Introduction: It has been shown that some respiratory diseases vary by gender. We aimed to compare clinical and evolutive feature of tuberculosis according to gender. Methods: We conducted a retrospective and comparative study in the pneumology department of Charles Nicolle hospital of Tunis, including patients hospitalized for tuberculosis between 2013 and 2022. Results: We included 166 patients with an average age at 44±17 years and male predominance (132 men and 34 women). Tabacco smoking and drug habits was higher among men (p<0.01). Age, comorbidities, and symptoms did not differ between two groups. The delay of consultation was longer for women (p=0.02) with a similar delay of diagnosis (p=0.07). The body mass index was lower in men (p=0.04). Clinical improvement, evaluated by symptom's improvement and weight gain was longer in men (p=0.001). However, bacilloscopic negativation delay and radiological improvement were statistically similar (p=0.1). Conclusion: Tunisian women with tuberculosis consult later but clinical improvement under treatment seems to be faster than men.

Background Thymic carcinomas are rare tumors with a challenging diagnosis. Our aim was to report our 17-year experience of these tumors and to highlight the challenges encountered and the main differential diagnoses ruled out. Methods We studied 12 (92%) men and 1 (7.7%) woman with a mean age of 37 years (range 15–60 years). All patients were symptomatic, with chest pain representing the most frequent symptom. Radiology revealed anterior mediastinal masses in all cases, with either infiltration of the adjacent organs or pulmonary parenchymal metastases. Results The diagnosis was made on surgical biopsies in 12 cases and a lymph node biopsy in one. Microscopic examination revealed squamous carcinoma in 3 cases, synovial sarcoma in 1, mucinous adenocarcinoma in 1, undifferentiated carcinoma in 2, clear cell carcinoma in 1, lymphoepithelioma-like carcinoma in 2, atypical carcinoid tumor in 2, and sarcomatoid carcinoma in 1. Total surgical resection was possible in one patient after neoadjuvant chemotherapy and radiotherapy. Follow-up was possible in only 6 patients, and the mean survival reached 13 months. Conclusion In spite of the lack of follow-up information, this study demonstrates the poor outcome associated with these tumors and the need for standardized treatment.

Background: The role of the pleura in lung cancer dissemination is of paramount importance. This role was highlighted in the International Union Against Cancer staging system (commonly referred to as UICC) staging published in 2009. We tried to assess the prognostic impact of this classification.Materials and Methods: The present study is about 32 patients with adenocarcinoma who underwent lobectomy or pneumonectomy between 2005 and 2010. Patients with tumors without evidence of pleural invasion, with positive surgical margins or with other histologic subtype than adenocarcinoma were excluded. Overall survival curves were drawn using the Kaplan-Meier method. Differences in survival curves were compared using the log rank test. Differences were considered significant at p<0.05.Results: The patient group includes 28 men and 4 women with a mean age of 54 years. The 32 patients were classified into stage PL1 in 11 cases, PL2 in 14 cases and PL3 in 7 cases. The comparison of the survival curves showed a significant statistical difference (p=0,49) with a chisquare of 0.46 only between pl1 and pl2 groups.Conclusion: Our study showed an impact on the prognosis of a lung cancer when tumor cells had infiltrated the elastic layer of the pleura in the PL1 and PL2 diagnostic groups. This fact highlights the necessity for pathologists to use elastic stains in order to use this classification.

A causal relationship between the thymus gland and myasthenia gravis (MG) has been assumed for decades. However, this relationship is still a matter of conjecture and speculations and awaits definitive proof. Recently, myoid cells have been considered as effectors in the pathogenesis of MG as well as thymic enlargement (thymolipoma, true thymic hyperplasia). Our objective is to discuss the role of myoid cells in the pathogenesis of MG associated with thymic enlargement. we report a retrospective study about 6 cases of thymic enlargement with 4 cases of true thymic hyperplasia (TTH) and 2 cases of thymolipoma (TL). The majority of our patients were men with a sex ratio of 4/2. Only 2 patients had a past medical history consistent for MG. Myoid cells were found in all cases. Through our small study, the implication of myoid cells in the pathogenesis of the association MG-TL or TTH remains unproved.

Introduction: Chondrosarcoma complicating osteochondromatous lesions is a microscopic diagnosis which treatment is based on surgical excision.These tumors need a close followup because the recovery can be ascertained only after 10 years of follow-up.Case Report: A 19-year-old male who presented respiratory symptoms and whose past medical history was remarkable for a previously noted cartilaginous exostosis in multiple long bones.Physical and radiologic investigations showed a mass attached to the first rib.The anterior arch of the rib was excised en-bloc with a layer of soft tissue.Histopathological examination concluded to a grade I chondrosarcoma arising from an osteochondroma.Conclusion: Secondary chondrosarcoma complicating a benign lesion such as osteochondroma has been rarely reported in the rib.We aim to highlight the diagnostic and therapeutic challenges of this rare tumor by describing a new case of secondary costal chondrosarcoma.

Background: Perineural lipoma, also known as fibro-fatty overgrowth, fibrolipomatous hamartoma, intraneural lipoma, and lipomatous hamartoma, is a rare, benign, congenital lesion most commonly found in the median nerve, usually at the level of the wrist or hand. To our knowledge, no published cases report a perineural lipoma arising from the intercostal nerve.Case presentation: We report a case of a perineural lipoma in a 55-year-old man which was totally resected. The diagnosis was based on microscopic examination which showed a benign fatty tumor composed of mature fat cells interspersed with fibrofatty connective tissue. This tumor surrounded numerous hyperplastic nerve bundles.Discussion: Perineural lipoma is a benign condition with non-specific symptoms. In fact, they depend on the concerned nerve. Surgical resection seems to be necessary only in symptomatic patients because of its high morbidity.

L’hydatidose est une maladie encore endémique dans notre pays : la Tunisie. Le développement du kyste est long, le plus souvent asymptomatique ne permettant généralement qu’un diagnostic tardif. Étude rétrospective portant sur 69 cas de kyste hydatique (KH) chez l’enfant colligé entre 2003 et 2013. Le profil évolutif ainsi que les facteurs prédictifs de complications ont été étudiés. Il s’agissait de 36 garçons et 33 filles avec un âge moyen de 11 ans (4–18 ans). Le contage hydatique a été retrouvé dans 74 % des cas. Le délai moyen de consultation était de 135 ± 180 jours. Les signes les plus fréquents étaient la toux (58 %), les douleurs thoraciques (49 %), l’hémoptysie (42 %) et la fièvre (36 %). Il s’agissait de KH unique dans 78,2 %. La taille moyenne du KH était de 7,56 ± 1,56 cm. Un KH du foie était associé dans 30,4 % des cas. La sérologie hydatique était positive dans 33 % des cas. Le traitement chirurgical a été réalisé dans 68 cas et un enfant a été mis sous Albendazole® devant une hydatidose multiple. Une résection parenchymateuse a été réalisée dans 20,3 % des cas (lobectomie dans 12 cas et bi-lobectomie dans 2 cas). La taille du kyste était un facteur prédictif de résection parenchymateuse (8,25 cm VS 6,46 cm ; p = 0,044) ce qui n’était pas le cas pour le délai du diagnostic ou le caractère compliqué du KH. Des complications postopératoires bénignes sont survenues dans 30,4 % des cas et des séquelles pulmonaires ont été notées dans 47,8 % des cas. Le KH du poumon chez l’enfant est une pathologie bénigne mais dont les conséquences peuvent être lourdes comme des résections parenchymateuse chez 1 enfant sur 5 dans notre étude.

The occurrence of a lung cancer is a consequence of a long-lasting process dealing with a transformation of a normal cell to a malignant one. The four steps of transformation reflect the genetic modifications of the cells. The molecular studies of pre-invasive lesions have already established a correlation between the lesion continuum and the multi-step carcinogenesis. Gradual genetic alterations are correlated with the increase of the cell's malignant potential. We tried to present the carcinogenesis of the lung non microcellular carcinomas and to highlight the main therapeutic targets.

Peripheral neuroblastic tumors are very rare and mainly observed in children. They are subdivided according to the International Neural Pathology Group (INPG) into neuroblastoma (NB), ganglioneuroblastoma (GNB), nodular GNB and ganglioneuroma (GN). They are mainly observed into the adrenal glands and the retroperitoneum (1). Mediastinal localization is very rare and consists mainly in the posterior mediastinum. These tumors present a challenging diagnosis which necessitates a narrow collaboration between surgeons, pathologists, clinicians and radiologists. This is due to the improvement of sampling methods dealing with smaller specimen which furnish insufficient material or provide a single component sometimes non representative of the tumor dealing with a false diagnosis and an inadequate management. Methods: A literature search was finalized on October 2013. Studies were identified using PubMed (http://www.ncbi.nih.gov/pubmed). The diagnostic criteria for diagnosis were those of the INPG classification. The histoprognostic classification was established according to the IBPG classification.

OBJECTIVE: Lymph node status represents a relevant prognostic factor in lung adenocarcinoma. Some authors proved that the histologic subtype is the most reliable predictive factor of lymph node status. In addition, a correlation between molecular profile of adenocarcinoma and lymph node metastases has recently been proved. This fact induces a necessity to assess the existence of a difference in lymph node status between the newly identified histologic subtypes of lung adenocarcinoma.MATERIAL AND METHODS: In order to explore this hypothesis, 70 surgically resected specimen of lung adenocarcinoma with lymph node dissection were reviewed retrospectively and reclassified according to the new classification of the International Association for the Study of Lung Cancer (IASLC), the American Thoracic Society (ATS) and the European Respiratory Society (ERS).RESULTS : The relation between lymph node stage and the histologic subtypes was evaluated with the chi-square test and we established that there was a statistical difference between histologic subtypes of lymph node metastases.CONCLUSION: This result should be confirmed by other multivariate studies using statistical tests with greater power.

Fibrous dysplasia (FD) is a benign lesion observed mainly in children and young adolescents. Although benign, it can sometimes be challenging to discriminate these lesions from well-differentiated malignant tumours. Here, we describe a confusing case of asymptomatic locally aggressive polyostotic FD in a 49-year-old woman followed for a molar pregnancy. The case was particular due to the rare localization of FD in the ribs and vertebrae, and it posed a diagnostic dilemma with parosteal osteosarcoma. This case highlights the difficulty of distinguishing FD from a well-differentiated malignant tumour, especially when facing artefacts arising from the decalcification procedure.

BACKGROUND:Lung cancer represents a major public health problem.It represents the first cause of mortality by cancer in Tunisia. Its incidence reaches 40% of lung cancers. Its clinical, radiologic and molecular aspects have been improved inducing the necessity of a new classification which will consider the necessity of a multidisciplinary management.AIM:To highlight the new classification of lung adenocarcinomas and to present the major recommendations.METHODS:We tried to present the main recommendations of the American Thoracic Society and the European Respiratory Society of lung adenocarcinoma.RESULTS:This new classification identifies pre-invasive lesions represented by in-situ adenocarcinoma (the ancient bronchioloalveolar), the micro-invasive adenocarcinoma and invasive adenocarcinoma. The latter have been divided in sub-types according to the predominant architectural features. Thus, three groups of invasive adenocarcinoma with presumed different prognoses have been identified: the lepidic predominant adenocarcinoma which has a good prognosis, the micro-papillary and solid predominant adenocarcinomas which have a bad prognosis and the papillary and acinar adenocarcinomas which have an intermediate prognosis. All these entities have specific diagnostic features and criteria. These recommendations are available for biopsies and surgical resected specimen.CONCLUSION:The new classification of lung adenocarcinoma puts emphasis on the necessity of a multi-disciplinary management of these tumors in order to improve their prognosis. It identifies new entities with different prognoses that could justify specific modalities of treatment and follow up.

CdS nanoparticles (NPs) with different shapes and sizes (rods and spheres) have been synthesized through decomposition of a newly synthesized precursor complex [Cd(SOCPh)2Lut2] using structure-directing solvents such as ethylenediamine (EN), dimethylsulfoxide (DMSO) and ammonia (NH3). In addition, CdS NPs is also prepared by thermal decomposition of the precursor complex under N2 atmosphere. The precursor complex is characterized by elemental analyses, TGA, FTIR, UV–vis spectroscopy and single crystal X-ray diffraction. The distorted tetrahedron geometry of the precursor complex has been determined by X-ray diffraction, which crystallizes in monoclinic crystal system of P2(1)/n space group with a = 11.0487(17) Å, b = 16.396(3), c = 15.413(2) Å, α = 90.00°, β = 109.708(4)°, γ = 90.00° and Z = 4. The CdS NPs are characterized using powder X-ray diffraction, transmission electron microscopy, BET analyses, UV–vis absorption and photoluminescence spectroscopy. The photo-catalytic activity of CdS NPs is studied by the degradation of Rose Bengal (RB) dye, indicating an excellent photocatalytic activity compared to that of commercial TiO2. The mechanism behind photocatalytic degradation of RB in presence of CdS NPs is elucidated using terephthalic acid photoluminescence probing technique and evidence have shown that the photogenerated holes to be the predominant active species. This paper also demonstrates the intrinsic peroxidase like activity of CdS NPs toward peroxidase substrates 3,3′,5,5′-tetramethyl benzidine (TMB) and hydrogen peroxide. Kinetic analysis indicates that the catalysis by CdS NPs show typical Michaelis–Menten kinetics. Moreover, our synthesized CdS NPs show higher catalytic performances with a higher binding affinity for the substrate TMB than horseradish peroxidase (HRP) and other recently reported nano-mimitics.