[Thoracic manifestations of systemic lupus erythematosus]

Systemic lupus erythematosus [SLE] is an autoimmune disease. The respiratory system is more commonly involved in SLE than in any other collagen vascular disease. To study the pleuropulmonary manifestations of SLE. Retrospective study including 10 patients hospitalized between January 2000 and December 2008 for pleuro-pulmonary manifestation revealing or complicating the SLE. Nine women and only one man aged between 21 and 67 years-old were included in this study. Two patients had already SLE and for the other patients the pleuro-pulmonary manifestations were revealing the SLE. Pleural effusion was the most common manifestation witch represents 50% of the patients. For the other patients we find one case of interstitial pneumonia, one case of pulmonary embolism, on case of pneumonia, on case of pulmonary haemorrhage and on case of pulmonary hypertension. All these patients were treated by corticoids and only one patient takes high doses of corticoids for managing a massive pulmonary haemorrhage. The evolution was favourable for 9 patients, one patient dead because of massive pulmonary haemorrhage complicated with acute respiratory failure. Pleuro-pulmonary involvement in SLE is common and may be life threatening, in which case prompt and aggressive treatment is mandatory

[Allergic bronchopulmonary aspergillosis: a review of 3 cases]

Allergic bronchopulmonary aspergillosis [ABPA] is a rare affection, initially described in 1952. Its pathophysiology incriminate several mechanisms in relation with the organism of the patient and the bronchial colonisation by the fongic agent. To report three cases of ABPA. Three patients had been treated for ABPA in Ibn Nafiss department in Abderrahmen Mami hospital in Ariana. ABPA had been discovered in the three cases by a corticodependant asthma, refractory for different therapeutics. Positif diagnosis reposed in the 3 patients at 6 major and one minor criterion. Traitment was essentially based in corticotherapy. Positif diagnosis of ABPA is actually well established, however, its traitement, although based on corticotherapy, remind not clearly codified. Association of antifongic treatment may improve the prognosis

[Impact of tobacco on bronchopulmonary affections: magnitude of the problem]

Tobacco smoking is frequent in the world affecting 20 a 50% of the population but with a decrease in occidental countries due to a huge effort based on sensiblisation and anti-tobacco decisions. To review the impact of tobacco on bronchopulmonary affections. A narrative review of literature. In the next future, yearly tobacco-related deaths could increase from 4.2 millions in 2000 to 10 millions in 2025-2030 making smoking as the main evitable cause of deaths by respiratory diseases. Lung cancer is the leading killer cancer. Tobacco is the most frequent cause of respiratory diseases. It is responsible of 80 to 90% of deaths by chronic obstructive pneumobronchopathiy [COPD] and 80 to 85% deaths by bronchopulmonary cancer. Tobacco is a " chronic disease " necessitating management with advices and medical treatment

[Neoplasic vena cava syndrome]

Vena cava superior syndrome results of an obstruction of superior vein cava [SVC] and/or brachiocaphalic venous troncs by extrinsic compression and/or by tumoral or cruoric thrombosis. The bronchopulmonary cancer represents the most frequent aetiology. The aim of this study is to establish clinical, radiological, evolutive profiles and modalities of treatment of neoplastic vena cava superior syndrome independently of its histological type. It is a retrospective study about 20 patients presenting vena cava superior syndrome compliquating primary bronchopulmonary cancer, hospitalized between January 2000 and December 2007 in Ibn Nafiss department in Abderrahmen Mami hospital. All patients were males with an average of 57, 8 years. Vena cava superior syndrome had revealed cancer in 60% of cases. It was metachrone in 40% of the patients. The most frequent histological type was small cell lung cancer. Treatment was proceeded in 2 steps, symptomatic and etiologic for the bronchopulmonary cancer. The bronchopulmonary cancer is the most frequent aetiology of vena cava superior syndrome. Its treatment is actually well codified

[Pulmonary metastases revealing choriocarcinoma]

Uterine choriocarcinoma is a trophoblastic tumour characterised by high metastasis potential. Pleuropulmonary metastasis can reveal rarely the neoplasm. Report a new case. We report the case of a 31 years- old woman, with no pathological antecedent, admitted in our department for thoracic pain and haemoptysis occurring two months after delivery of a dead child-birth. Chest X ray and thoracic CT scan showed several bilateral opacities. A diagnosis of metastatic choriocarcinoma was confirmed by plasmatic level of beta human chorionic gonadotrophin [beta HCG] superior to 4000 Ul/ml. Gynaecological exam revealed latero-uterine mass. Abdomino-pelvicn ultra sound and CT scan showed tissular latero uterine and hepatic masses. Brain CT scan had been normal. Patient did after 3 cures of chemotherapy because of acute respiratory failure caused by massive pulmonary embolism. Diagnosis of choriocarcinoma must be evocated in front of several pulmonary opacities occurring in genital activity women and necessities the dosage of level of betaHCG

[Pseudo tumoralbronchial tuberculosis about 4 cases]

Bronchial lesion is a rare site for tuberculosis, It can mimic lung cancer especially when sputum- smear is negative, and this be a cause of a delay in diagnosis, that can be made later on by a culture of Koch bacillus or after a bronchial biopsy. Through these 4 cases reports, the authors recall the ethiopathogenic hypotheses of this lesion and review the radiologic, clinical and prognostic features of these unusual forms of T.B.

Application d'un algorithme decisionnel au diagnostic de l'embolie pulmonaire non grave en milieu pneumologique: Resultats d'une etude prospective de 40 cas

We have study prospectively cases of non severe pulmonary embolism in a pulmonary department by an analysis based strategy associating radio-clivical probability, venous ultra sonography, D-Dimers value followed, if no performed diagnosis, by pulmonary scintigraphy or angio-CT scan. 64 cases of pulmonary embolism suspicion have been hospitalised in our department between October 1998 and July 2001; 40 patients was included in our study and have been classified in 3 groups regarding pre test clinical probability. Anticoagulant treatment has been initialised only in the third group [probability > 80%]Clinical probability associated with venous ultra sonography and D- Dimeres value allow or exclude pulmonary embolism diagnosis in 27 patients. In the others, scintigraphy and angio CT scan were necessary for establishing diagnosis. Application of this algorithm allow diagnosis of pulmonary embolism in 29 patients and exclude this pathology in the other 11. None of this patient complained from recurrent thrombo embolic accident during 17 to 42 months observance period

[Costal hydatid cyst[about 2 cases]]

Hydatidosis is an endemic affection in our country. Hepatic and pulmonary localisation is the most frequent. The other localisation especially in the bone, are exceptional. We report 2 cases of costal hydatid diagnosed on 17 and 33 yeas old male patients admissed for parietal tumor respectively localized in cervix and thorax. The diagnosis,suspected on chest tomography,is confirmed by histologic patterns of resected rib

Histiocytose x pulmonaire revelee par une lyse costale

Histocytosis x in an unknown etiologic affection characterized by an anatomopathologic pattern: the Langerhans cell granuloma. We report a case of a chronic lung histiocytosis x revealed by costal lysis in a 32 years-old man admitted with a five month history of thoracic pain. Physical examination revealed a right axillary pain. Chest roentogram showed a 6 th right rib lysis and in computed tomography a bilateral diffuse alveolar infiltrates. An open lung biopsy with costal resection is effectuated and histologic pattern confirmed histiocytosis