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Chiboub D, Romdhane N, Jameleddine E, Rejeb E, Khanchel F, Jouini R, Zoghlami I, Nefzaoui S, Hariga I, Mbarek C. Pleomorphic adenoma of the parotid gland concomitant with tuberculosis infection: A case report and review of the literature. SAGE Open Med Case Rep 2024; 12:2050313X241236153. [PMID: 38444692 PMCID: PMC10913494 DOI: 10.1177/2050313x241236153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
Tuberculosis of the salivary glands and particularly of the parotid gland is a localization that remains rare even in endemic countries. The association of intra parotid tuberculosis with a benign tumor has been found only in rare cases in literature. A 50-year-old woman with a history of normal pressure hydrocephalus treated surgically, non-smoker, presented with a right parotid swelling progressively increasing in size for 3 years. Clinical examination revealed a 4 cm long, firm, mobile, painless parotid swelling without inflammatory signs and without accessory lymphadenopathy. The oropharyngeal examination was without abnormalities. Ultrasound showed a mass of 31 × 27 mm suggesting a pleomorphic adenoma. MRI confirmed the suspicion of a pleomorphic adenoma of both lobes. The patient underwent a conservative total parotidectomy. The extemporaneous examination was in favor of a pleomorphic adenoma while the final pathology showed the coexistence of active tuberculosis lesions. The patient was put on long-term antituberculosis treatment with good clinical evolution. The clinical presentation of parotid tuberculosis is nonspecific mimicking any other tumor and the diagnosis can only be made by histological examination. Therapeutic management is based on long-term antituberculosis treatment.
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Affiliation(s)
- Dorra Chiboub
- Department of Otorhinolaryngology, Head and Neck Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Nadia Romdhane
- Department of Otorhinolaryngology, Head and Neck Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Esma Jameleddine
- Department of Otorhinolaryngology, Head and Neck Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Emna Rejeb
- Department of Otorhinolaryngology, Head and Neck Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Fatma Khanchel
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
| | - Raja Jouini
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
| | - Imen Zoghlami
- Department of Otorhinolaryngology, Head and Neck Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Safa Nefzaoui
- Department of Otorhinolaryngology, Head and Neck Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Ines Hariga
- Department of Otorhinolaryngology, Head and Neck Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Chiraz Mbarek
- Department of Otorhinolaryngology, Head and Neck Surgery, Habib Thameur Hospital, Tunis, Tunisia
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Ben Thayer M, Khanchel F, Helal I, Chiboub D, Raoueh H, Ben Brahim E, Jouini R, Chadli-Debbiche A. Epidemiological and histopathological characteristics of thyroid carcinoma in a Tunisian health care center. World J Otorhinolaryngol Head Neck Surg 2024; 10:37-42. [PMID: 38560041 PMCID: PMC10979045 DOI: 10.1002/wjo2.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 08/10/2023] [Accepted: 09/19/2023] [Indexed: 04/04/2024] Open
Abstract
Background Thyroid carcinoma (TC) accounts for almost 0.5%-1% of total malignancies. Its incidence is increasing rapidly worldwide. Several studies have drawn up the epidemiological profile of TC and its clinical and pathological features. However, to date, no similar studies have been conducted in Tunisia. Aims To establish an epidemiological profile of TC in a Tunisian health care institute and to analyze its clinical and histopathological characteristics in our institute. Materials and Methods We present a retrospective study reviewing the cases of TC diagnosed in our institution in a 4-year period. Results We collected a sample of 192 cases of TC. It consisted of 31 males and 161 females (83.8%) with a sex-ratio M/F of 0.19. The mean age was 46.4 years. Papillary thyroid carcinoma was the most frequent histological subtype. The multifocality rate was 33.8%. The mean size of TC was 2.2 ± 1.9 cm. 60.9% of TC were staged pT1 and 20.3% had nodal involvement. Papillary thyroid microcarcinomas were noted in 37.5% of cases. Conclusion Our results were consistent with those of the literature. A high proportion of pT1 and pN0 tumors were noted in our series, suggesting that TC's diagnosis and management was performed at an early stage of the disease in our institution. In addition, our study enabled us to notice the impact of the Coronavirus disease 19 crisis on the management of TC in our institution. Further studies are needed to establish the epidemiological profile of TC in Tunisia and to assess its clinical and pathological features.
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Affiliation(s)
- Maissa Ben Thayer
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Fatma Khanchel
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Imen Helal
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Dorra Chiboub
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Department of Otorhinolaryngology-Head and Neck surgery Habib Thameur's Hospital Tunis Tunisia
| | - Hedhli Raoueh
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Ehsen Ben Brahim
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Raja Jouini
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Aschraf Chadli-Debbiche
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
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Bougacha M, Blibech H, Bouchabou B, Jouini R, Helal I, Snene H, Belkhir D, Mehiri N, Ennaifer R, Chedly A, Ben Salah N, Louzir B. A rare coexistence of sarcoidosis with overlap syndrome and sarcoidosis with primary biliary cholangitis and Sjogren's syndrome: Two distinct case reports. Heliyon 2024; 10:e25826. [PMID: 38390068 PMCID: PMC10881881 DOI: 10.1016/j.heliyon.2024.e25826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/27/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Sarcoidosis and the overlap syndrome of autoimmune hepatitis and primary biliary cholangitis (PBC) share common clinical, biological, and histological features. The simultaneous occurrence of these diseases have been reported in few cases and suggests that a common pathway which may contribute to granuloma formation in both conditions. We report the cases of two female patients having an association of sarcoidosis and inflammatory liver diseases. The first case is of a 61-year-old woman had been monitored for an overlap syndrome of PBC and autoimmune hepatitis (AIH). Therefore, treatment with azathiprine has been initiated associated with ursodeoxycholic acid (UDCA). Azathioprine had to be discontinued due to digestive intolerance, specifically chronic diarrhea and abdominal pain. The patient remained clinically stable on UDCA and her liver function tests were stable for years, until she developed symptoms of progressive dyspnea without any other associated signs. Chest computed tomography (CT) revealed mediastinal enlargement, bilateral pulmonary nodules, and symmetrical adenomegalies in the mediastinum. The bronchoalveolar lavage (BAL) revealed increased cellularity, with a notable elevation in lymphocyte count (48 %) and a CD4/CD8 ratio of 4. The patient underwent mediastinoscopy; a biopsy of the right laterotracheal (4R) adenomegaly was performed. Histological examination of the lymph node showed epithelioid and giant-cell tuberculoid lymphadenitis without necrosis, compatible with sarcoidosis. Ophthalmological and cardiac assessments were normal. Plethysmography test was normal and there was no need for corticosteroid treatment; a surveillance was planned. Treatment with UDCA was pursued. The second case is of a 50-year-old woman with no medical history presented symptoms including dry eyes and mouth, inflammatory-type polyarthralgia affecting knees and wrists, bilateral Raynaud's phenomenon, right hypochondrium pain, and worsening dyspnea over six months. Liver analysis showed elevation of alkaline phosphatase (ALP) to three times upper limit of normal (ULN) and gamma-glutamyltransferase (GGT) to 5 times ULN. This cholestasis was associated with an increase in transaminase activity to 5 times ULN for over six months. Immunological tests revealed positive anti-nuclear antibodies (ANA), anti-Ro52, anti-M23E, and anti-centromere antibodies. Chest-CT showed multiple bilateral bronchiolar parenchymal micronodules mostly in the upper and posterior regions without any mediastinal adenomegaly. Bronchial endoscopy was normal, and biopsies indicated chronic inflammation. The BAL revealed increased cellularity, characterized by a high lymphocyte count (51.7 %) and a CD4/CD8 ratio of 2.8. Biopsy of minor salivary gland revealed grade 4 lymphocytic sialadenitis. Skin biopsy revealed an epithelioid granuloma without caseous necrosis. Liver biopsy performed in the presence of cytolysis and moderate hepatic insufficiency, revealed granulomatous hepatitis and cholangitis lesions along with septal fibrosis suggestive of PBC. The diagnosis of cutaneous and pulmonary sarcoidosis with PBC and Sjögren's syndrome was retained. The spirometry and diffusing capacity for carbon monoxide value were normal. Treatment involved UDCA, corticosteroids, and azathioprine, leading to clinical and biological improvement. Sarcoidosis shares some clinical manifestations with autoimmune liver diseases, primarily PBC. A hepatic granuloma with a different appearance and location can guide the diagnosis. Early diagnosis and appropriate management can avoid serious complications and improve prognosis.
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Affiliation(s)
- Marwa Bougacha
- Pulmonology Department, Mongi Slim Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Hana Blibech
- Pulmonology Department, Mongi Slim Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Bouchra Bouchabou
- Gastroenterology Department, Mongi Slim Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Raja Jouini
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Imen Helal
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Houda Snene
- Pulmonology Department, Mongi Slim Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Donia Belkhir
- Pulmonology Department, Mongi Slim Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Nadia Mehiri
- Pulmonology Department, Mongi Slim Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Rim Ennaifer
- Gastroenterology Department, Mongi Slim Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Achraf Chedly
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Nozha Ben Salah
- Pulmonology Department, Mongi Slim Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Bechir Louzir
- Pulmonology Department, Mongi Slim Hospital, Tunis, Tunisia
- University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
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Hasnaoui A, Helal I, Ben Azouz Z, Hmidi A, Jouini R, Chadli-Debbiche A. A dataset of tumour-infiltrating lymphocytes in colorectal cancer patients using limited resources. Database (Oxford) 2023; 2023:0. [PMID: 38104276 PMCID: PMC10725308 DOI: 10.1093/database/baad089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
In the realm of cancer research, specifically focusing on colorectal carcinomas (CRCs), a novel diagnostic test referred to as 'Immunoscore' (IS) has emerged. This test relies on assessing the density of tumour-infiltrating lymphocytes, specifically CD3 and CD8, in both the centre of the tumour (CT) and its invasive margin (IM). IS holds promise as a potential prognostic factor. A retrospective descriptive study was conducted within the Pathology Department of Habib Thameur Hospital in Tunis, Tunisia. The study's aim was to evaluate the prognostic efficacy of IS for patients with CRC by means of a comprehensive survival analysis. This publication introduces the immunoscore in colorectal cancer (ISCRC) dataset, which was meticulously compiled during the aforementioned study. The ISCRC dataset comprises digital slide images sourced from biopsies of 104 patients diagnosed with CRC. Using the tissue microarray technique, an immunohistochemical investigation involving anti-CD3 and anti-CD8 markers was performed in regions designated as 'Hot Spots' within the CT and IM. The images were captured using a smartphone camera. Each marker's percentage presence within its respective region was quantified. The IS was estimated utilizing a semi-quantitative method. The ISCRC dataset encompasses anonymized personal data, along with macroscopic and microscopic attributes. The captured images, acquired through manual efforts using smartphones, stand as a valuable asset for the advancement of predictive algorithms Importantly, the potential applications of these models extend beyond mere prediction capabilities. They lay the groundwork for innovative mobile applications that could potentially revolutionize the practices of pathologists, particularly in healthcare settings constrained by resources and the absence of specialized scanning equipment. Database URL: https://figshare.com/s/5b4fa3e58c247a4851d4.
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Affiliation(s)
- Anis Hasnaoui
- Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar, Tunis 1006, Tunisia
- Signals and Smart Systems Lab L3S, National Engineering School of Tunis, Tunis El Manar University, Campus Universitaire Farhat Hached B.P. n° 94 - ROMMANA, Tunis 1068, Tunisia
| | - Imen Helal
- Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar, Tunis 1006, Tunisia
- Department of Pathology, Habib Thameur Hospital, Rue Ali Ben Ayed Montfleury, Tunis 1008, Tunisia
| | - Zouhour Ben Azouz
- Signals and Smart Systems Lab L3S, National Engineering School of Tunis, Tunis El Manar University, Campus Universitaire Farhat Hached B.P. n° 94 - ROMMANA, Tunis 1068, Tunisia
| | - Amira Hmidi
- Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar, Tunis 1006, Tunisia
- Department of Pathology, Habib Thameur Hospital, Rue Ali Ben Ayed Montfleury, Tunis 1008, Tunisia
| | - Raja Jouini
- Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar, Tunis 1006, Tunisia
- Department of Pathology, Habib Thameur Hospital, Rue Ali Ben Ayed Montfleury, Tunis 1008, Tunisia
| | - Aschraf Chadli-Debbiche
- Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar, Tunis 1006, Tunisia
- Department of Pathology, Habib Thameur Hospital, Rue Ali Ben Ayed Montfleury, Tunis 1008, Tunisia
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5
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Zaouak A, Magdoud O, Jouini R, Jannet SB, Hammami H, Fenniche S. Lichenoid Keratosis. Skinmed 2023; 21:428-429. [PMID: 38051242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Affiliation(s)
- Anissa Zaouak
- Department of Dermatology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Oumayma Magdoud
- Department of Dermatology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Raja Jouini
- Department of Anatomopathology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia;
| | - Salima Ben Jannet
- Department of Dermatology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Houda Hammami
- Department of Dermatology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Samy Fenniche
- Department of Dermatology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
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6
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Ben Ismail I, Sghaier M, Jouini R, Rebii S, Zoghlami A. Skin metastasis originating from a gastric adenocarcinoma. ANZ J Surg 2023; 93:1451. [PMID: 37226663 DOI: 10.1111/ans.18359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/17/2023] [Indexed: 05/26/2023]
Affiliation(s)
- Imen Ben Ismail
- Department of General Surgery, Trauma center Ben Arous, University of Tunis El Manar, Tunis, Tunisia
| | - Marwen Sghaier
- Department of General Surgery, Trauma center Ben Arous, University of Tunis El Manar, Tunis, Tunisia
| | - Raja Jouini
- Department of Pathology, Habib Thameur Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Saber Rebii
- Department of General Surgery, Trauma center Ben Arous, University of Tunis El Manar, Tunis, Tunisia
| | - Ayoub Zoghlami
- Department of General Surgery, Trauma center Ben Arous, University of Tunis El Manar, Tunis, Tunisia
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7
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Hayder F, Zaouak A, Frioui R, Chamli A, Jouini R, Hammami H, Fenniche S. Exceptional outcome in cutaneous myeloid sarcoma. Clin Case Rep 2023; 11:e7154. [PMID: 36998328 PMCID: PMC10043137 DOI: 10.1002/ccr3.7154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/24/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
Recognition of cutaneous myeloid sarcoma is important for all dermatologists to avoid further progression to acute myeloid leukemia. Nevertheless, we highlight the presence of a favorable clinical outcome in some patients with spontaneous regression.
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Affiliation(s)
- Faten Hayder
- Department of DermatologyHabib Thameur HospitalTunisTunisia
| | - Anissa Zaouak
- Department of DermatologyHabib Thameur HospitalTunisTunisia
| | - Refka Frioui
- Department of DermatologyHabib Thameur HospitalTunisTunisia
| | - Amal Chamli
- Department of DermatologyHabib Thameur HospitalTunisTunisia
| | - Raja Jouini
- Anatomopathology DepartmentHabib Thameur HospitalTunisTunisia
| | - Houda Hammami
- Department of DermatologyHabib Thameur HospitalTunisTunisia
| | - Samy Fenniche
- Department of DermatologyHabib Thameur HospitalTunisTunisia
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8
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Houidi S, Houas Y, Thamri F, Mehrzi O, Jouini R. Ileo-ileal intussusception revealing a “Rapunzel syndrome”: Case report and literature review. Journal of Pediatric Surgery Case Reports 2023. [DOI: 10.1016/j.epsc.2023.102606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
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9
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Jouini R, Kerkeni Y, Zouaoui A, Habbachi G, Sahli S, Thamri F. A new alternative for management of urethral transection in young girl. Journal of Pediatric Surgery Case Reports 2023. [DOI: 10.1016/j.epsc.2022.102551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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10
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Rouiss H, Bettaieb H, Souayeh N, El Aifi H, Jouini R, Helal I, Oueslati H, Mbarki C. Breast rescue after necrotizing fasciitis. Heliyon 2022; 8:e12305. [PMID: 36590552 PMCID: PMC9798178 DOI: 10.1016/j.heliyon.2022.e12305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 10/02/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Necrotizing fasciitis is a dangerous and rapidly spreading infection of soft tissue involving skin, subcutaneous tissue and fascia; muscles can be concerned but often omitted. It's considered as emergency due to its fulminant nature. The necrotizing fasciitis of the breast is exceptional. Management is based on surgical debridement and, in the case of breast, mastectomy in most cases is inevitable. We describe a case-report of breast necrotizing fasciitis with prompt management and with satisfactory cosmetic result owing to dermal autograft.
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Affiliation(s)
- Hadhami Rouiss
- Department of Obstetrics and Gynecology, Ben Arous Hospital, Tunis, Tunisia,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Hajer Bettaieb
- Department of Obstetrics and Gynecology, Ben Arous Hospital, Tunis, Tunisia,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia,Corresponding author.
| | - Nesrine Souayeh
- Department of Obstetrics and Gynecology, Ben Arous Hospital, Tunis, Tunisia,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Hichem El Aifi
- Department of Obstetrics and Gynecology, Ben Arous Hospital, Tunis, Tunisia
| | - Raja Jouini
- Department of Pathology, Hbib Thameur Hospital, Tunis, Tunisia,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Imen Helal
- Department of Pathology, Hbib Thameur Hospital, Tunis, Tunisia,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Hedhili Oueslati
- Department of Obstetrics and Gynecology, Ben Arous Hospital, Tunis, Tunisia,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Chaouki Mbarki
- Department of Obstetrics and Gynecology, Ben Arous Hospital, Tunis, Tunisia,University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
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Ben Thayer M, Helal I, Khanchel F, Mbarki C, Bettaieb H, Ben Brahim E, Jouini R, Chadli Debbiche A. Hemangioma of the umbilical cord: A case report on a rare entity. Clin Case Rep 2022; 10:e6441. [PMID: 36245456 PMCID: PMC9547990 DOI: 10.1002/ccr3.6441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/01/2022] [Accepted: 09/23/2022] [Indexed: 11/11/2022] Open
Abstract
Several hundred cases of placental hemangiomas have been reported in the literature. However, the umbilical cord is extremely uncommon as a site of occurrence. We present a case of postnatal discovery of giant hemangioma of the umbilical cord (HUM) in a Coronavirus Disease 2019 (COVID 19) positive mother. To our knowledge, this is the first reported case of HUM synchronous to a maternal infection with COVID 19. We aim, through this case and a review of the literature, to study the clinicopathological characteristics of this singular entity. Our patient, a 37‐year‐old woman, presented to the Department Of Obstetrics And Gynecology for respiratory distress and loss of fetal movements. Ultrasound examination concluded to intrauterine fetal desmise. After stabilization of the patient, a cesarean section was performed. A macerated fetus was extracted. Placenta showed a giant mass attached to the cord. It was submitted for pathological examination. Gross examination showed that the umbilical cord was inserted eccentrically with a fusiform dilation. Near its placental end, three cohesive solid angiomatous nodules were noted. Microscopic examination revealed lobules of dilated blood‐filled capillaries set in a myxoid stroma. The diagnosis of HUM have been established. HUM arise from endothelial cells of the umbilical vessels. Their etiology, physio‐pathology and pathways of tumorigenesis are not yet well defined. Further studies are needed to explore the pathways of tumorigenesis and to determin the implication of COVID‐19 in HUM.
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Affiliation(s)
- Maissa Ben Thayer
- Tunis El Manar UniversityFaculty of Medicine of TunisTunisTunisia,Department of pathologyHabib Thameur's HospitalTunisTunisia
| | - Imen Helal
- Tunis El Manar UniversityFaculty of Medicine of TunisTunisTunisia,Department of pathologyHabib Thameur's HospitalTunisTunisia
| | - Fatma Khanchel
- Tunis El Manar UniversityFaculty of Medicine of TunisTunisTunisia,Department of pathologyHabib Thameur's HospitalTunisTunisia
| | - Chaouki Mbarki
- Tunis El Manar UniversityFaculty of Medicine of TunisTunisTunisia,Department of Obstetrics and gynaecologyYasminette's HospitalBen ArousTunisia
| | - Hajer Bettaieb
- Tunis El Manar UniversityFaculty of Medicine of TunisTunisTunisia,Department of Obstetrics and gynaecologyYasminette's HospitalBen ArousTunisia
| | - Ehsen Ben Brahim
- Tunis El Manar UniversityFaculty of Medicine of TunisTunisTunisia,Department of pathologyHabib Thameur's HospitalTunisTunisia
| | - Raja Jouini
- Tunis El Manar UniversityFaculty of Medicine of TunisTunisTunisia,Department of pathologyHabib Thameur's HospitalTunisTunisia
| | - Aschraf Chadli Debbiche
- Tunis El Manar UniversityFaculty of Medicine of TunisTunisTunisia,Department of pathologyHabib Thameur's HospitalTunisTunisia
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12
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Frioui R, Zaouak A, Chamli A, Jouini R, Fenniche S, Hammami H. An unusual presentation of celiac disease in adult patient. Clin Case Rep 2022; 10:e6437. [PMID: 36245465 PMCID: PMC9547345 DOI: 10.1002/ccr3.6437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/22/2022] [Accepted: 09/22/2022] [Indexed: 11/11/2022] Open
Abstract
Pyoderma gangrenosum is among the exceptional extra‐intestinal manifestations of celiac disease. We report a case of a 52‐year‐old patient who presented with pyoderma gangrenosum that turned out to be the initial presentation of celiac disease. We report a case of a 52‐year‐old patient who presented with pyoderma gangrenosum as initial presentation of celiac disease. We highlighted the importance of considering cutaneous manifestations in celiac disease patients presenting in adulthood.
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Affiliation(s)
- Refka Frioui
- Department of DermatologyHabib Thameur Hospital of TunisTunisTunisia
| | - Anissa Zaouak
- Department of DermatologyHabib Thameur Hospital of TunisTunisTunisia,Department of PathologyHabib Thameur Hospital of TunisTunisTunisia
| | - Amal Chamli
- Department of DermatologyHabib Thameur Hospital of TunisTunisTunisia,Department of PathologyHabib Thameur Hospital of TunisTunisTunisia
| | - Raja Jouini
- Department of DermatologyHabib Thameur Hospital of TunisTunisTunisia,Department of PathologyHabib Thameur Hospital of TunisTunisTunisia
| | - Samy Fenniche
- Department of DermatologyHabib Thameur Hospital of TunisTunisTunisia,Department of PathologyHabib Thameur Hospital of TunisTunisTunisia
| | - Houda Hammami
- Department of DermatologyHabib Thameur Hospital of TunisTunisTunisia,Department of PathologyHabib Thameur Hospital of TunisTunisTunisia
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13
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Ben Lazreg K, Helal I, Khanchel F, El Fekih S, Hedheli R, Zaafouri H, Ben Brahim E, Jouini R, Chadli-Debbiche A. L’immunoscore dans les carcinomes colorectaux : l’analyse de deux régions tumorales permet-elle une meilleure prédiction de la survie ? Ann Pathol 2022. [DOI: 10.1016/j.annpat.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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14
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Houidi S, Sahli S, Zouaoui A, Mansouri Y, Doghri I, Mrad K, Jouini R. Unusual occurrence of acquired hypoganglionosis following surgery for Hirschsprung's disease. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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15
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Lazreg KB, Helal I, Khanchel F, Daieb A, Tlili S, El fekih S, Brahim EB, Hellal Y, Jouini R, Debbiche AC. Splenogonadal fusion: A case series of two challenging diagnoses. Clin Case Rep 2022; 10:e6250. [PMID: 36034606 PMCID: PMC9400032 DOI: 10.1002/ccr3.6250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/29/2022] [Accepted: 07/16/2022] [Indexed: 12/04/2022] Open
Abstract
Splenogonadal fusion is an abnormal connection between the spleen and gonads. This rare entity can be easily confused with testicular tumors. It usually accompanies congenital malformations, such as cryptorchidism, making diagnosis more difficult. Surgeons must be aware of this entity to avoid unnecessary orchiectomy. In some cases, biopsy may help with diagnosis.
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Affiliation(s)
| | - Imen Helal
- Habib Thameur Hospital Pathology department Tunis Tunisia
- Faculty of medicine of Tunis El Manar Tunis Tunisia
| | - Fatma Khanchel
- Habib Thameur Hospital Pathology department Tunis Tunisia
- Faculty of medicine of Tunis El Manar Tunis Tunisia
| | - Aida Daieb
- Faculty of medicine of Tunis El Manar Tunis Tunisia
- Pediatric Surgery Department Habib Thameur Hospital Tunis Tunisia
| | - Sameh Tlili
- Pediatric Surgery Department Regional Hospital of Zaghouan Zaghouan Tunisia
| | - Sirine El fekih
- Habib Thameur Hospital Pathology department Tunis Tunisia
- Faculty of medicine of Tunis El Manar Tunis Tunisia
| | - Ehsen Ben Brahim
- Habib Thameur Hospital Pathology department Tunis Tunisia
- Faculty of medicine of Tunis El Manar Tunis Tunisia
| | - Youssef Hellal
- Faculty of medicine of Tunis El Manar Tunis Tunisia
- Pediatric Surgery Department Habib Thameur Hospital Tunis Tunisia
| | - Raja Jouini
- Habib Thameur Hospital Pathology department Tunis Tunisia
- Faculty of medicine of Tunis El Manar Tunis Tunisia
| | - Achraf Chadli Debbiche
- Habib Thameur Hospital Pathology department Tunis Tunisia
- Faculty of medicine of Tunis El Manar Tunis Tunisia
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16
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Ben Thayer M, Khanchel F, Helal I, Chiboub D, Ben Lazreg K, Hedhli R, Ben Brahim E, Jouini R, Cheddli‐Debbich A. Incidental discovery of a Hodgkin lymphoma synchronous to a papillary thyroid carcinoma. Clin Case Rep 2022; 10:e6246. [PMID: 35957786 PMCID: PMC9361809 DOI: 10.1002/ccr3.6246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/07/2022] Open
Abstract
Papillary thyroid carcinoma is the most common type of thyroid cancer and accounts for almost 89.4% of all thyroid carcinomas. Hodgkin lymphoma is a heterogeneous group of neoplasms and represents 10% of lymphomas. These two cancers do not share the same risk factors. Some studies have reported the association of thyroid papillary carcinoma with lymphomas, mainly Hodgkin's lymphoma, treated with radiotherapy. However, to our knowledge less than 10 cases have illustrated synchronous papillary thyroid carcinoma and Hodgkin lymphoma with no history of radiotherapy. We present the case of a 49‐year‐old female patient, with no history of past exposure to radiation, who was incidentally diagnosed with Hodgkin lymphoma during the work up for papillary thyroid carcinoma. Our patient had total thyroïdectomy with cervical lymphadenectomy. The histopathologic examination concluded to a papillary thyroid carcinoma of classical variant. And the lymph node dissection enabled us to diagnose not only papillary thyroid carcinoma's lymph node metastasis, but also Hodgkin Lymphoma. This discovery of the Hodgkin lymphoma was totally incidental. The discovery of synchronous tumors in patients with papillary thyroid carcinoma has been reported in the literature. However, the diagnosis of Hodgkin through lymph node dissection for papillary thyroid carcinoma is extremely rare. This underlines the singularity and the importance of our case. The synchronous papillary thyroid carcinoma and Hodgkin lymphoma is a rare condition, which may pose significant diagnostic and treatment dilemmas. To date, there is no standardized approach due to lack of experience. The molecular mechanisms of this link are poorly understood and yet remain to be elucidated.
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Affiliation(s)
- Maissa Ben Thayer
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Fatma Khanchel
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Imen Helal
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Dorra Chiboub
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Department of Otorhinolaryngology‐Head and neck surgery Habib Thameur's Hospital Tunis Tunisia
| | | | - Raweh Hedhli
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Ehsen Ben Brahim
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Raja Jouini
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
| | - Aschraf Cheddli‐Debbich
- Faculty of Medicine of Tunis Tunis El Manar University Tunis Tunisia
- Depatment of Pathology Habib Thameur's Hospital Tunis Tunisia
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17
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Zaafouri H, Jouini R, Khedhiri N, Khanchel F, Cherif M, Mesbahi M, Daghmouri A, Mahmoudi W, Akremi S, Sabbah M, Benzarti Y, Hadded D, Gargouri D, Bader MB, Maamer AB. Comparison between signet-ring cell carcinoma and non-signet-ring cell carcinoma of the stomach: clinicopathological parameters, epidemiological data, outcome, and prognosis-a cohort study of 123 patients from a non-endemic country. World J Surg Oncol 2022; 20:238. [PMID: 35858903 PMCID: PMC9297662 DOI: 10.1186/s12957-022-02699-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/29/2022] [Indexed: 02/08/2023] Open
Abstract
Background Signet-ring cell carcinoma of the stomach (SRCC) is a particular gastric cancer entity. Its incidence is increasing. Its diagnosis is pathological; it corresponds to adenocarcinoma with a majority of signet-ring cells component (> 50%). These histological features give it its aggressiveness characteristics. This has repercussions on the prognostic level and implications for the alternatives of therapy, especially since some authors suggest a potential chemoresistance. This survey aimed to identify the epidemiological, pathological, therapeutic, and prognostic characteristics of SRCC as a separate disease entity. Methods This was a retrospective study of 123 patients admitted for gastric adenocarcinoma to Habib Thameur Hospital in Tunis over 11 years from January 2006 to December 2016. A comparative study was performed between 2 groups: the SRCC group with 62 patients and the non-SRCC (non-signet-ring cell carcinoma of the stomach) with 61 patients. Results The prevalence of SRCC in our series was 50%. SRCC affected significantly younger patients (55 vs 62 years; p = 0.004). The infiltrative character was more common in SRCC tumors (30.6 vs 14.8%; p = 0.060), whereas the budding character was more often noted in non-SRCC tumors (78.7 vs 58.1%; p = 0.039). There was no significant difference in tumor localization between both groups. Linitis plastica was noted in 14 patients with SRCC against a single patient with non-SRCC (p = 0.001). The tumor size was more important in the non-SRCC group (6.84 vs 6.39 cm; p = 0.551). Peritoneal carcinomatosis was noted in 4.3% of cases in the SRCC group versus 2.2% of cases in the NSRCC group (p = 0.570). Total gastrectomy was more often performed in the SRCC group (87 vs 56%; p = 0.001). Resection was more often curative in the non-SRCC group (84.4 vs 78.3%; p = 0.063). Postoperative chemotherapy was more commonly indicated in the SRCC group (67.4 vs 53.3%; p = 0.339). Tumor recurrence was more common in the non-SRCC group (35.7 vs 32%; p = 0.776). The most common type of recurrence was peritoneal carcinomatosis in the SRCC group (62.5%) and hepatic metastasis in the non-SRCC group (60%; p = 0.096). The overall 5-year survival in the SRCC group was lower than in the non-SRCC group, with no statistically significant difference (47.1 vs 51.5%; p = 0.715). The overall survival was more important for SRCC in early cancer (100 vs 80%; p = 0.408), whereas it was higher for non-SRCC in advanced cancer (48.1 vs 41.9%; p = 0.635). Conclusion Apart from its epidemiological and pathological features, SRCC seems to have a worse prognosis. Indeed, it is diagnosed at a more advanced stage and has a worse prognosis in advanced cancer than non-SRCC. It is therefore to be considered as a particular entity of gastric adenocarcinoma requiring a specific therapeutic protocol where the place of chemotherapy remains to be more investigated.
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Affiliation(s)
- Haithem Zaafouri
- Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia.
| | - Raja Jouini
- Department of Cytopathology, Habib Thameur Hospital, Tunis, Tunisia
| | - Nizar Khedhiri
- Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Fatma Khanchel
- Department of Cytopathology, Habib Thameur Hospital, Tunis, Tunisia
| | - Mona Cherif
- Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Meryam Mesbahi
- Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Aziz Daghmouri
- Department of Anesthesiology, Habib Thameur Hospital, Tunis, Tunisia
| | - Wiem Mahmoudi
- Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Soumaya Akremi
- Department of Anesthesiology, Habib Thameur Hospital, Tunis, Tunisia
| | - Meriam Sabbah
- Department of Gastroenterology, Habib Thameur Hospital, Tunis, Tunisia
| | - Yazid Benzarti
- Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Dhafer Hadded
- Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Dalila Gargouri
- Department of Gastroenterology, Habib Thameur Hospital, Tunis, Tunisia
| | - Mourad Ben Bader
- Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Anis Ben Maamer
- Department of General Surgery, Habib Thameur Hospital, Tunis, Tunisia
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18
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Kammoun I, Jouini R, Aissa A, Boukhchina R, Zgueb Y, Khelifa E, Ouali U, Jomli R, Nacef F, El Hechmi Z. Treatment-resistant schizophrenia : the relationship between clozapine plasma concentration and clinical outcome. Eur Psychiatry 2022. [PMCID: PMC9567787 DOI: 10.1192/j.eurpsy.2022.2039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Clozapine is highly effective in patients with treatment-resistant schizophrenia but, to ensure optimal clinical response it is important to optimize its use and this depends on adequate pharmacological monitoring. Objectives Evaluate the therapeutic response rate according to clozapine plasma concentration. Methods It was a cross-sectional, retrospective and analytical study, carried out over a period of six months, in the F and A psychiatry departments of the Razi hospital in Tunis, including patients followed for treatment-resistant schizophrenia and receiving clozapine. We evaluated the response to clozapine using the Brief Psychiatric Rating Scale (BPRS). Results
The average age was 37.7 ± 9.4. The mean age of introduction of clozapine was 31 years and the mean time to its introduction was 9.3 years. Clozapine was administered as a single drug in 85% of cases. The mean dose of clozapine was 373 mg/day. The mean of clozapine plasma concentration was 386.5 ng/ml with a minimum of 89 ng/ml and a maximum of 913 ng/ml. The clinical response rate to clozapine was 25% with a BPRS good response threshold value of less than 35. Patients with clozapine levels above the conventional cut-off of 350 ng/ml (n=34) had a response rate of 34.6%. A response rate of 37% was observed in the group of patients with a clozapine plasma concentration interval of 200-350 ng/ml. There was no statistically significant difference in therapeutic response (p=0186) Conclusions Our study revealed a therapeutic response variation according to plasma clozapine concentration and showed the existence of a non-negligible and effective response rate. Disclosure No significant relationships.
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19
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Kerkeni Y, Thamri F, Houidi S, Zouaoui A, Jouini R. Secondary closure of large omphalocele using component separation technique: A pediatric case report. Int J Surg Case Rep 2022. [PMCID: PMC9184860 DOI: 10.1016/j.ijscr.2022.107263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction and importance Component separation technique is utilized in adults to repair large abdominal wall defects but rarely used in children. We report a successfully performed component separation technique in a child after neonatal Gross closure for large omphalocele without biologic mesh placement. Case presentation A 6-year-old girl was treated at the age of 4 days for omphalocele type 2 according to Gross technique. She reconsulted six years later. Clinical examination showed a large eventration measuring 150 ∗ 100 mm. CT scan revealed a broad collar of 150 mm and a large pocket containing liver, transverse colon, stomach and part of the small intestine. The child was proposed for a cure of the eventration using synthetic mesh type GORTEX. Intraoperatively, releasing bowel adhesions with abdominal wall resulted in perforation of the small intestine. Faced with the inability to use the mesh we resorted to abdominal closure with component separation technique. The postoperative was simple without complications or recurrence of the eventration. Follow up was of 4 years. Clinical discussion Staged surgical closure and non-operative delayed closure are the two distinct strategies for managing giant omphaloceles. By providing closure with less intra-abdominal pressure, the Component separation technique is a procedure which can be used in the two strategies. It may minimize the complications associated with large omphalocele management. Conclusion Faced with the impossibility of using a mesh, the component separation technique must be recognized as part of the therapeutic arsenal for secondary closure in children with a giant omphalocele. We report a case of a secondary closure of large omphalocele using component separation technique in 12 years-old girl. Our pediatric patient illustrates the safety and feasibility of this technique in children without any complication. Component separation technique must be recognized in the therapeutic arsenal closure of large abdominal wall defect in children
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Kerkeni Y, Thamri F, Zouaoui A, Houidi S, Jouini R. Is pneumoperitoneum specific of post-traumatic appendicitis? Case report and literature review. Ann Pediatr Surg 2022. [DOI: 10.1186/s43159-022-00168-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
Acute appendicitis and blunt abdominal trauma may co-exist, imposing a dilemma of whether there is only coincidence or there is a cause to effect relationship. The etiopathogenesis of this rare association remains obscure. Pneumoperitoneum has rarely been described in patients with acute perforative appendicitis following abdominal trauma.
Case presentation
We report a rare case of acute perforated appendicitis after blunt abdominal trauma in an 8-year-old boy revealed by a pneumoperitoneum. We also reviewed the literature on this rare condition to assess the specificity of pneumoperitoneum in the diagnosis and to understand its etiopathogenesis.
Conclusion
Abdominal pain and fever several days after an abdominal trauma may be a sign of post-traumatic appendicitis in the pediatric population. Pneumoperitoneum is not specific of post-traumatic appendicitis but it can be a protective sign, since it will lead to immediate laparotomy in patients with an unrecognized surgical abdomen.
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21
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Kerkeni Y, Thamri F, Zouaoui A, Aziza B, Jouini R. Spontaneous perforation of common hepatic duct: an intraoperative surprise. Ann Pediatr Surg 2022. [DOI: 10.1186/s43159-022-00159-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pediatric spontaneous bile duct perforation is one of the rare causes of acute abdomen in infants. With a highly variable presentation, diagnosis and treatment can prove challenging. We report a case of spontaneous common hepatic duct perforation mistaken for appendicular peritonitis.
Case presentation
An otherwise healthy 3-year-old boy presented to the emergency department with complaints of abdominal pain, distention, bilious vomiting, and fever evolving for 4 days. Preoperative ultrasound was suggestive of appendicular peritonitis. Laparotomy revealed abundant biliary fluid, a distended gallbladder with thickened and inflammatory wall, and a macroscopically normal appendix. Intraoperative cholangiography showed a leak of contrast from the anterior wall of the common hepatic duct, 2–3 mm below the upper biliary confluence and 2 cm above the junction of the cystic duct to the common hepatic duct. A cholecystostomy was performed, and two external intraabdominal drains were placed. A retrograde cholangiogram was performed on postoperative day 21 showing no extravasation of contrast product. The patient was discharged on postoperative day 25.
Conclusion
Spontaneous perforation of the common hepatic duct is a rare phenomenon. It should be considered as a differential diagnosis in pediatric patients that present with unexplained peritonitis. The optimal method of diagnosis and management remains controversial.
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22
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Gara S, Zaouak A, Brahim EB, Jouini R, Fenniche S, Hammami H. Acquired Digital Fibrokeratoma of the Toe. J Am Podiatr Med Assoc 2021; 111. [PMID: 35294160 DOI: 10.7547/20-215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Acquired digital fibrokeratoma is a rare and benign fibrous tumor; it is usually asymptomatic, and frequently arises from the fingers. The diagnosis is easily confirmed by pathologic evaluation. However, in some cases, it may be misdiagnosed as other benign conditions, mainly adnexal tumors and common warts, especially when located on the foot and toes. In this article, we report the case of a 45-year-old man who presented to our clinic for an acquired growth over the plantar surface of the second right toe. The tumor had evolved for 1 year and affected the patient's activities and mobility. On examination, the lesion was a dome-shaped, firm tumor with keratotic distal changes and a broad base attached to the overlying skin. Pathologic assessment was consistent with the diagnosis of acquired digital fibrokeratoma, ruling out other causes of abnormal growth. The tumor was completely excised with surgery, with excellent outcomes and no recurrence at follow-up. Although acquired digital fibrokeratoma is a rare condition, mostly located on the distal upper extremities and fingers, it should be considered in the differential diagnosis of plantar soft-tissue tumors. Surgical management remains the mainstay of treatment.
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23
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Charfeddine C, Laroussi N, Mkaouar R, Jouini R, Khayat O, Redissi A, Mosbah A, Dallali H, Chedly Debbiche A, Zaouak A, Fenniche S, Abdelhak S, Hammami-Ghorbel H. Expanding the clinical phenotype associated with NIPAL4 mutation: Study of a Tunisian consanguineous family with erythrokeratodermia variabilis-Like Autosomal Recessive Congenital Ichthyosis. PLoS One 2021; 16:e0258777. [PMID: 34669720 PMCID: PMC8528321 DOI: 10.1371/journal.pone.0258777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 10/05/2021] [Indexed: 11/19/2022] Open
Abstract
Erythrokeratodermia variabilis (EKV) is a rare disorder of cornification usually associated with dominant mutations in the GJB3 and GJB4 genes encoding connexins (Cx)31 and 30.3. Genetic heterogeneity of EKV has already been suggested. We investigated at the clinical and genetic level a consanguineous Tunisian family with 2 sisters presenting an autosomal recessive form of EKV to better characterize this disease. Mutational analysis initially screened the connexin genes and Whole-exome sequencing (WES) was performed to identify the molecular aetiology of the particular EKV phenotype in the proband. Migratory shaped erythematous areas are the initial presenting sign followed by relatively stable hyperkeratotic plaques are the two predominates characteristics in both patients. However, remarkable variability of morphological and dominating features of the disease were observed between patients. In particular, the younger sister (proband) exhibited ichthyosiform-like appearance suggesting Autosomal Recessive Congenital Ichthyosis (ARCI) condition. No causative mutations were detected in the GJB3 and GJB4 genes. WES results revealed a novel missense homozygous mutation in NIPAL4 gene (c.835C>G, p.Pro279Ala) in both patients. This variant is predicted to be likely pathogenic. In addition, in silico analysis of the mutated 3D domain structure predicted that this variant would result in NIPA4 protein destabilization and Mg2+ transport perturbation, pointing out the potential role of NIPAL4 gene in the development and maintenance of the barrier function of the epidermis. Taken togheter, these results expand the clinical phenotype associated with NIPAL4 mutation and reinforce our hypothesis of NIPAL4 as the main candidate gene for the EKV-like ARCI phenotype.
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Affiliation(s)
- Cherine Charfeddine
- University Tunis El Manar, Institut Pasteur de Tunis, Biomedical Genomics and Oncogenetics Laboratory, LR20IPT05, Tunis, Tunisia
- Université de la Manouba, Institut de Biotechnologie de Sidi Thabet, Ariana, Tunisia
- * E-mail:
| | - Nadia Laroussi
- University Tunis El Manar, Institut Pasteur de Tunis, Biomedical Genomics and Oncogenetics Laboratory, LR20IPT05, Tunis, Tunisia
| | - Rahma Mkaouar
- University Tunis El Manar, Institut Pasteur de Tunis, Biomedical Genomics and Oncogenetics Laboratory, LR20IPT05, Tunis, Tunisia
| | - Raja Jouini
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
| | - Olfa Khayat
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
| | - Aladin Redissi
- BVBGR-LR11ES31, ISBST, Université de la Manouba, Institut de Biotechnologie de Sidi Thabet, Ariana, Tunisia
| | - Amor Mosbah
- BVBGR-LR11ES31, ISBST, Université de la Manouba, Institut de Biotechnologie de Sidi Thabet, Ariana, Tunisia
| | - Hamza Dallali
- University Tunis El Manar, Institut Pasteur de Tunis, Biomedical Genomics and Oncogenetics Laboratory, LR20IPT05, Tunis, Tunisia
| | | | - Anissa Zaouak
- Department of Dermatology, Genodermatosis and Cancers Laboratory LR12SP03, Habib Thameur Hospital, Tunis, Tunisia
| | - Sami Fenniche
- Department of Dermatology, Genodermatosis and Cancers Laboratory LR12SP03, Habib Thameur Hospital, Tunis, Tunisia
| | - Sonia Abdelhak
- University Tunis El Manar, Institut Pasteur de Tunis, Biomedical Genomics and Oncogenetics Laboratory, LR20IPT05, Tunis, Tunisia
| | - Houda Hammami-Ghorbel
- Department of Dermatology, Genodermatosis and Cancers Laboratory LR12SP03, Habib Thameur Hospital, Tunis, Tunisia
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Ben Thayer M, Khanchel F, Helal I, Haddad D, Hmidi A, Hedhli R, Ben Brahim E, Jouini R, Chammakhi C, Chedli-Debbich A. Myélolipome, une tumeur rare de la surrénale. Annales d'Endocrinologie 2021. [DOI: 10.1016/j.ando.2021.08.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Ben Ismail I, Zenaidi H, Jouini R, Rebii S, Zoghlami A. Pedunculated hepatic focal nodular hyperplasia: A case report and review of the literature. Clin Case Rep 2021; 9:e04202. [PMID: 34136232 PMCID: PMC8190514 DOI: 10.1002/ccr3.4202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 02/21/2021] [Accepted: 04/12/2021] [Indexed: 11/24/2022] Open
Abstract
Focal nodular hyperplasia (FNH) is a common asymptomatic benign hepatic tumor encountered in middle-aged women. However, pedunculated FNH is exceedingly rare and more frequently associated with complications. That is why surgical management is mandatory in this form.
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Affiliation(s)
- Imen Ben Ismail
- Department of General SurgeryTrauma Center Ben ArousUniversity of Tunis El ManarTunisTunisia
| | - Hakim Zenaidi
- Department of General SurgeryTrauma Center Ben ArousUniversity of Tunis El ManarTunisTunisia
| | - Raja Jouini
- Department of PathologyHabib Thameur HospitalUniversity of Tunis El ManarTunisTunisia
| | - Saber Rebii
- Department of General SurgeryTrauma Center Ben ArousUniversity of Tunis El ManarTunisTunisia
| | - Ayoub Zoghlami
- Department of General SurgeryTrauma Center Ben ArousUniversity of Tunis El ManarTunisTunisia
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Jouini R, Chabchoub I, Khanchel F, Helal I, Badri T, Ben Brahim E, Hammami H, Chadli-Debbiche A. Primary and isolated cutaneous precursor B-lymphoblastic lymphoma in an infant. Pediatr Dermatol 2021; 38:707-708. [PMID: 33738831 DOI: 10.1111/pde.14579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cutaneous lesions may represent the initial sign of various neoplasms in children, including histiocytosis, neuroblastomas, and lymphomas. Primary cutaneous lymphoblastic lymphomas are rare and involve mostly the B-cell phenotype. Herein, we report a case of isolated, primary B-lymphoblastic lymphoma in a 7-month-old infant and emphasize the importance of early diagnosis.
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Affiliation(s)
- Raja Jouini
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Ines Chabchoub
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Fatma Khanchel
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Imen Helal
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Talel Badri
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Houda Hammami
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia
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Sabbah M, Gharbi G, Jouini R, Haddad D, Bibani N, Chamakhi C, Gargouri D. A pseudotumoral form of Crohn's disease: A case report and review of the literature. Clin Case Rep 2021; 9:1677-1682. [PMID: 33768913 PMCID: PMC7981728 DOI: 10.1002/ccr3.3875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/16/2020] [Accepted: 01/14/2021] [Indexed: 11/09/2022] Open
Abstract
In front of a colonic tumor, the diagnosis of a pseudotumoral form of Crohn's disease must be considered. However, it is a rare form, especially when inaugural and a neoplasia must be eliminated before retaining the diagnosis.
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Affiliation(s)
- Meriem Sabbah
- Department of GastroenterologyHabib Thameur HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Ghada Gharbi
- Department of GastroenterologyHabib Thameur HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Raja Jouini
- Department of PathologyHabib Thameur HospitalTunisTunisia
| | - Dhafer Haddad
- Department of SurgeryHabib Thameur HospitalTunisTunisia
| | - Norsaf Bibani
- Department of GastroenterologyHabib Thameur HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
| | - Chiraz Chamakhi
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
- Department of RadiologyHabib Thameur HospitalTunisTunisia
| | - Dalila Gargouri
- Department of GastroenterologyHabib Thameur HospitalTunisTunisia
- Faculty of Medicine of TunisUniversity of Tunis El ManarTunisTunisia
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Zenaidi H, Ben Ismail I, Jouini R, Maalej Y, Zoghlami A. Appendicular mass: a rare form of Yersinia pseudotuberculosis. ANZ J Surg 2020; 90:2098-2100. [PMID: 32618049 DOI: 10.1111/ans.16137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/20/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Hakim Zenaidi
- Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia
| | - Imen Ben Ismail
- Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia
| | - Raja Jouini
- Department of Pathology, Habib Thameur Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Yassine Maalej
- Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia
| | - Ayoub Zoghlami
- Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia
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Romdhane N, Zoghlami I, Fradi R, Chiboub D, Nefzaoui S, Jouini R, Mbarek C. [Tracheal rhinoscleroma]. Med Mal Infect 2020; 50:623-624. [PMID: 32278063 DOI: 10.1016/j.medmal.2020.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 11/24/2022]
Affiliation(s)
- N Romdhane
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - I Zoghlami
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - R Fradi
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - D Chiboub
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - S Nefzaoui
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
| | - R Jouini
- Service d'anatomopathologie, hôpital Habib-Thameur, Tunis, Tunisie.
| | - C Mbarek
- Service ORL et CCF, hôpital Habib-Thameur, Tunis, Tunisie.
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Jouini R, Khanchel F, Sabbah M, Helal I, Gharsallah A, Ferchichi M, Hadded D, Zaafouri H, Ben Brahim E, Ben Maamer A, Debbiche AC. Prognostic significance of poorly cohesive gastric carcinoma in Tunisian patients. Heliyon 2020; 6:e03460. [PMID: 32195384 PMCID: PMC7078324 DOI: 10.1016/j.heliyon.2020.e03460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/07/2019] [Accepted: 02/18/2020] [Indexed: 02/05/2023] Open
Abstract
Background While the incidence of gastric cancer has decreased worldwide in recent decades, the incidence of poorly cohesive carcinoma (PCC) is rising. The prognostic significance of gastric PCC remains a subject of debate. Objective To analyze the prognosis of gastric PCC in a Tunisian cohort. Methods A total of 122 gastric adenocarcinoma patients who underwent curative gastrectomy from 2001 to 2014 at Habib Thameur hospital in Tunis, Tunisia were included. The clinicopathological parameters and prognosis of PCC were analyzed in comparison with non PCC (NPCC). Results Sixty one patients (50%) presented PCC. Patients were younger in PCC group (p = 0,001). There was no difference in sex distribution between the two groups. PCC was more likely to be stage T4 (55.7% vs 34.4%; p = 0.033), N3 (67.8% vs 30%; p < 0.001) and have a higher metastatic lymph node ratio (p < 0.001). Hepatic metastases were more frequent in NPCC group (p = 0.031) whereas peritoneal carcinomatosis was more common in PCC group (p = 0.004). Perineural invasion was more frequent in PCC group (p = 0.001). Resection margins were more often positive in PCC group (31.1% vs 9.8%; p = 0.004). There was no difference in recurrence rate between the 2 groups (p = 0.348). The 5-year survival was similar in the NPCC and PCC (respectively 43% vs 23 %; p = 0.247). Survival rates were also comparable in early stage (100% vs 80% respectively for PCC and NPCC; p = 0.527) as well as for advanced stage (16% vs 35% respectively for PCC and NPCC; p = 0.538). PCC was not a prognostic factor for survival. Interestingly, advanced age, adjacent structures invasion, positive resection margins were specific prognostic factors for PCC. Conclusion In our study PCC was not a prognostic factor for survival. Advanced age, adjacent structures invasion and positive resection margins were specific prognostic features for this histological subtype.
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Affiliation(s)
- Raja Jouini
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
- Corresponding author.
| | - Fatma Khanchel
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - Meriam Sabbah
- Department of Gastroenterology, Habib Thameur Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - Imen Helal
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | | | - Marwa Ferchichi
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
- Faculty of Sciences of Tunis, Tunis El Manar University, Tunisia
| | - Dhafer Hadded
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
- Department of Surgery, Habib Thameur Hospital, Tunisia
| | - Haithem Zaafouri
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
- Department of Surgery, Habib Thameur Hospital, Tunisia
| | - Ehsen Ben Brahim
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - Anis Ben Maamer
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
- Department of Surgery, Habib Thameur Hospital, Tunisia
| | - Aschraf Chadli Debbiche
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
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Zaouak A, Chamli A, Jouini R, Koubaa W, Hammami H, Fenniche S. A tale of bilateral violaceous nodules of the face in a child. Int J Dermatol 2020; 59:e15-e17. [PMID: 31483490 DOI: 10.1111/ijd.14627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 08/01/2019] [Accepted: 08/09/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Anissa Zaouak
- Department of Dermatology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Amal Chamli
- Department of Dermatology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Raja Jouini
- Anatomopathology Department, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Wafa Koubaa
- Anatomopathology Department, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Houda Hammami
- Department of Dermatology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
| | - Samy Fenniche
- Department of Dermatology, Research Unit "Genodermatoses and cancers LR12SP03", Habib Thameur Hospital, Tunis, Tunisia
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Jouini R, Hedhli R, Khanchel F, Sabbah M, Trad D, Hlel I, Koubaa W, Khayat O, Ben Brahim E, Debbiche AC. Anguillulosis: circumstances of infestation and evolution towards the malignant form. Tunis Med 2019; 97:1419-1421. [PMID: 32173814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Anguillulosis is a ubiquitous digestive parasitosis. Rare in Tunisia, it is due to a round worm, strongyloid stercoralis, whose natural lodging is the duodeno-jejunal mucosa. Its malignant form is rare but it represents a potentially life-threatening disease. AIM We report a case of malignant anguillulosis occurring in a context of immunosuppression. OBSERVATION The case we report is about a 46-year-old man treated by a long-term corticosteroid therapy for Takayasu disease. He was hospitalized for an acute digestive syndrome. Biopsies were performed but the evolution was rapidly marked by multiorgan failure, sepsis and death of the patient. Histological analysis of the digestive biopsies concluded to an oeso-gastroduodenal anguillulosis. CONCLUSION Anguillulosis is a rare parasitosis but it can pose a health problem especially in its malignant form wich can be a life-threatening.
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Sabbah M, Trad D, Helal I, Jouini R, Ouakaa A. Atypical hyperplastic polyp. Presse Med 2019; 48:1351-1352. [PMID: 31732363 DOI: 10.1016/j.lpm.2019.09.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/09/2019] [Accepted: 09/26/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Meriam Sabbah
- Habib Thameur Hospital, Departement of gastroenterology, Tunis, Tunisia; Faculty of medecine of Tunis, university of Tunis El Manar, Tunis, Tunisia.
| | - Dorra Trad
- Habib Thameur Hospital, Departement of gastroenterology, Tunis, Tunisia; Faculty of medecine of Tunis, university of Tunis El Manar, Tunis, Tunisia
| | - Imen Helal
- Habib Thameur Hospital, Departement of gastroenterology, Tunis, Tunisia; Faculty of medecine of Tunis, university of Tunis El Manar, Tunis, Tunisia
| | - Raja Jouini
- Habib Thameur Hospital, Departement of gastroenterology, Tunis, Tunisia; Faculty of medecine of Tunis, university of Tunis El Manar, Tunis, Tunisia
| | - Asma Ouakaa
- Habib Thameur Hospital, Departement of gastroenterology, Tunis, Tunisia; Faculty of medecine of Tunis, university of Tunis El Manar, Tunis, Tunisia
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Jouini R, Saidi A, Khanchel F, Helal I, Chtourou M, Chadli-Debbiche A. Sarcomatoid chromophobe renal cell carcinoma revealed by acute pyelonephritis in a diabetic patient. Urol Case Rep 2019; 28:101037. [PMID: 31681535 PMCID: PMC6818138 DOI: 10.1016/j.eucr.2019.101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/05/2019] [Accepted: 10/08/2019] [Indexed: 11/24/2022] Open
Abstract
Chromophobe renal cell carcinoma (CRCC) is a rare tumor comprising 2 types of cells (eosinophilic and clear cells), coexisting in varying proportions. CRCC has an overall good prognosis. However, the rarely encountered sarcomatoid differentiation is associated with a pejorative outcome and must, therefore, be rigorously ruled out. Acute pyelonephritis and other infectious complications rarely occur. We report a case of CRCC with sarcomatoid differentiation in a woman in her sixties which was revealed by acute pyelonephritis and had a lethal outcome.
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Affiliation(s)
- Raja Jouini
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Ayoub Saidi
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Fatma Khanchel
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Imen Helal
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Maher Chtourou
- Department of Urology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
| | - Aschraf Chadli-Debbiche
- Department of Pathology, Habib Thameur Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia, 8, Ali Ben Ayed Street, 1008, Tunis, Tunisia
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Meriam S, Trad D, Jouini R, Haddad D, Ouakaa A. Rectal neuroendocrine tumor presenting as a polyp with hepatic metastases. Gastrointest Endosc 2019; 90:688-689. [PMID: 31375265 DOI: 10.1016/j.gie.2019.05.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 05/30/2019] [Indexed: 02/08/2023]
Affiliation(s)
- Sabbah Meriam
- Department of Gastroenterology, Habib Thameur Hospital, Tunis, Tunisia
| | - Dorra Trad
- Department of Gastroenterology, Habib Thameur Hospital, Tunis, Tunisia
| | - Raja Jouini
- Department of Pathology, Habib Thameur Hospital, Tunis, Tunisia
| | - Dhafer Haddad
- Department of Surgery, Habib Thameur Hospital, Tunis, Tunisia
| | - Asma Ouakaa
- Department of Gastroenterology, Habib Thameur Hospital, Tunis, Tunisia
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Zaouak A, Chamli A, Jouini R, Hammami H, Fenniche S. Patch granuloma annulare of the legs. Presse Med 2019; 48:1200-1201. [PMID: 31471095 DOI: 10.1016/j.lpm.2019.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 07/01/2019] [Accepted: 07/23/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Anissa Zaouak
- Dermatology Department, Habib Thameur Hospital, 1008 Tunis, Tunisia; Research Unit "Genodermatoses and cancers" LR12SP03, 1008 Tunis, Tunisia.
| | - Amal Chamli
- Dermatology Department, Habib Thameur Hospital, 1008 Tunis, Tunisia; Research Unit "Genodermatoses and cancers" LR12SP03, 1008 Tunis, Tunisia
| | - Raja Jouini
- Anatomopathology Department, Habib Thameur Hospital, 1008 Tunis, Tunisia; Research Unit "Genodermatoses and cancers" LR12SP03, 1008 Tunis, Tunisia
| | - Houda Hammami
- Dermatology Department, Habib Thameur Hospital, 1008 Tunis, Tunisia; Research Unit "Genodermatoses and cancers" LR12SP03, 1008 Tunis, Tunisia
| | - Samy Fenniche
- Dermatology Department, Habib Thameur Hospital, 1008 Tunis, Tunisia; Research Unit "Genodermatoses and cancers" LR12SP03, 1008 Tunis, Tunisia
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Zaouak A, Brahim EB, Sassi W, Jouini R, Hammami H, Fenniche S. A Painful Thumb. Skinmed 2019; 17:281-282. [PMID: 31627794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Anissa Zaouak
- Department of Dermatology, Research Unit "Genodermatoses and Cancers LR12SP03," Habib Thameur Hospital, Tunis, Tunisia
| | - Ehsen Ben Brahim
- Department of Anatomopathology, Research Unit "Genodermatoses and Cancers LR12SP03," Habib Thameur Hospital, Tunis, Tunisia
| | - Wiem Sassi
- Department of Dermatology, Research Unit "Genodermatoses and Cancers LR12SP03," Habib Thameur Hospital, Tunis, Tunisia
| | - Raja Jouini
- Department of Anatomopathology, Research Unit "Genodermatoses and Cancers LR12SP03," Habib Thameur Hospital, Tunis, Tunisia
| | - Houda Hammami
- Department of Dermatology, Research Unit "Genodermatoses and Cancers LR12SP03," Habib Thameur Hospital, Tunis, Tunisia
| | - Samy Fenniche
- Department of Dermatology, Research Unit "Genodermatoses and Cancers LR12SP03," Habib Thameur Hospital, Tunis, Tunisia
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Zaouak A, Jaouadi H, Chamli A, Jouini R, Abdelhak S, Hammami H, Fenniche S. H‐like syndrome successfully treated with methotrexate. Dermatol Ther 2019; 32:e12994. [DOI: 10.1111/dth.12994] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 05/29/2019] [Accepted: 06/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Anissa Zaouak
- Dermatology Department, Research Unit “Genodermatoses and cancers LR12SP03”HabibThameur Hospital Tunis Tunisia
| | - Hager Jaouadi
- Laboratory of Biomedical Genomics and OncogeneticsInstitut Pasteur de Tunis Tunis Tunisia
| | - Amal Chamli
- Dermatology Department, Research Unit “Genodermatoses and cancers LR12SP03”HabibThameur Hospital Tunis Tunisia
| | - Raja Jouini
- Anatomopathology DepartmentHabibThameur Hospital Tunis Tunisia
| | - Sonia Abdelhak
- Laboratory of Biomedical Genomics and OncogeneticsInstitut Pasteur de Tunis Tunis Tunisia
| | - Houda Hammami
- Dermatology Department, Research Unit “Genodermatoses and cancers LR12SP03”HabibThameur Hospital Tunis Tunisia
| | - Samy Fenniche
- Dermatology Department, Research Unit “Genodermatoses and cancers LR12SP03”HabibThameur Hospital Tunis Tunisia
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Bellil N, Jouini R, Sabbah M, Khanchel F, Trad D, Imen H, Wafa K, Asma O, Ehsen B, Hela E, Aschraf D, Gargouri D. Rentabilité du brossage cytologique au cours des sténoses des voies biliaires. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bellil N, Jouini R, Sabbah M, Khanchel F, Trad D, Imen H, Wafa K, Ehsen B, Asma O, Aschraf D. Tuberculose gastrique : à propos de 6 cas. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bellil N, Jouini R, Trad D, Khanchel F, Sabbah M, Asma O, Imen H, Wafa K, Ehsen B, Hela E, Aschraf D, Gargouri D. Lymphome gastrique primitif : étude comparative en fonction de l’âge. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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42
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Bellil N, Jouini R, Khanchel F, Sabbah M, Trad D, Asma O, Wafa K, Bibani N, Ehsen B, Hela E, Aschraf D, Gargouri D. Lymphome gastrique du MALT : à propos d’une expérience Tunisienne. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ferchichi M, Jouini R, Koubaa W, Khanchel F, Helal I, Hadad D, Bibani N, Chadli-Debbiche A, BenBrahim E. Ampullary and pancreatic adenocarcinoma-a comparative study. J Gastrointest Oncol 2019; 10:270-275. [PMID: 31032094 DOI: 10.21037/jgo.2018.09.09] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Pancreatic ductal adenocarcinoma (PDAC) and ampullary adenocarcinoma (AAC) are 2 gastrointestinal cancers that share overlapping symptoms. Although some studies have proposed the hypothesis of differences in pathogenesis and prognosis in these 2 cancers; they remain treated similarly. The classification of AAC into three subtypes [pancreatobiliary (PB), intestinal (IT) and mixed (M)] is especially crucial for the 3 axes of patients management (diagnosis, prognosis and therapy). Some studies suggest that PB subtype pathogenesis is comparable to PDAC. The objective of this study was to conduct a comparative analysis between PDAC and AAC; notably PB subtype; via mutational status analysis of 3 oncogenes (KRAS, NRAS and BRAF) hoping to consolidate AAC biology understanding. Methods Nine hot spot mutation sites of KRAS, NRAS and BRAF were analysed using pyrosequencing in 39 PDAC and 21 AAC from Tunisian patients. Comparative study was performed using SPSS software. Results Mutations in oncogenes were detected in almost 43% of AAC, especially in PB (47%) and 95% of PDAC. KRAS was the most mutated oncogene. There were statistical significant differences between PDAC and AAC in tumor differentiation (P<0.001), perineural invasion (P<0.001), vascular emboli (P=0.001), T stage (P=0.007), N stage (P=0.001) and mutational status (P<0.001). When comparing PDAC and PB subtype, there were also significant differences in tumor size (P=0.001), tumor differentiation (P<0.001), perineural invasion (P<0.001), vascular emboli (P=0.001), T stage (P=0.033), N stage (P<0.001) and mutational status (P<0.001). Conclusions AAC even PB subtype is different from PDAC. We think that these different tumor types require highly individualized therapy guided by their histomolecular characteristics and that we should stop diagnosing and treating them as a unique entity.
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Affiliation(s)
- Marwa Ferchichi
- University of Sciences, Farhat Hached Campus, Tunis El Manar, Tunis, Tunisia.,Pathology Department, Habib Thameur Hospital, University of Medicine, Tunis, Tunisia
| | - Raja Jouini
- Pathology Department, Habib Thameur Hospital, University of Medicine, Tunis, Tunisia
| | - Wafa Koubaa
- Pathology Department, Habib Thameur Hospital, University of Medicine, Tunis, Tunisia
| | - Fatma Khanchel
- Pathology Department, Habib Thameur Hospital, University of Medicine, Tunis, Tunisia
| | - Imen Helal
- Pathology Department, Habib Thameur Hospital, University of Medicine, Tunis, Tunisia
| | - Dhafer Hadad
- Surgery Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Norsaf Bibani
- Gastroenterology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Ehsen BenBrahim
- Pathology Department, Habib Thameur Hospital, University of Medicine, Tunis, Tunisia
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Jouini R, Ferchichi M, BenBrahim E, Ayari I, Khanchel F, Koubaa W, Saidi O, Allani R, Chadli-Debbiche A. KRAS and NRAS pyrosequencing screening in Tunisian colorectal cancer patients in 2015. Heliyon 2019; 5:e01330. [PMID: 30949599 PMCID: PMC6430077 DOI: 10.1016/j.heliyon.2019.e01330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 02/23/2019] [Accepted: 03/06/2019] [Indexed: 02/07/2023] Open
Abstract
Background Mutations in KRAS and NRAS often result in constitutive activation of RAS in the epidermal growth factor receptor (EGFR) signaling pathway. Mutations in KRAS exon 2 (codon 12–13) predict resistance to anti-EGFR targeted therapy in patients with metastatic colorectal carcinoma (mCRC). However, it's currently known that a significant proportion of mCRC have RAS mutations outside KRAS exon 2, particularly in exons 3 and 4 of KRAS and exons 2, 3 and 4 of NRAS. No data about RAS mutations outside KRAS exon 2 are available for Tunisian mCRC. The aim of this study was to analyze RAS, using pyrosequencing, in nine hotspots mutations in Tunisian patients with mCRC. Methods A series of 131 mCRC was enrolled. Nine hotspots sites mutations of KRAS and NRAS were analyzed (KRAS: codons 12–13, codons 59–61, codon 117 and codon 146, NRAS: codons 12–13, codon 59, codon 61, codon 117 and codon 146) using Therascreen KRAS and RAS extension pyrosequencing kits. Results Analysis was successful in 129 cases (98.5%). Mutations were observed in 97 cases (75.2%) dominated by those in KRAS exon 2 (86.6%). KRAS G12V was the most dominated mutation, observed in 25 cases (25.8%), and followed by KRAS G12S and KRAS G12D, each in 17 cases (17.5%). Mutations outside of KRAS exon 2 presented 13.4% of mutated cases and almost a third (28.8%) of KRAS exon 2 wild type mCRC. Among those, 9 cases (69.3%) carried mutations in NRAS exons 2, 3 and 4 and 4 cases (30.7%) in KRAS exons 3 and 4. Conclusions RAS mutations outside exon 2 of KRAS should be included in routine practice, since they predict also response to anti-EGFR. That would make certain these patients benefit from appropriate testing and treatment. In addition unjustified expenses of anti-EGFR targeted therapy could be avoided.
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Affiliation(s)
- Raja Jouini
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
- University of Medicine, Farhat Hached Campus, Tunis El Manar, Tunisia
| | - Marwa Ferchichi
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
- University of Sciences, Farhat Hached Campus, Tunis El Manar, Tunisia
- Corresponding author.
| | - Ehsen BenBrahim
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Imen Ayari
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
- University of Sciences, Farhat Hached Campus, Tunis El Manar, Tunisia
| | - Fatma Khanchel
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Wafa Koubaa
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Riadh Allani
- University of Medicine, Farhat Hached Campus, Tunis El Manar, Tunisia
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Zaouak A, Ben Brahim E, Jouini R, Hammami H, Fenniche S. "My Daughter Has Thin and Short Hair". Skin Appendage Disord 2019; 5:127-129. [PMID: 30815452 DOI: 10.1159/000490774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 06/11/2018] [Indexed: 11/19/2022] Open
Affiliation(s)
- Anissa Zaouak
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
| | - Ehsen Ben Brahim
- Anatomopathology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
| | - Raja Jouini
- Anatomopathology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
| | - Houda Hammami
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
| | - Samy Fenniche
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia.,Research Unit "Genodermatoses and cancers" LR12SP03, Tunis, Tunisia
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Zaouak A, Magdoud O, Jouini R, Hammami H, Fenniche S. A tale of subcutaneous nodules, broad thumbs, supernumerary teeth, and intellectual disability in a patient. Int J Dermatol 2019; 58:795-796. [PMID: 30623417 DOI: 10.1111/ijd.14379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/21/2018] [Accepted: 12/11/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Anissa Zaouak
- Dermatology Department, Research Unit "Genodermatoses and cancers" LR12SP03, Habib Thameur Hospital, Tunis, Tunisia
| | - Oumayma Magdoud
- Dermatology Department, Research Unit "Genodermatoses and cancers" LR12SP03, Habib Thameur Hospital, Tunis, Tunisia
| | - Raja Jouini
- Anatomopathology Department, Research Unit "Genodermatoses and cancers" LR12SP03, Habib Thameur Hospital, Tunis, Tunisia
| | - Houda Hammami
- Dermatology Department, Research Unit "Genodermatoses and cancers" LR12SP03, Habib Thameur Hospital, Tunis, Tunisia
| | - Samy Fenniche
- Dermatology Department, Research Unit "Genodermatoses and cancers" LR12SP03, Habib Thameur Hospital, Tunis, Tunisia
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Alami Aroussi A, Fouad A, Omrane A, Razzak A, Aissa A, Akkad A, Amraoui A, Aouam A, Arfaoui A, Belkouchi A, Ben Chaaben A, Ben Cheikh A, Ben Khélifa A, Ben Mabrouk A, Benhima A, Bezza A, Bezzine A, Bourrahouat A, Chaieb A, Chakib A, Chetoui A, Daoudi A, Ech-Chenbouli A, Gaaliche A, Hassani A, Kassimi A, Khachane A, Labidi A, Lalaoui A, Masrar A, McHachi A, Nakhli A, Ouakaa A, Siati A, Toumi A, Zaouali A, Condé AY, Haggui A, Belaguid A, El Hangouche AJ, Gharbi A, Mahfoudh A, Bouzouita A, Aissaoui A, Ben Hamouda A, Hedhli A, Ammous A, Bahlous A, Ben Halima A, Belhadj A, Bezzine A, Blel A, Brahem A, Banasr A, Meherzi A, Saadi A, Sellami A, Turki A, Ben Miled A, Ben Slama A, Daib A, Zommiti A, Chadly A, Jmaa A, Mtiraoui A, Ksentini A, Methnani A, Zehani A, Kessantini A, Farah A, Mankai A, Mellouli A, Zaouali A, Touil A, Hssine A, Ben Safta A, Derouiche A, Jmal A, Ferjani A, Djobbi A, Dridi A, Aridhi A, Bahdoudi A, Ben Amara A, Benzarti A, Ben Slama AY, Oueslati A, Soltani A, Chadli A, Aloui A, Belghuith Sriha A, Bouden A, Laabidi A, Mensi A, Ouakaa A, Sabbek A, Zribi A, Green A, Ben Nasr A, Azaiez A, Yeades A, Belhaj A, Mediouni A, Sammoud A, Slim A, Amine B, Chelly B, Jatik B, Lmimouni B, Daouahi B, Ben Khelifa B, Louzir B, Dorra A, Dhahri B, Ben Nasrallah C, Chefchaouni C, Konzi C, Loussaief C, Makni C, Dziri C, Bouguerra C, Kays C, Zedini C, Dhouha C, Mohamed C, Aichaouia C, Dhieb C, Fofana D, Gargouri D, Chebil D, Issaoui D, Gouiaa D, Brahim D, Essid D, Jarraya D, Trad D, Ben Hmida E, Sboui E, Ben Brahim E, Baati E, Talbi E, Chaari E, Hammami E, Ghazouani E, Ayari F, Ben Hariz F, Bennaoui F, Chebbi F, Chigr F, Guemira F, Harrar F, Benmoula FZ, Ouali FZ, Maoulainine FMR, Bouden F, Fdhila F, Améziani F, Bouhaouala F, Charfi F, Chermiti Ben Abdallah F, Hammemi F, Jarraya F, Khanchel F, Ourda F, Sellami F, Trabelsi F, Yangui F, Fekih Romdhane F, Mellouli F, Nacef Jomli F, Mghaieth F, Draiss G, Elamine G, Kablouti G, Touzani G, Manzeki GB, Garali G, Drissi G, Besbes G, Abaza H, Azzouz H, Said Latiri H, Rejeb H, Ben Ammar H, Ben Brahim H, Ben Jeddi H, Ben Mahjouba H, Besbes H, Dabbebi H, Douik H, El Haoury H, Elannaz H, Elloumi H, Hachim H, Iraqi H, Kalboussi H, Khadhraoui H, Khouni H, Mamad H, Metjaouel H, Naoui H, Zargouni H, Elmalki HO, Feki H, Haouala H, Jaafoura H, Drissa H, Mizouni H, Kamoun H, Ouerda H, Zaibi H, Chiha H, Kamoun H, Saibi H, Skhiri H, Boussaffa H, Majed H, Blibech H, Daami H, Harzallah H, Rkain H, Ben Massoud H, Jaziri H, Ben Said H, Ayed H, Harrabi H, Chaabouni H, Ladida Debbache H, Harbi H, Yacoub H, Abroug H, Ghali H, Kchir H, Msaad H, Ghali H, Manai H, Riahi H, Bousselmi H, Limem H, Aouina H, Jerraya H, Ben Ayed H, Chahed H, Snéne H, Lahlou Amine I, Nouiser I, Ait Sab I, Chelly I, Elboukhani I, Ghanmi I, Kallala I, Kooli I, Bouasker I, Fetni I, Bachouch I, Bouguecha I, Chaabani I, Gazzeh I, Samaali I, Youssef I, Zemni I, Bachouche I, Youssef I, Bouannene I, Kasraoui I, Laouini I, Mahjoubi I, Maoudoud I, Riahi I, Selmi I, Tka I, Hadj Khalifa I, Mejri I, Béjia I, Bellagha J, Boubaker J, Daghfous J, Dammak J, Hleli J, Ben Amar J, Jedidi J, Marrakchi J, Kaoutar K, Arjouni K, Ben Helel K, Benouhoud K, Rjeb K, Imene K, Samoud K, El Jeri K, Abid K, Chaker K, Abid K, Bouzghaîa K, Kamoun K, Zitouna K, Oughlani K, Lassoued K, Letaif K, Hakim K, Cherif Alami L, Benhmidoune L, Boumhil L, Bouzgarrou L, Dhidah L, Ifrine L, Kallel L, Merzougui L, Errguig L, Mouelhi L, Sahli L, Maoua M, Rejeb M, Ben Rejeb M, Bouchrik M, Bouhoula M, Bourrous M, Bouskraoui M, El Belhadji M, El Belhadji M, Essakhi M, Essid M, Gharbaoui M, Haboub M, Iken M, Krifa M, Lagrine M, Leboyer M, Najimi M, Rahoui M, Sabbah M, Sbihi M, Zouine M, Chefchaouni MC, Gharbi MH, El Fakiri MM, Tagajdid MR, Shimi M, Touaibia M, Jguirim M, Barsaoui M, Belghith M, Ben Jmaa M, Koubaa M, Tbini M, Boughdir M, Ben Salah M, Ben Fraj M, Ben Halima M, Ben Khalifa M, Bousleh M, Limam M, Mabrouk M, Mallouli M, Rebeii M, Ayari M, Belhadj M, Ben Hmida M, Boughattas M, Drissa M, El Ghardallou M, Fejjeri M, Hamza M, Jaidane M, Jrad M, Kacem M, Mersni M, Mjid M, Sabbah M, Serghini M, Triki M, Ben Abbes M, Boussaid M, Gharbi M, Hafi M, Slama M, Trigui M, Taoueb M, Chakroun M, Ben Cheikh M, Chebbi M, Hadj Taieb M, Kacem M, Ben Khelil M, Hammami M, Khalfallah M, Ksiaa M, Mechri M, Mrad M, Sboui M, Bani M, Hajri M, Mellouli M, Allouche M, Mesrati MA, Mseddi MA, Amri M, Bejaoui M, Bellali M, Ben Amor M, Ben Dhieb M, Ben Moussa M, Chebil M, Cherif M, Fourati M, Kahloul M, Khaled M, Machghoul M, Mansour M, Abdesslem MM, Ben Chehida MA, Chaouch MA, Essid MA, Meddeb MA, Gharbi MC, Elleuch MH, Loueslati MH, Sboui MM, Mhiri MN, Kilani MO, Ben Slama MR, Charfi MR, Nakhli MS, Mourali MS, El Asli MS, Lamouchi MT, Cherti M, Khadhraoui M, Bibi M, Hamdoun M, Kassis M, Touzi M, Ben Khaled M, Fekih M, Khemiri M, Ouederni M, Hchicha M, Kassis M, Ben Attia M, Yahyaoui M, Ben Azaiez M, Bousnina M, Ben Jemaa M, Ben Yahia M, Daghfous M, Haj Slimen M, Assidi M, Belhadj N, Ben Mustapha N, El Idrissislitine N, Hikki N, Kchir N, Mars N, Meddeb N, Ouni N, Rada N, Rezg N, Trabelsi N, Bouafia N, Haloui N, Benfenatki N, Bergaoui N, Yomn N, Ben Mustapha N, Maamouri N, Mehiri N, Siala N, Beltaief N, Aridhi N, Sidaoui N, Walid N, Mechergui N, Mnif N, Ben Chekaya N, Bellil N, Dhouib N, Achour N, Kaabar N, Mrizak N, Mnif N, Chaouech N, Hasni N, Issaoui N, Ati N, Balloumi N, Haj Salem N, Ladhari N, Akif N, Liani N, Hajji N, Trad N, Elleuch N, Marzouki NEH, Larbi N, M'barek N, Rebai N, Bibani N, Ben Salah N, Belmaachi O, Elmaalel O, Jlassi O, Mihoub O, Ben Zaid O, Bouallègue O, Bousnina O, Bouyahia O, El Maalel O, Fendri O, Azzabi O, Borgi O, Ghdes O, Ben Rejeb O, Rachid R, Abi R, Bahiri R, Boulma R, Elkhayat R, Habbal R, Rachid R, Tamouza R, Jomli R, Ben Abdallah R, Smaoui R, Debbeche R, Fakhfakh R, El Kamel R, Gargouri R, Jouini R, Nouira R, Fessi R, Bannour R, Ben Rabeh R, Kacem R, Khmakhem R, Ben Younes R, Karray R, Cheikh R, Ben Malek R, Ben Slama R, Kouki R, Baati R, Bechraoui R, Fakhfakh R, Fradi R, Lahiani R, Ridha R, Zainine R, Kallel R, Rostom S, Ben Abdallah S, Ben Hammamia S, Benchérifa S, Benkirane S, Chatti S, El Guedri S, El Oussaoui S, Elkochri S, Elmoussaoui S, Enbili S, Gara S, Haouet S, Khammeri S, Khefecha S, Khtrouche S, Macheghoul S, Mallouli S, Rharrit S, Skouri S, Helali S, Boulehmi S, Abid S, Naouar S, Zelfani S, Ben Amar S, Ajmi S, Braiek S, Yahiaoui S, Ghezaiel S, Ben Toumia S, Thabeti S, Daboussi S, Ben Abderahman S, Rhaiem S, Ben Rhouma S, Rekaya S, Haddad S, Kammoun S, Merai S, Mhamdi S, Ben Ali R, Gaaloul S, Ouali S, Taleb S, Zrour S, Hamdi S, Zaghdoudi S, Ammari S, Ben Abderrahim S, Karaa S, Maazaoui S, Saidani S, Stambouli S, Mokadem S, Boudiche S, Zaghbib S, Ayedi S, Jardek S, Bouselmi S, Chtourou S, Manoubi S, Bahri S, Halioui S, Jrad S, Mazigh S, Ouerghi S, Toujani S, Fenniche S, Aboudrar S, Meriem Amari S, Karouia S, Bourgou S, Halayem S, Rammeh S, Yaïch S, Ben Nasrallah S, Chouchane S, Ftini S, Makni S, Manoubi S, Miri S, Saadi S, Manoubi SA, Khalfallah T, Mechergui T, Dakka T, Barhoumi T, M'rad TEB, Ajmi T, Dorra T, Ouali U, Hannachi W, Ferjaoui W, Aissi W, Dahmani W, Dhouib W, Koubaa W, Zhir W, Gheriani W, Arfa W, Dougaz W, Sahnoun W, Naija W, Sami Y, Bouteraa Y, Elhamdaoui Y, Hama Y, Ouahchi Y, Guebsi Y, Nouira Y, Daly Y, Mahjoubi Y, Mejdoub Y, Mosbahi Y, Said Y, Zaimi Y, Zgueb Y, Dridi Y, Mesbahi Y, Gharbi Y, Hellal Y, Hechmi Z, Zid Z, Elmouatassim Z, Ghorbel Z, Habbadi Z, Marrakchi Z, Hidouri Z, Abbes Z, Ouhachi Z, Khessairi Z, Khlayfia Z, Mahjoubi Z, Moatemri Z. 46th Medical Maghrebian Congress. November 9-10, 2018. Tunis. Tunis Med 2019; 97:177-258. [PMID: 31535714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Koubaa Mahjoub W, Jouini R, Khanchel F, Ben Brahim E, Llamas-Velasco M, Helel I, Khayat O, Chadli A, Badri T, Mentzel T. Neuroblastoma-like schwannoma with giant rosette: A potential diagnostic pitfall for hyalinizing spindle cell tumor. J Cutan Pathol 2018; 46:234-237. [PMID: 30582192 DOI: 10.1111/cup.13405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/27/2018] [Accepted: 12/17/2018] [Indexed: 12/31/2022]
Abstract
Neuroblastoma-like schwannoma (NLS) is a rare variant of a common tumor. The aim of this study is to discuss, through a literature review, the differential diagnoses of NLS while emphasizing the importance of ancillary studies. So far, 24 cases have been reported. We describe an additional case in a 64-year-old woman who had a 3-cm subcutaneous tumor on her flank. The histological examination showed an encapsulated neoplasm. Most of the tumor was made of giant rosettes. These rosettes had several sizes reaching 2.6 mm. They showed a palisade of rounded cells. Nuclei were hyperchromatic but bland. The center was made of eosinophilic cores of collagenous radiating fibrils. Neoplastic cells stained strongly for S-100 protein. In the capsule, perineural cells stained for epithelial membrane antigen (EMA). No expression of Mucin 4 (MUC4) was present. This was consistent with NLS. The same peculiar appearance of giant rosettes has been described in hyalinizing spindle cell tumor with giant rosettes (HSCT). We propose the term "neuroblastoma-like schwannoma" when there are small rosettes, "HSCT-like schwannoma" for tumors with giant rosettes and "collagen-rich schwannoma" when there are "ill-defined" structures reminiscent of rosettes. Immunohistochemical panel containing S100, EMA, and MUC4, as well as molecular testing when needed should be performed.
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Affiliation(s)
| | - Raja Jouini
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Fatma Khanchel
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Mar Llamas-Velasco
- Dermatology Department, Hospital Universitario de La Princesa, Madrid, Spain
| | - Imen Helel
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Olfa Khayat
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Aschraf Chadli
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Talel Badri
- Dermatology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Thomas Mentzel
- Dermatopathology Lake Constance, Friedrichshafen, Germany
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Ferchichi M, Jouini R, Ayari I, Koubaa W, Chadli-Debbiche A, BenBrahim E. KRAS, NRAS and BRAF analysis of ampullary adenocarcinoma classified using CK7, CK20, MUC1 and MUC2. J Gastrointest Oncol 2018; 9:820-827. [PMID: 30505580 DOI: 10.21037/jgo.2018.05.03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Ampullary carcinomas are rare and dominated by adenocarcinomas. They account for only 0.5% of all gastrointestinal malignancies. Ampullary adenocarcinoma (AAC) with pancreaticobiliary (PB) histology has a worse outcome than that with intestinal (IT) histology. The mixed subtype contains the two epitheliums. This subclassification remains a challenge for pathologists and induces a reasonable level of disagreement. Genetic features of these subtypes are unclear. In this study, we aimed to reclassify AAC cases then to evaluate differences in prognostic, pathological and molecular parameters including mutational status of three oncogenes between these subtypes. Methods AACs from 21 Tunisian patients were used in this study. Reclassification was made based on histology and immunohistochemistry (IHC) using CK7, CK20, MUC1 and MUC2. Mutational analysis included the pyrosequencing of KRAS, NRAS and BRAF. Results Fifteen cases were PB subtype, 2 cases were IT subtype and 4 cases were mixed subtype. CK20 and MUC2 were associated with N stage, MUC1 and histomolecular subtype with T stage. Nine cases were mutated and 12 were wild-type. Eight cases were KRAS mutated (5 G12D and 3 G12V). Only 1 case was NRAS mutated (G12D). No BRAF mutation was found. Genetic alterations didn't influence prognostic factors. Conclusions We validate the prognostic utility of AAC histomolecular classification.
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Affiliation(s)
- Marwa Ferchichi
- University of Sciences, Farhat Hached Campus, Tunis El Manar, Tunis, Tunisia.,Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Raja Jouini
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Imen Ayari
- University of Sciences, Farhat Hached Campus, Tunis El Manar, Tunis, Tunisia.,Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Wafa Koubaa
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Ehsen BenBrahim
- Pathology Department, Habib Thameur Hospital, Tunis, Tunisia
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Bellabah A, Benkirane A, Ibrahimi A, Nakhli A, Sair A, Nakhli A, Essaid A, Blel A, Ibrahimi A, Lahchaichi A, Ben Slama A, Ouni A, Amouri A, Jemaa A, Cherif A, Khsiba A, Hssine A, Djobbi A, Guedich A, Laabidi A, Mensi A, Ouakaa A, Sriha A, Choukri A, Green A, Belkhamsa A, Hammami A, Bourigua A, Filali A, Belabeh A, Ouakaa A, Sentissi A, Ait Errami A, Nadi A, Filankembo A, Lamine A, Badre W, Ben Kaab B, Ben Slimane B, S B, Hasnaoui B, Bouchabou B, Bouguerra C, Baccouche C, Ayadi C, Bennasrallah C, Benajah D, Gargouri D, Zehi D, Issaoui D, Cherif D, Ben Ghachem D, Trad D, Bouaiti E, Boutouria E, Bel Hadj Mabrouk E, Chalbi E, Aait E, Bouhamou F, Haddad F, Lairani F, Saffar F, Torjmen F, Haj Kacem F, Hamdane F, Chabib FZ, Elrhaoussi FZ, Moumayez FZ, Loukil F, Ahmed Djouldé Diallo F, Aissaoui F, Ajana F, Chabib F, Hamdoun F, Moumayez F, Hamdane F, Haddad F, Bennani Kella G, Bennani G, Abid H, Cheikhani H, Ouazzani H, Romdhane H, Seddik H, Sghir H, Debbabi H, Ben Jeddi H, Garraoui H, Letaief H, Kchir H, Elloumi H, Hammami H, Jaziri H, Ben Abdallah H, Chaabouni H, Ben Romdhane H, Yacoub H, Ben Jeddi H, Elloumi H, Gdoura H, Kchir H, Sahli H, Loghmari H, Bouguerra H, Maghrebi H, Ben Nejma H, Jlassi H, Elloumi H, Fourati H, Alaoui H, Ismail H, Benelbarhdadi I, Cohen I, Errabih I, Koti I, Doghri I, Cohen I, Elhidaoui I, Haraki I, Cheikh I, Abdelaali I, Jemni I, Bouennene I, Akoch I, H I, Boubaker J, Krati K, Eljery K, Temani K, Bellil K, Chabbouh K, Boughoula K, Ouazzani L, Ben Yaghlene L, Kallel L, A L, Hamzaoui L, Chtourou L, Ben Farhat L, Bouabid L, Mnif L, Mouelhi L, Safer L, Zouiten Mekki L, Bourehma M, El Akbari M, El Khayari M, Elyousfi M, Firwana M, Lahlali M, Tahiri M, Mestouri M, Abdelwahed M, Ben Hamida M, Ben Chaabane M, Moalla M, Yakoubi M, Sabbah M, Serghini M, Amri M, Ben Abbes M, Ben Cheikh M, Ghribi M, Hafi M, El Khayari M, Ben Abdelwahed M, Ksiaa M, Essid M, Zakhama M, Yousfi M, Sabbah M, Ayari M, Belhadj M, Cheickh M, Kacem M, Horma Alaoui M, Abid M, Bennour MA, Ghanem M, Loghmari MH, Douggui MH, Azouz MM, Abdelli MN, Boudabous M, Feki M, Fekih M, Kacem M, Mahmoudi M, Boudabbous M, Figuigui M, Medhioub M, Safer M, Azzouz M, Yakoubi M, Abbes M, Amri M, El Abkari M, Aqodad N, Azib N, Bellil N, Benhoumane N, Benzoubbeir N, Elkhabiz N, Hemdani N, Lahmidani N, Abdelli N, Ben Chaabane N, Tahri N, Azib N, Benhoummane N, Ben Jaafar N, Ben Mustapha N, Maamouri N, Elkhabiz N, Bellil N, Hannachi N, Hemdani N, Ben Alaya N, Bibani N, Trad N, Elleuch N, Lahmidani N, Kharmach O, Bahri O, Bousnina O, Gharbi O, Kharmach O, Benjira R, Ennaifer R, Dabbèche R, Jouini R, Zgolli R, Baklouti R, Bouali Mohamed R, Marouani R, Kallel R, Ennaifer R, Berrag S, El Yazal S, Jiddi S, Mechhour S, Morabit S, Oubaha S, Sentissi S, Bouaziz S, Soua S, Hachicha S, Elaboudi S, Ajmi S, Mallat S, Bouchoucha S, Mrabti S, Ben Slama S, Hamdi S, Laabidi S, Ayadi S, Hidri S, Bizid S, Ben Hamida S, Zertiti S, Ben Amor S, Nsibi S, Bellakhal S, Bahja S, Jomni T, Hliwa W, Rebai W, Ben Mansour W, Ben Othmen W, Dhouib W, Hammoumi W, Zaatour W, Bouhlel W, Feki W, Triki W, Said Y, Zaimi Y, Gorgi Y, Bouhnoun Z, Samlani Z, Hamidi Z, Mnif Z, Ben Safta Z. Oral communication and poster abstracts of the 22nd National Congress of Gastroenterology joint to the 4th Maghrebian Congress of Gastroenterology. December 2018. Tunis Med 2018; 96:932-1007. [PMID: 31131873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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