Scrotal Epidermoid Cyst Presenting as Extra-Testicular Scrotal Mass: A Diagnostic Dilemma

We hereby report a scrotal epidermoid cyst presenting as a scrotal mass which a rare entity in the absence of trauma. 36years old male presents with a complaint of left sided testicular swelling and discomfort. The workup included clinical examination, alpha-fetoprotein (αFP) and beta-human chorionic gonadotropin (β-hCG) analyses and scrotal ultrasound. Clinically confused as testicular malignancy. Complete surgical excision of the cyst was performed. Histopathology confirmed epidermoid cyst with no evidence of malignancy.

Acute Peritonitis: A Rare Complication Revealing Intestinal Tuberculosis

Intestinal tuberculosis diagnosis is often difficult because of non-specific symptoms, miming many other conditions such as malignancy, infectious disease, and inflammatory bowel disease. Free intestinal perforation is an uncommon but life-threatening complication of intestinal tuberculosis, associated with high morbidity and mortality.

Exercise and Vitamin D Supplementation Modify Spleen Morphology in Lean, but not, in Monosodium-Glutamate-Obese Rats

We evaluated the effect of exercise and vitamin D supplementation on histological aspects of the spleens of lean and obese rats. Male Wistar rats received neonatal administration of monosodium glutamate (MSG; 4g/Kg), while Control (CON) rats received an equimolar solution. At 30 days of age, CON and MSG rats were subdivided into Exercised (E) or Sedentary (S) groups and Vitamin D (VD; 12µg/Kg) supplemented or non-supplemented (NS) groups. At the 86th day of life, rats were euthanized, and their body weights and adiposity were evaluated. Spleens were submitted to histomorphometric analysis of the white pulp (WP), germinal center (GC) and lymphatic nodule (LN). Data are presented as mean ± SEM (p<0.05). MSG treatment promoted a reduction in spleen weight, increased LN thickness and WP area, but reduced GC occupation, compared to spleens of CON-lean rats (p<0.05). Exercise and VD did not provoke changes in the spleens of MSG-obese rats. In CON-lean rats, E and VD induced augmentation of LN thickness. VD supplementation increased the WP area, while E reduced GC area occupation in spleens of CON-lean rats (p<0.05). In conclusion, exercise and VD supplementation increased LN thickness and WP area, but had the opposite effect on the GC in spleens of CON-lean rats. However, neither exercise nor VD supplementation prevented the development of morphological abnormalities in the spleens of MSG-obese rats.

Granulomatous Gastritis: A Clinicopathologic Analysis of 39 Biopsy Cases

Introduction: Granulomas in gastric biopsy specimens are extremely rare. The final diagnosis of granulomatous gastritis is based on morphological findings, clinical and laboratory data. The aim of our study is to evaluate the clinical fields and to determine the etiology of gastric granulomatosis in our experience Patients and Methods: Thirty nine patients were reviewed retrospectively in the department of pathology of Habib Thameur between 2000 and 2018. Slides from all cases were stained by hematoxylin and eosin. The clinic-pathologic findings and the associated lesions were analyzed and the final etiology of the gastric granulomatosis was noted. Results: Biopsies from the 39 patients diagnosed as having granulomatous gastritis were reviewed. Mean age was 49 years (24 – 96) and sex ratio was 0,25 (M/F=8/31). Indication of endoscopy was gastric pain in 12 cases, chronic diarrhea in 6 cases, anemia in 2 cases, vomiting in 4 cases. Other symptoms were rare. Upper endoscopy was normal in 8 cases, showed antral gastropathy in 20 cases (erythematous in 6 cases, nodular in 8 cases and ulcerated in 6 cases). In four cases, fundic lesions were observed. Granuloma was unique in 14 cases and multiple in 25 cases. Localisation of granuloma was the antrum in 25 cases, the fundus in 7 cases, and both of them in 7 cases. An associated chronic gastritis was noted in 25 cases. Concerning the etiology, 10 of our patients had Crohn's disease while 6 of them had gastric tuberculosis. In five cases, H Pylori was the retained cause of gastric granulomatosis. In the other patients, the final diagnosis was sarcoidosis (n=3), foreign body reaction (n=1), yersiniosis (n=1). In our series, thirteen cases were unclassifiable. Conclusion: Although many cases remain unclassified, in most cases of granulomatous gastritis, a diagnosis of Crohn's disease or tuberculosis could be established. If this cases are excluded, an association between H. pylori and granulomatous gastritis cannot be ruled out. The others causes are extremely rare.

Association between Sclerosing Cholangitis and Paget Disease: Diagnostic Difficulties

A rare case of association between primary sclerosing cholangitis and Paget's disease emphasizing the diagnostic difficulties in front of increased alkaline phosphatase is reported. The association between sclerosing cholangitis and Paget's disease wasn’t yet described and could thus be coincidental. However, our observation underlines the benefit of dosing ALP isoenzyme to characterize the bone or hepatic origin of ALP and therefore, help to guide the diagnosis.

Hepatic Tuberculosis of Pseudotumor Form

Tuberculosis involving the liver in the absence of active pulmonary tuberculosis is very rare. The inflammatory pseudotumoral form is an entity difficult to diagnose. We report a case of an inflammatory pseudotumor of the liver due to tuberculosis, who didn’t underwent hepatectomy because of the size of the tumor. The diagnosis of tuberculosis was made on biopsy and Polymerase Chain Reaction (PCR).

Pseudotumor Tuberculosis Of Liver: A Rare Entity

We present a rare case of a 46-year-old man who presented with recurrent fever and abdominal pain without other symptoms. Laboratory data were no specific for diagnosis. Abdominal imaging revealed a pseudotumor liver. A diagnosis of isolated liver tuberculosis with abscess component was confirmed with US-guided liver biopsy and histopathological examination. The patient received antibacillous drugs with success.

Giant Isolated Hydatid Cyst of Spleen

Liver is most commonly involved organ in hydatid cyst. Primary splenic hydatid cysts are rare; we report a case of an isolated giant hydatid cyst of spleen in a 17-year-old man. The diagnosis was confirmed by imaging findings and serology. Partial cystectomy was performed with success. In cystic lesions of spleen, hydatid cyst should be kept in patrician’s mind in the differential diagnosis. Although splenectomy is the gold standard for treating hydatid disease of the spleen, in young patient spleen-preserving surgery seems give good results.