[Intravascular large cell lymphoma revealed by diffuse telangiectasia and cauda equina syndrome]. / Lymphome intravasculaire révélé par des télangiectasies diffuses et un syndrome de la queue de cheval.

BACKGROUND: Intravascular lymphoma is a rare disease with usually fatal outcome, characterized by the proliferation within the lumen of small blood vessels of neoplastic large lymphoid cells of B-cell origin. We report a case of intravascular lymphoma revealed by diffuse telangiectasia and cauda equina syndrome. CASE REPORT: A 64-year-old Vietnamese woman presented with unexpected fever and weight loss. Three months after the onset of the first symptoms, an oedema appeared on the lower limbs and the trunk, followed by the eruption of diffuse superficial telangiectasia. Neurologic examination revealed a cauda equina syndrome. The diagnosis of intravascular B cell lymphoma was established on cutaneous and muscular biopsy specimen. A moderate hemophagocytic syndrome was observed, confirmed by bone marrow biopsy. Corticosteroid therapy was started, followed by combination chemotherapy yielding complete response. Six months later death occurred, without evidence of relapse of intravascular lymphoma. DISCUSSION: Clinical presentation of intravascular lymphoma is often confusing, mimicking systemic disease, with a predilection for skin and nervous system involvement. Diagnosis is difficult and often an autopsy finding. Prognosis is generally poor, but favourable responses to chemotherapy have been observed after early diagnosis and treatment. The pathogenesis of intravascular lymphoma remains unknown. Dysfunction of cell-endothelial interaction affecting adhesion molecules has been suspected. The implication of Epstein-Barr virus in intravascular lymphoma remains controversial.

[Encephalopathy with pure nicotinic acid deficiency in alcoholic patients. Two cases, with anatomoclinical study in one (author's transl)]. / L'encéphalopathie pseudo-pellagreuse chez l'alcoolique. Deux observations et corrélations anatomo-cliniques.

Two chronic alcoholic patients developed severe encephalopathy while receiving high doses of parenteral thiamine and pyridoxine. Both presented with unusually marked hypertonia of the gegenhalten type, myoclonias and fluctuating mental impairment with memory disturbances and hallucinations. Later on, one patient went into stupor and coma and died ; the other recovered after parenteral niacin treatment. No skin lesions or diarrhoea were observed. Post-mortem examination of the first patient confirmed the presence of a pellagra-like encephalopathy characterized by widespread neuronal chromatolysis. There were no changes suggesting an associated alcoholic encephalopathy.

[Hyperthyroidism from placental choriocarcinoma: a case report and review of the literature (author's transl)]. / Hyperthyroïdie par choriocacinome placentaire: un cas avec revue de la littérature.

The first case of placental choriocarcinoma producing clinical hyperthyroidism reported in France is described. Recovery occurred, with disappearance of the choriocarcinoma metastases and hyperthyroidism signs, after chemotherapy alone (vincristine and methotrexate). A review of the seven cases reported in the published literature showed that the hyperthyroidism could be related to the thyroid-stimulating activity of the tumoral gonadotropin (HCG).