Prostate sclerosing adenopathy:A clinicopathological and immunohistochemical study of twelve patients

BACKGROUND Although sclerosing adenopathy of the prostate is a very rare benign disease,an effective differential diagnosis is required.Here,we report the clinicopathological and immunohistochemical morphological features of 12 cases of sclerosing adenopathy of the prostate to improve understanding of the disease.AIM To investigate the clinicopathological features,diagnosis,and immunohistochemical phenotypes that distinguish prostate sclerosing adenopathy from other conditions.METHODS The clinical data,laboratory tests,pathological morphology,and immunohistochemical phenotypes of 12 cases of prostatic sclerosing adenopathy were retrospectively analyzed,and the relevant literature was reviewed.RESULTS All patients were elderly men(mean age,71.7 years;62–83 years).Eleven of them had hematuria,urinary frequency,urinary urgency,difficulty in urination,and serum total prostate-specific antigen values within the normal range.One patient had increased blood pressure.Enlarged prostates with single to multiple calcifying foci were observed.Moreover,prostate tissue hyperplastic changes were observed in all patients.Small follicular hyperplastic nodules without an obvious envelope,with a growth pattern mimicking the infiltration pattern of"prostate adenocarcinoma"were noted.Basal cells expressed AR,CKH,P63,and CK5/6,and myoepithelial markers,such as calponin,S100,and smooth muscle actin.No recurrence or exacerbation of the lesions was observed,except for one case of death due to bladder cancer.CONCLUSION Prostatic sclerosing adenopathy is highly misdiagnosed as prostate adenocarcinoma or other tumor-like lesions.Therefore,it should attract the attention of clinicopathologic researchers.

Unusual Causes of Adenopathy in a Tropical Environment: About 3 Observations

Introduction: The discovery of peripheral lymphadenopathy is a frequent reason for consultation and hospitalization in Internal Medicine. The aim of this article is to review through three cases the etiologies of chronic lymphadenopathy rarely reported in a tropical environment. Observations: The first patient is a 62-year-old man who has been infected with HIV-1 for 14 years and who had a multicenter form of Castleman disease. The diagnosis was confirmed after 3 histological lymph nodes. The progression was favorable under Etoposide-based chemotherapy. The second observation is about a 38-year-old woman with a 2-month chronic febrile adenopathy without improvement after anti-tuberculosis treatment. The diagnosis of Kikuchi Fujimoto disease, in its necrotizing form, was confirmed in histology. The evolution was made favorable by the corticosteroid therapy. The third observation is about a 63-year-old woman with an enlargement of groups of lymph nodes, liver, and spleen. This tumoral syndrome was associated to an exudative ascites and a Systemic Inflammatory Response Syndrome (SIRS). The initial diagnosis was a multifocal tuberculosis based on a set of evidence (exudative lymphocytic ascites, epidemiological context and a positive Quantiferon TB test). The first ganglionic histology was not contributory. It was the second ganglionic histology that indicated the diagnosis of lymph node plasmocytoma revealing a myeloma. The patient died of septic shock. Conclusion: In tropical environment, the etiologies of chronic lymphadenopathy are not limited to tuberculosis and malignant haemopathies. Carrying out ganglionic histology is an absolute necessity.

Adenopathies in Internal Medicine Etiological Profile and Diagnostic Limits

INTRODUCTION: An adenopathy is a pathological hypertrophy of a lymph node of various etiologies requiring a rigorous approach. Thus we proposed in this work to study the etiological particularities of patients admitted for adenopathy in order to identify their specificities. METHODS: This was an observational study of a transverse and descriptive type, which took place from 1 July 2015 to 30 June 2016 in the internal medicine department of the Aristide Le Dantec national hospital in Dakar. RESULTS: We identified 84 patients, consisted of 46 male and 38 female. The sex ratio was 1.2. The mean age was 37.5 years. The consultation period was on average 2 months with extremes of 1 month and 1 year. The mean hospital stay was 29. 2 days with extremes of 1 week and 2 months. The etiologies found were classified into 6 groups. Hemopathies (30.9%) were dominated by acute leukemia in 8 patients (9.52%), non-Hodgkin’s lymphoma in 9 patients (9.5%), Hodgkin’s disease in 5 patients (5.9%). Chronic lymphocytic leukemia was retained in 3 patients (3.5%) and Castleman disease in 1 patient. Systemic diseases (11.9%) were divided into lupus disease in 4 patients and rheumatoid arthritis in 4 patients, one case of Sj?gren’s syndrome and one case of sarcoidosis. Infections were very frequent in our study, found in 34 patients (40.4%). Tuberculosis was more frequent (27.3%). The association with HIV was noted in 4 patients. The other infections were pyogenic in 3 patients (3.5%), HIV in 6 patients (7.1%), Borrelia and toxoplasma in 1 patient respectively. Cancers (8.3%) were metastatic of primary tumors including the esophagus, lung, prostate, cavum, stomach, pancreas and breast, one case each. One patient presented lymphadenopathy with inguinal localization, the etiology of which was found to be thrombophlebitis of the right lower limb. The hystiocytic pathologies (3.5%) were all related to lymphohystiocytic activation syndrome (LHAS) secondary to tuberculosis in 2 patients and pyomyositis in 1 patient. The difficulties encountered were mainly the inaccessibility of certain complementary examinations and the delay in obtaining the results. CONCLUSION: Adenopathies are a very common reason for consultation in internal medicine. This study allowed us to draw up the etiological profile of adenopathies in our practice but also to identify the main difficulties which are among other things the inaccessibility of certain complementary examinations.