[The pseudoalveolar form of sarcoïdosis: a diagnostic pitfall]. / La forme pseudo-alvéolaire de la sarcoïdose: un piège diagnostique à ne pas méconnaître.

BACKGROUND: Sarcoïdosis is a benign systemic granulomatosis whose aetiology remains unknown. Lung is the most frequently involved organ. The pseudoalveolar form of this disease is known to have an acute onset and is quite uncommon. Therefore, diagnosing such a rare variety of sarcoidosis is rather often challenging. OBSERVATIONS: In the present article, the authors report two cases of pseudoalveolar sarcoidosis. The patients, both young adults, showed no suggestive signs of sarcoidosis at first presentation. This resulted in a considerable delay to diagnosis and to the corticosteroid therapy. CONCLUSION: The authors emphasize the rarity of the pseudoalveolar form of sarcoidosis. They insist on its roentgenographic characteristics and demonstrate the functional benefits allowed by the precocious medical management. They also propose a current review of the literature.

[Multifocal tuberculosis (palpebral and pleural) in an immunocompetent woman]. / Tuberculose multi-focale (palpébrale et pleurale) chez une immunocompétente.

INTRODUCTION: Tuberculosis of the eyelid and its development in the setting of multifocal tuberculosis is exceptionally rare. CASE REPORT: The authors report a new observation of multifocal tuberculosis in a non-immunosuppressed woman of 28 years with histologically confirmed pleural and palpebral involvement. A paradoxical reaction was seen following the initiation of anti-tuberculous treatment with appearance of new manifestations (thoracic cold abscesses). CONCLUSION: The authors draw attention to this rare localisation and to the paradoxical reactions during treatment, emphasising the need for early diagnosis to avoid local and remote complications.

[Congenital esophagobronchial fistula in an adult. Case report]. / Fistule oeso-bronchique congénitale chez l'adulte. A propos d'un cas.

Congenital esophagobronchial fistulae are uncommon anomalies generally discovered during the neonatal period due to overt symptoms. Rarely symptoms are discrete, leading to discovery in adulthood; exceptionally the patients are totally symptom free or present minimal signs such as coughing at ingestion of fluids. Less than 200 adult cases have been reported in the literature. We report a new case of this type II congenital esophagobronchial fistula. A 59-year-old woman was hospitalized for exploration of cough at ingestion of fluids. The radiographic work-up reveal dilatation of the left bronchial tree and suspected esophagobronchial fistula. An esophago-gastro-duodenal barium study demonstrated a fistula between the mid esophagus and the left posterobasal bronchus. Fistulectomy and left lower lobectomy were performed. Outcome was favorable. The diagnosis of adult esophagobronchial fistula should be entertained in patients with an uneventful history who present localized bronchial dilatation associated with cough induced by fluid ingestion.

[An unusual localization of a rare tumor: giant-cell tumor of the rib. Case report and review of the literature]. / Une localisation inhabituelle d'une pathologie rare: la tumeur costale à cellules géantes. A propos d'un cas avec revue de la littérature.

INTRODUCTION: Giant-cell tumors of bone are rare primary neoplasms commonly encountered in young adults. Women are slightly more affected than men. CASE REPORT: We report the case a 27 year old woman presenting with a twelve months history of painful and progressively growing thoracic mass in the right anterior chest wall. Physical examination found out a fixed thoracic mass in the right retro-mammary area measuring 8 x 6 centimeters. The overlying skin was normal. Chest roentgenogram demonstrated a large ill defined mass continuing the anterior arc of the fourth right rib. Computed tomography evidenced a well defined pathologic process originating from the fourth right rib without expansion of the surrounding soft tissue. Pulmonary functional tests were normal and other complementary investigations evidenced no abnormalities. Our patient first had a fine needle cytological biopsy that brought strong suspicion of Giant-cell tumor of the rib. She then underwent an "en bloc" resection of the tumor whose histopathologic analysis allowed a definitive diagnosis. The post-surgical follow up during 12 months showed no signs of tumor recurrence. CONCLUSION: Through this observation the authors emphasize not only the rarity of the giant-cell tumors of bone but also its unusual costal localization (few cases reported till date). They focus on the importance of precocious screening and treatment and underline the value of the follow up in order to detect timely any sign of local recurrence or sarcomatous transformation. Finally, they report a current review of the literature.

[Epithelioid malignant peripheral nerve sheath tumor. A case report]. / Tumeur maligne des gaines des nerfs périphériques type épithélioïde. A propos d'un cas.

Malignant peripheral nerve sheath tumors (MPNST) are exceptional and painful. The typical localization along a peripheral nerve is not always present. Prognosis is very poor. Diagnosis is particularly difficult because of the variable pathological presentation and unpredictable differentiation. We report an exceptional case of epithelioid differentiation in a 43-Year-old patient who complained of right thoracic pain for one and a half Years. Physical examination revealed weight loss and a paravertebral mass under the scapula. The chest x-ray showed a suprahilar opacity suggestive of parietal involvement and lysis of the sixth rib. Surgical biopsy of the parietal mass led to the diagnosis of epithelioid MPNST.

[Cystic adenoid carcinoma of the trachea]. / Carcinome adénoïde kystique trachéal. A propos de trois cas.

Cystic adenoid carcinoma (CAC) of the trachea, also called cylindroma, is a rare malignant tumor accounting for 1 per thousand of all respiratory tract cancers. We report three cases of cylindroma in patients hospitalized for inspiratory dyspnea due to a tracheal tumor. Bronchoscopy using a rigid tube revealed a smooth tumor of the trachea. Pathology analysis of the biopsy specimen diagnosed CAC. The three patients underwent resection with end-to-end anastomosis. Adjuvant radiotherapy was given in one patient. The short-term outcome was good but one patient developed local recurrence and lung metastasis at six years.