Peritoneal tuberculosis (TbP), an uncommon peritoneal infection, is commonly diagnosed in immigrants from developing countries and represents a substantial proportion of cases of extra pulmonary tuberculosis. The variability in patient presentation and the indolent nature of the infection, combined with limited diagnostic strategies available for TbP, often results in delayed diagnosis. Case: Described herein is the case of a 39 years old male recent immigrant from Mali (West Africa), with no significant medical history that presented to hospital with a four-day history of abdominal pain and swelling. Examination was significant for distended abdomen and shifting dullness. No signs and symptoms suggested pulmonary infection, however, QuantiFERON-TB Gold and purified protein derivative (PPD) test were positive suggesting latent Tb infection. In the absence of pulmonary tuberculosis, a diagnosis of TbP should be established histologically. Laparoscopic biopsy showed granuloma but the typical caseating granuloma of TbP was not seen. Nonetheless, based on the extent of the clinical and laboratory findings, the patient was diagnosed with TbP and anti Tb treatment ensued with successful outcome. Conclusion: The lack of caseating granulomas in the pathology should not rule out a diagnosis of TbP, especially in cases where accompanying evidence suggests some form of Tuberculosis.

IntroductionSickle cell disease has been associated with many renal structural and functional abnormalities. Collapsing glomerulopathy or the collapsing variant of focal segmental glomerulosclerosis is a rare clinicopathologic entity in patients with sickle cell disease that requires timely diagnosis and aggressive management.Case presentationIn this case report we describe a 21-year-old African-American woman with a medical history of significant sickle cell disease and asthma. She was admitted for pain, decreased urine output, bilateral leg swelling and reported weight gain. During her period of hospitalisation she developed acute renal failure requiring dialysis. Further investigation revealed the collapsing variant of focal segmental glomerulosclerosis.ConclusionsAlthough focal segmental glomerulosclerosis is a common feature of sickle cell nephropathy, the collapsing variant of focal segmental glomerulosclerosis or collapsing glomerulopathy has been rarely documented. Even when other risk factors are controlled, collapsing glomerulopathy has a very poor prognosis. This is a rare case of a patient with massive proteinuria presenting as acute renal failure with a very poor response to corticosteroids and a much faster rate of progression to end-stage renal disease.

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I In nt tr ro od du uc ct ti io on n S ynovial sarcoma is a stromal tumor that usually arises in adolescents and young adults from preformed synovial structures near the joints of the extremities. Ten percent of the cases arise from soft tissues around the head, neck, thoracic or abdominal wall, and retroperitoneum. It has been reported as a primary tumor in the heart, lungs, kidneys, prostate, and other sporadic sites in the human body. 1 Only 12 reported cases were in the digestive tract, and none of these was in the gastro-duodenal region. 2-3 The most distinctive feature of synovial sarcoma is (X;18) translocation, which results in a SYT-SSX R Ra ad di ia at ti io on n-a as ss so oc ci ia at te ed d S Sy yn no ov vi ia al l S Sa ar rc co om ma a A Ar ri is si in ng g i in n t th he e D Di ig ge es st ti iv ve e T Tr ra ac ct t: : A A C Ca as se e R Re ep po or rt t a an nd d L Li it te er ra at tu ur re e R Re ev vi ie ew w