Ledderhose Disease: Clinical, Radiological (Ultrasound and MRI), and Anatomopathological Findings.

Plantar fibromatosis, or Ledderhose disease, is a rare hyperproliferative disorder of the plantar aponeurosis. It may occur at any age, with the greatest prevalence at middle age and beyond. This disorder is more common in men than woman and it is sometimes associated with other forms of fibromatosis. Diagnosis is based on clinical examination. Ultrasound (US) and magnetic resonance imaging (MRI) can be useful to confirm the diagnosis. A 44-year-old man with Ledderhose disease who underwent ultrasound and MR is described in this paper.

MRI whirpool sign in midgut volvulus with malrotation in pregnancy.

Midgut volvulus is a rare complication of pregnancy with high morbidity and mortality rates. Clinical diagnosis may be difficult in pregnant women. Ionizing radiation imaging modalities are not advised. Ultrasonography (US) is safer but sometimes is unable to reveal the characteristic whirlpool sign of midgut volvulus. Magnetic resonance imaging (MRI) contributed to confirm diagnosis in our case. We present here a case of 34-year-old pregnant woman at 14 weeks of gestation who presented with abdominal pain, nausea and vomiting. US was not conclusive. MRI revealed the typical whirlpool sign of midgut volvulus.

A phase III randomised study comparing concomitant radiochemotherapy as induction versus consolidation treatment in patients with locally advanced unresectable non-small cell lung cancer.

As concomitant chemoradiotherapy for stage III NSCLC is associated with survival advantage in comparison to a sequential approach, we conducted a phase III randomised study aiming to determine the best sequence and safety of chemotherapy (CT) and chemoradiotherapy (CT-RT), using a regimen with cisplatin (CDDP), gemcitabine (GEM) and vinorelbine (VNR). Unresectable stage III NSCLC patients received CDDP (60 mg/m(2)), GEM (1g/m(2), days 1 and 8) and VNR (25mg/m(2), days 1 and 8) with reduced dosage of GEM and VNR during radiotherapy (66Gy). Two cycles of CT with radiotherapy followed by two further cycles of CT alone were administered in arm A or the reverse sequence in arm B. The study was prematurely closed for poor accrual due to administrative problems. Forty-nine eligible patients were randomised. Response rates and median survival times were, respectively 57% (95% CI: 36-78%) and 17 months (95% CI: 9.3-24.6 months) in arm A and 79% (95% CI: 64-94%) and 23.9 months (95% CI: 13.3-34.5 months) in arm B (p>0.05). Chemotherapy dose-intensity was significantly reduced in arm A. Grade 3-4 oesophagitis occurred in 5 patients. One case of grade 5 radiation pneumonitis was observed. In conclusion, chemoradiotherapy with CDDP, GEM and VNR appears feasible as initial treatment or after induction chemotherapy. Consolidation chemoradiotherapy seems less toxic with a better observed response rates and survival although no valid conclusion can be drawn from the comparison of both arms.

[NSCLC of early stage. Imaging exploration of the mediastinum]. / Exploration par imagerie du médiastin.

INTRODUCTION: The lung cancers are among the five most frequent cancers (and incidence continues to increase in men and females), with the highest percentage of mortality and an obvious stagnation of surviving rates, in spite of therapeutic improvements. STATE OF ART: The lung cancers constitute a more mixed group than expected, with unpredictable behaviours and sensitivities to treatments. The detection of early small lesions allowing a drastic surgery and an adjuvant chemotherapy improve the prognostic, if we can differentiate precisely and effectively the resectable tumors from the others. PERSPECTIVES: The analysis of the earliest radio-clinical, histological and surgical studies associated with the most recent technical evolutions of multidetector CT scan and PET scan, among others, improve our understanding and organization of screenings, radio-clinic and histologic diagnostics, as well as the evaluation of the tumoral extension of non small cell lung carcinomas (NSCLC). CONCLUSION: Notably, the WHO histological classification of lung cancer, the diagnostic algorithms of solitary nodules, the mediastinal lymph nodes mapping and the TNM staging are so redefined to achieve effective improvements on the prognosis of such cancers.

Lymph node enlargement as a sign of acute hepatitis A in children.

Abdominal ultrasound was performed in 58 children presenting with proven acute hepatitis A and in 63 controls of the same age. There are well-known echographic signs of hepatitis (liver enlargement, gallbladder wall thickening, periportal hyperechogenicity) but they were not constantly found. We describe in all the hepatitis cases an enlargement of lymph nodes located in the hepatic hilum, pancreatic area and small omentum: they appeared hyperechogenic at the centre with hypoechogenic outer layer. Such enlarged lymph nodes were not observed in the controls.