[Adult T-cell leukemia and non-malignant adenopathies associated with HTLV I virus. Apropos of 17 patients born in the Caribbean region and Africa]. / Leucémies à cellules T de l'adulte et adénopathies non malignes associées au virus HTLV I. A propos de 17 malades originaires des Caraïbes et d'Afrique.

Adult T-cell leukaemia is the first blood disease caused by a retrovirus: HTLV-1. The authors report the first French series of 15 patients, of whom 9 came from the classical endemic areas--the Antilles and outer Caribbean Islands--and 6 from Africa where the serological prevalence of HTLV-1 is high but few cases of adult T-cell leukaemia have been reported. Emphasis is laid on the importance of immunodeficiency (refractory strongyloidiasis, Pneumocystis carinii pneumonia, polyclonal B lymphoproliferative syndrome) and of other pathologies associated with the retrovirus (polyarthritis, lymphocytic interstitial pneumonia). The authors also describe the presence of adenopathy in healthy carriers: either adenitis suggestive of retroviral infection, or Castelman's disease adenopathy. These clinical presentations are similar to those described in lymphadenopathy syndromes due to the human immunodeficiency viruses. Aggressive lymphomas require chemotherapy, but sooner or later resistance develops, and the prognosis is very poor. The indications for allogeneic bone marrow transplantation are still to be determined. The diagnosis of adult T-cell leukaemia must be considered in all patients with blood disease coming from the endemic areas.

[Cancer of a solitary kidney and multiple paraneoplastic syndromes (arterial hypertension, polycythemia, hypercalcemia and limbic encephalopathy)]. / Cancer sur rein unique et syndromes paranéoplasiques multiples (hypertension artérielle, polyglobulie, hypercalcémie, encéphalopathie limbique).

In a case of cancer of a congenital solitary kidney with lung metastases four paraneoplastic syndromes accompanied the neoplasia: arterial hypertension, polycythaemia, hypercalcaemia and limbic encephalitis. The inaugural arterial hypertension had provided no clue, but polycythaemia led to the diagnosis. In the course of the disease neuropsychic disorders due to the limbic encephalitis and unrelated to the hypercalcaemia developed and made this particular case unusual, especially since only one similar case of renal cancer has been published. The literature available concerning the four neoplastic syndromes is reviewed.

[Occurrence of non-Hodgkin's lymphoma in chronic myeloid leukemia]. / Survenue d'un lymphome non hodgkinien au cours d'une leucémie myéloïde chronique.

The authors report the case of a 42-year old woman who developed chronic myelocytic leukemia with Philadelphia chromosome followed, 21 months later, by malignant follicular lymphoma with small cleaved cells and giant cells. This case is comparable to the other associations of acute or chronic myelocytic and lymphocytic blood diseases previously published. Several pathogenic theories are reviewed. They involve chemotherapy with alkylating drugs (but the diagnosis is sometimes simultaneous), cellular oncogens or, more probably, a clonal abnormality of the stem cell sequentially or concomitantly expressed in the cells of both lineages; unfortunately, in the absence of Philadelphia chromosome this theory has not yet been demonstrated on lymphoma cells.

[Bone localisation of Hodgkin's disease. A report on 13 cases (author's transl)]. / Les localisations osseuses de la maladie de Hodgkin. A propos de 13 observations.

The authors review 13 cases of bone localisation of Hodgkin's disease taken from 120 case-reports, and compare the findings with those reported in the published literature. The frequency of bone lesions in this series was 18%. Initial signs were clinical in one half of the cases and radiological or scintigraphic in the other half. Early diagnosis of bone lesions was more frequently made in this series than late discovery of bone locations; the lesions ware more frequently present in the spine, the pelvis, and the sternum; the usual appearance was osteolytic or mixed, lytic and condensed. Scintigraphy is a reliable early diagnostic procedure, as is medullary biopsy which has become essential for the investigation of extension of the lesions. An inflammatory syndrome is present in most cases. In this series, bone lesions usually were of haematogenic origin and were mainly of the scleronodular histological type. Definite recovery was obtained in more than half of the cases. In the other patients, the bone lesions coincided with a long disease course, were never the reason for great concern, and were never directly responsible for death in the 3 patients that died.

[Malignant histiocytosis with bone involvement (author's transl)]. / L'histiocytose maligne à forme osseuse.

Malignant histiocytosis, an affection in which there is proliferation of morphologically atypical histiocytes, traditionally associates high fever, deterioration of the general condition, adenopathy, hepatosplenomegaly, and less frequently, cutaneous lesions. Clinical, radiological, and histological signs of bone involvement are rarely observed, which demonstrates the interest of the case reported of a pure medullary form with massive necrosis and successive bone localisations of the osteolytic type. The clinical picture was completed by the progressive development of adenopathy and hepatosplenomegaly. Multiple chemotherapy, according to the A.V.E.C. procedure, controlled the affection for three months before it became totally ineffective. Survival for twelve months after clinical onset demonstrates the extreme malignancy of the affection.