaires matures monotypiques exprimant la chaine legere lambda. Des localisations extracutanees de la maladie ont ete exclues par la realisation d’un bilan complet. Le pronostic du PCP est meilleur que celui des localisations cutanees de myelome. Les facteurs pronostiques majeurs sont la taille et la presentation clinique (solitaires, versus multiples). Les PCP solitaires sont traites uniquement par chirurgie conservatrice et eventuellement radiotherapie locale.