[Primary digestive tract Kaposi sarcoma with idiopathic CD4+ lymphocytopenia, HIV negative, HHV8 positive]

A 52-year-old Tunisian patient had fever, impaired health and several opportunistic infections (Campylobacter jejuni, Mycobacterium hominis, Herpes virus, Giardia intestinalis, Vibrio metschnikovii). Lymphocytopenia was noted (348/mm3; CD4+: 2.2%; CD4+/CD8+: 0.1). Polymerase chain rection search for HIV was negative in serum and in tumor tissue. Diagnosis of primary digestive Kaposi sarcoma was established at autopsy due to the deep location of the lesions. There was an ulcerofungating tumor spreading over 1.3 m of the duodenojejunum. This is the fourth reported case of CD4+ lymphocytopenia, a new and very rare immunodeficiency syndrome recently defined by the Centers for Disease Control. We detected human herpes virus 8 by immunohistochemistry of tumor tissue. Human herpes virus 8 is implicated in the pathogenesis of Kaposi sarcoma.

Gastric MALT lymphoma. A clinico-pathological study of 65 cases. Relationship to Helicobacter pylori

We report 65 cases of MALT gastric lymphomas. HP was looked for with Giemsa and Whartin Starry stains. Immunohistochemistry was done with PAP method. Anti-HP treatment was used in 9 cases. 38 were of low grade of malignancy, 23 were high grade, 4 were high grade with a low grade component. The mean age was 51.5 years, the sex ratio 1.5. Epigastric pain was the most frequent feature (87.7% of cases). Endoscopically, low grade lymphomas presented as unique or multiple ulcerations (55.3% of cases) with antral localisation (52.6% of cases). 60% of our patients were stage IE, of which 61% had low grade lymphoma, 18% were at stage II2E, 10% at stage III and 10% at stage IV. From 23 operated patients, 29% had early lymphoma which was low grade malignant in 71.5% of cases, and 71% had lymphomas which were widely spread beyond the submucosa. HP was found in 63% of cases. Histologic regression of two early lymphomas of low grade malignancy was achieved after HP eradication.

[Detection of Epstein-Barr virus in Malt type gastric malignant lymphoma using in situ hybridization]

The aim of our study was to look for Epstein Barr virus (EBV) genome by in situ hybridization in 23 MALT gastric lymphomas. 15 cases were of low grade, and 8 were of high grade malignancy. We obtained a positive result in 3 cases (13%) of low grade lymphomas. EBV was present in few centrocyte-like and centroblastic cells. Literature review shows an EBV infection rate varying between 8 and 12% with variables results which don't allow strong and reliable conclusion. An etiopathogenic role for EBV in Malt gastric lymphoma remain yet hypothetic.

[A prospective histologic and immunohistochemical study of the liver in blood donors who are asymptomatic chronic carriers of HBs antigens. Apropos of 34 cases]

The authors report a prospective study of 34 chronic HBs Ag carriers detected among a cohort of 9029 blood donors. Liver biopsy performed in all cases revealed a normal liver in 5 cases (14.7%), non-specific lesions in the form of fatty infiltration or mild portal inflammation in 3 cases (8.8%), chronic persistent hepatitis (CPH) in 21 cases (61.7%) (mild in 19 and moderate in 2) and chronic active hepatitis (CAH) in 5 cases (14.6%) (mild in 1 and moderate in 4). Liver function tests were abnormal in 28.8% of patients with CPH and 20% of those with CAH. Histologic activity index was calculated and was more than 6 in 40% of CAH and 6 or less in CPH and non-specific lesions. Immunohistochemical study revealed cytoplasmic labelling for HBs Ag in 82.4 per cent of cases and nuclear labelling for HBc Ag in 11.4% of cases with a heterogeneous and non-regular pattern affecting all or part of the cytoplasm, single or clusters of hepatocytes or even sheets of hepatocytes.