[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

[Pulmonary atinomycosis: a great clinical polymorphism]

Pulmonary actinomycosis is a rare bacteriological disease, caracterized by local suppuration and an extensive fibroinflammatory process, with a possible pseudotumoral outcome. To report a new observation of a pulmonary actinomycosis. A 52-year-old patient, smoker, admitted in our department for infectious pneumopathy complicated by purulent pleurisy. Clinical and radiological findings were not contributive.Fiberoptic had evocate the diagnosis of bronchopulmonary cancer. Evolution had been marqued by abondant hemoptysia indicating right low lobectomie. The diagnosis of actinomycosis was obtained by the pathology of the surgical resection. Diagnosis of pulmonary actinomycosis can be difficult because it can mimic the presentation of lung carcinoma.If the diagnosis is no late established, and if the patient is correctely treated medically, the prognosis still excellent

[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

[Rare localisation of sarcoma of the child: thoracic Ewing sarcoma]

Ewing Sarcoma is considered as primitive neuron ectodermic tumor. It's the most frequent osseous tumor in children and adolescent. It was localised frequently at long osseous and pelvis, however, it can be arising from the rib. this article aimed to show that Ewing sarcome could arise twely from thorax. We report the case of 15-year-old girl, admitted in our hospital because of left scapular pain with important weight loss. Chest X ray showed dense left latero tracheal opacity with mediastinal limits. Bronchofiberoscopy was performed and it showed no abnormalities. Thoracic CT scan and MRI noted left posteroir expansif mediastinal process infiltrating D2, D3 and homolateral conjugation's canal. This process was associated at vertebral metastasis in Dl, D4 and D8.Rapid clinical aggravation, with installation for medullar compression was noted. The patient had benefit for three cures of decompress radiotherapy and treated by laminectomy of dorsal vertebras in neurosurgery department. Morphologic aspects and immunohistochimical study for the operator piece concluded at Ewing sarcoma of the children considered as primitive neuron ectodermic tumor. Six cures of chemotherapy had been prescribed with well recuperation of the motor failure. She still on life since 7 months. Even rare, thoracic localisation of Ewing sarcoma in not exceptional, it is necessary to evocate it in front of mediastinal mass