Radial Probe Endobronchial Ultrasound-guided Lung Biopsy for Histopathological Diagnosis of Cryptogenic Organizing Pneumonia

INTRODUCTIONCryptogenic organizing pneumonia （COP） is a distinct type of idiopathic interstitial pneumonia with a response rate of 65 85% on corticosteroid therapy. The difficulty of COP diagnosis is that the clinical features and the radiological findings are nonspecific. The pathological hallmark of organizing pneumonia （OP） needs to be confirmed. It can also occur in a variety of other interstitial pneumonia, infectious diseases, vasculitis, and so on. To increase the pathological reliability, larger and more tissue samples are required. According to the current classification of interstitial lung disease and guidelines, the surgical lung biopsy is recommended and is considered to be the best way of obtaining a representative lung specimen However, the invasive diagnostic procedures require general anesthesia and also increase the morbidity and mortality risks; therefore, only few patients undergo such biopsy. Thus, safer and more acceptable methods for identifying COP are urgently needed.

Histopathological and Ultrasound Correlation in Women Presenting with Breast Lumps in Yaoundé, Cameroon

Context: Breast cancer is very deadly among women with higher rates in the developing world. Imaging tools such as ultrasound, can be used to differentiate between the types of breast lumps. This study aimed to determine the value of ultrasound as a first-line examination in the diagnosis of breast masses. Methods: This was a retrospective cross-sectional study of women presenting with breast lumps from November 2022 to June 2023 at the Yaounde General Hospital, which lasted seven months, from November 2022 to June 2023. The sampling was exhaustive and consecutive. Association between variables was studied using the x2 test and concordance between ultrasound and histopathological findings was assessed using the Kappa correlation coefficient. Results: 234 women were included in the study. Their mean age was 46.3 ± 11.4 years. Overall, 15 (6.4%) lumps were benign while 219 (93.6%) were malignant. Triple negative (5.6%) was the most recurrent genomic classification. The correlation between the ultrasound and histopathological findings was significant, with an observed concordance rate at 85.1%, kappa = 0.322 and a p-value Conclusion: The performance of ultrasound in differentiating benign and malignant lesion was high. However, the discordant cases highlight the need for a diagnosis system which blends histopathological and radiological findings for an improved management of patients with breast lumps.

A case of hemangiopericytoma of the soft palate with articulate disorder and dysphagia

We report a case of hemangiopericytoma of the soft palate of 60-year-old patient, who noticed a mass of the soft palate and experienced difficulty in speaking. We found a pediculate, hard, elastic mass measuring 38 mm （cross-sectional diameter）. Computed tomography （CT） scans and dynamic magnetic resonance imaging （MRI） confirmed irregularly shaped mass and revealed a heterogeneous internal composition, consistent with vascular tumors. We excised the tumor under general anesthesia. Histopathological diagnosis was based on positive immunoreactivity of CD99 and vimentin and weak, positive staining of CD34. Three and half years following tumor excision, there is no recurrence or metastasis.

Tuberculous otitis media eseries of 10 cases

Background:Tuberculosis(TB)of the middle ear cleft(MEC)is a rare extra-pulmonary manifestation.Signs and symptoms of tuberculous otitis media are indistinguishable from that of non-tuberculous otitis media making early diagnosis difficult.Objectives:To study the clinical presentations,complications and effective diagnostic modalities in tuberculosis of middle ear cleft.Methods:We retrospectively studied 10 patients diagnosed with chronic otitis media,unresponsive to 2 months conventional treatment.Pure tone audiogram,High resolution computed tomography(HRCT)of temporal bone,and AFB staining of ear discharge were done.All patients underwent mastoid surgery.AFB staining and histopathological examination of granulation tissue removed from the middle ear and mastoid were also done.Results:Clinical findings were mastoid swelling,facial palsy and post-aural fistula 3,4&2 patients respectively.All patients had persistent ear discharge and three had vertigo.Hearing loss was of moderate conductive type in five,sensorineural type in three and mixed type in two.HRCT of temporal bone revealed soft tissue density in MEC in 9 and evidence of bone destruction in 6 cases.Diagnosis of TB was confirmed either by(a)demonstration of AFB in ear discharge(4 patients)/tissue removed during surgery(4 patients)or(b)by demonstration of tuberculous granulomas with necrosis on histopathological examination of tissue from MEC(8 patients).Conclusion:Tuberculosis should be suspected in all cases of chronic otitis media unresponsive to conventional treatment particularly in endemic areas.Histopathological examination and AFB staining of tissue removed during mastoid surgery are reliable diagnostic methods.

Silent diabetic nephropathy

AIM： To examine the risk of renal events in patients with biopsy-proven diabetic nephropathy （DN） and its possible associated factors.METHODS： Clinical and histological data of 60 pa-tients diagnosed with diabetic nephropathy were retro-spectively collected. Patients with evidence or suspicion of other nephropathies were excluded from the study. The fnal event was defned as renal replacement ther-apy （RRT） initiation or progression of chronic kidney disease （CKD）, according to the KDIGO 2012 defnition of a decrease in CKD category and a decrease in GFR of 25% or more. RESULTS： A total of 45 patients with a follow-up of at least 3 mo were included. Most of the patients presented type 2 DM, with a mean age of 58.3 years old. The time of evolution of DM was 9.6 ± 7.8 years, al-though in 13 patients, it was less than 5 years. A total of 62% of patients reached the fnal event in a mean period of 3.4 years （95%CI： 2.1-4.7）, with 21 of them requiring dialysis. The factors that were indepen-dently associated with renal survival were estimated glomerular fltration rate （eGFR） at the time of biopsy, cardiovascular disease （CVD） history and HbA1c less than 7%. Therefore, for each 10 mL/min per 1.73 m2 reduction in eGFR, we obtained a DN progression risk of HR = 2 （1.3-3.0） （P = 0.001）; patients with CVD were at greater risk for DN progression （HR = 2.8, 1.1-7.1, P = 0.032）, and CKD patients with HbA1c 〈 7% demonstrated greater renal risk than patients with HbA1c ≥ 7%, with an HR of 2.9 （1.0-8.4） （P = 0.054）.CONCLUSION： A past history of CVD is a risk fac-tor for DN progression. Levels of HbA1c less than 7% could favor an eGFR decrease in these patients.

A Brazilian Case of Tongue Cysticercosis

Human cysticercosis is a neglected tropical parasitic disease due to the tapeworm Taenia solium, common in endemic developing countries. Cysticerci are most commonly found within the central nervous system, but they may also localize in a variety of tissues, including the tongue. Here, we described a case of a 21-year-old woman with a painless, firm, smooth, mucosa-colored nodule located in the lateral region of the tongue was seen by a dentist. An excisional biopsy was performed, and the surgical specimen was examined histomorphologically. The analysis revealed the presence of a cystic lesion containing a serrated larva (Cysticercus cellulosae) as well as a cystic capsule with predominantly mononuclear inflammation. The morphological findings were consistent with the diagnosis of cysticercosis of the tongue. The patient was followed for 22 months and showed no signs of recurrence.

Endovascular Catheter-guided Forceps Biopsy for the Diagnosis of Suspected Pulmonary Artery Sarcoma： A Preliminary Study of Eight Cases

Pulmonary artery sarcoma （PAS） is a rare malignant tumor that originates from the pulmonary artery （PA） with a poor prognosis,Early diagnosis and radical surgical resection offer the only chance for survival As most PA sarcomas involve the PA trunk, making a preoperative histopathological diagnosis is quite difficult. So far, most PAS cases were reported with diagnosis made either at autopsy or intraoperatively with frozen sections.