[Tracheal stenosis revealing systemic lupus erythematosus]. / Sténose trachéale révélant un lupus érythémateux systémique.

Systemic Lupus Erythematosus (SLE) with respiratory involvement is less well known than cutaneous, articular and renal involvement. Clinical course is quite variable and dominated by pleural involvements. Tracheal stenosis is unusual, if not exceptional in patients with this disease. We here report a quite particular case of systemic lupus erythematosus revealed by tracheal stenosis with dry eye-buccal syndrome.

Endobronchial localization of Hodgkin's disease.

The endobronchial localization of Hodgkin's disease is a rare entity which is often confused with endobronchial tuberculosis in our setting. We report the case of a 16 years old female who presented with 6 months history of dry cough, hemoptysis, dyspnea, dysphagia and dysphonia. The chest radiography showed a mediastinal and pulmonary opacity. The chest CT scan found enlarged mediastinal lymph nodes. The bronchial biopsy and peripheral lymph node biopsy confirmed Hodgkin's disease with endobronchial localization. The patient received chemotherapy (ABVD protocol) and radiotherapy with a favorable follow up.

[Unusual location of multiple hydatidosis, pancreatic and pelvic: about a case]. / Hydatidose multiple à localisation inhabituelle, pancréatique et pelvienne : à propos d'un cas.

Hydatid cyst is an infectious disease which is quite frequent in Morocco. Pelvic and pancreatic locations of this parasitic infection are rare, namely exceptional. We report the case of a 66-year old patient who was operated for liver hydatic cyst 6 years before, presenting for chest pain associated with hydatidoptysis. Chest X-ray objectified left hydropneumothorax. Thoraco-abdominopelvic CT showed mediastinal liquid mass as well as multiple hepatic, pancreatic (isthmus), pelvic and left under diaphragmatic cystic lesions. Hydatid serology was positive. Treatment involved thoracotomy associated with medical treatment.

[Pleuropulmonary metastases originating from extra-thoracic neoplasia]. / Métastases pleuro-pulmonaires des néoplasies extra-thoraciques.

The lungs receive the entire venous drainage of the body. This explains the high incidence of pleuropulmonary metastases originating from several cancers. The goal of this is to study the clinical manifestations of pleuro-pulmonary metastases originating from extra-thoracic cancers. We conducted a retrospective study of patients with pleuro-pulmonary metastasis whose data were collected in our department between January 2006 and december 2014. 76 patient medical records were studied. The average age was 50 years (aged 21-89 years) with a male predominance in 57.8% of cases. Clinical symptoms were mainly cough (32.8% of cases), dyspnea (23.7% of cases) and hemoptysis (11.2%). Primary cancers responsible for various pleuro-pulmonary metastases found in our case series were dominated by breast cancers in 27.6% of cases, gastro-intestinal cancers in 15.8% of cases, genital cancers in 9, 2% of cases, sarcomas in 7.8% of cases, renal cancers in 5.2% of cases, bladder cancers in 5.2% of cases, prostate cancers in 3.9% cases, ENT cancers in 3.9% of cases, thyroid cancers in 3.9% of cases, skin cancers in 2.6% of cases and cancers of unknown primary origin in 14.4% of cases respectively. Several radiologic features of pleuro-pulmonary metastases have been found in our case series; they can be isolated or combined. The most common radiologic aspect was multiple pulmonary nodules in 52.6% of cases, followed by pleurisies in 34.2% of cases, diffuse micronodules in 23.6% of cases and a solitary nodule in 3.94% of cases. Secondary pleuropulmonary cancers are frequent. They come in 3rd place after lymph nodes and liver metastases and are found in 30% of autopsies of patients with neoplasia.

[Prevalence of smoking among doctors and paramedical staff in Hospital University Center Mohammed VI, Marrakech]. / Prévalence du tabagisme chez le personnel médical et paramédical du CHU Mohamed VI à Marrakech.

Smoking is a major public health problem. Doctors and paramedical staff are not excluded from this plague. Smoking ban in hospitals originated from government effort to reduce passive smoking. The objectives were to evaluate smoking habits among doctors and paramedical staff in order to implement tobacco control strategy in this study population and to refer them to the smoking-cessation counselling. We conducted a descriptive cross-sectional study of the entire staff of the Hospital University Center Mohammed VI, Marrakech based on the distribution of anonymous questionnaires. A total of 530 questionnaires were distributed, and 380 were returned, a response rate of 71.7%. The study population consisted of 58.2% women (n=221) and 41.8% men (n=159). Doctors (n=220) were the most represented occupational category (57.9%) followed by nurses (31.8%). Smokers (n=62) accounted for 16.3% of our study population; the ex-smokers (n=31) accounted for 8.1% and the non-smokers (n=287) 75.5%. The average age of smokers was 31.1 years, ranging from 22 to 56 years. The prevalence of smoking was 16.3% (n=62) of study population, of whom 32.7% (n=52) among men compared to 4.5% (n=10) among women. The average age of smoking onset was 19 years with a range from 11 to 29 years and with a mean consumption of 9 cigarettes/day. 13% (n=50) of people even smoked narguilé, 9% (n=34) consumed alcohol, and 3% (n=21) cannabis. 67.7% of smokers (n=42) were planning to quit, of whom 30.9% (n=13) in the next 3 months, 52.4% (n=22) in the next 6 months and 16, 7% (n=16) were planning to quit in the year. Several activities encouraged smoking, including night shift, coffee breaks and meals in 90.3% (n=56), 64.3% (n=40) and 61.3% (n=38) of cases respectively. This survey highlights the need to carry out awareness-raising actions to strengthen people motivation to quit smoking and help them during their withdrawal.

Prevalence of Skin Sensitization to Pollen of Date Palm in Marrakesh, Morocco.

Background. Date palm's pollen has been identified as a source of allergy; the rate of sensitization of this pollen is between 6 and 29%. Objective. To determine the prevalence of sensitization to date palm in Marrakesh and to identify the clinical profile. Patients and Methods. This study is based on a questionnaire and the prick test on 7 allergens, in population aged 5 years and above with clinical symptoms suggesting allergic diseases, from November 2012 to February 2013 in Marrakech. Results. We included 468 patients (women: 79.5%). The prick tests were considered interpretable in 467 cases. The prevalence of skin sensitization to pollen of date palm was 6.6%. The 31 cases of sensitization to date palm involved 7 men and 24 women with an average age of 37.5 years. Cutaneous monosensitization to date palm's pollen was observed in 2 cases. Asthma, rhinitis, and conjunctivitis were recorded, respectively, in 48.4%, 93.5%, and 67.7%. Conclusion. Skin sensitization to pollen of date palm does not seem unusual among allergic patients in Marrakech and is comparable to that found in Casablanca (7%), Barcelona (6.6%), and Cartagena (6.1%).

[Eosinophilic pneumonia revealing B-cell non-Hodgkin lymphoma]. / Pneumopathie à éosinophile révélant un lymphome non hodgkinien de type B.

The diagnosis of eosinophilic pneumonia is rare and malignant etiology remains exceptional. Eosinophilic pneumonia etiology varies and is mainly dominated by allergic and drug causes. We report the case of a 61-year-old patient with B-cell non-Hodgkin lymphoma revealed by eosinophilic pneumonia. The diagnosis of eosinophilic pneumonia was confirmed by eosinophil count of 56% in bronchoalveolar lavage. Immunohistochemical examination of bone marrow biopsy revealed malignant Small B cells non-Hodgkin lymphoma.

[Pulmonary Langerhans' cell histiocytosis (PLCH) revealed by pneumothorax: about a case]. / Histiocytose langerhansienne pulmonaire révélée par un pneumothorax: à propos d'un cas.

Langerhans cell histiocytosis is a rare disease of unknown etiology characterized by the infiltration of Langerhans cells in one or more organs. It has a polymorphic clinical presentation. We report the case of Mr R.Y, age 22, with 8 pack year history of smoking, admitted to hospital with complete spontaneous right-sided pneumothorax. Chest drainage was performed with good evolution. Control chest CT scan showed multiple diffuse cyst formations, predominant in the upper lobes. Lab and imaging tests were performed in order to detect systemic histiocytosis with negative results. Patient's evolution was marked by pneumothorax recurrence; pleurodesis and lung biopsy were performed which confirmed the diagnosis. The diagnosis of Langerhans cell histiocytosis should be evoked in front of pneumothorax associated with lung cystic. The diagnosis is easy in front of a suggestive clinical and radiological picture. Nevertheless, therapeutic options are limited and pneumothorax recurrence is common.

[Pulmonary hydatid cyst: unusual double apical location. About a case]. / Kyste hydatique pulmonaire: double localisation pulmonaire apicale inhabituelle. A propos d'un cas.

Hydatid cyst (KH) is still endemic in several areas of Morocco. Pulmonary involvement is a consequence of liver disease. Hydatid cyst is characterized by diverse anatomical and clinical presentations and by the possibility of multiple locations within the lung parenchyma, predominantly involving pulmonary bases. We report the case of Mr J. M, 54 years old, admitted with suspected pulmonary hydatid cyst based on chest pain lasting for six months and an episode of hydatidoptysis. Chest x-ray objectified a double apical location suggesting different stages of evolution for pulmonary hydatid cyst. The diagnosis was confirmed by thoracic CTscan and hydatid serology. Multiple pulmonary hydatid cyst is not rare in areas in which hydatid disease is highly endemic. Our study reports an unusual double apical location of hydatid cyst at various stages of evolution.

Flexible bronchoscopic removal of a fractured metallic tracheostomy tube.

Patients frequently require a tracheostomy for a variety of indications, but its prolonged use is associated with several complications, including fracture of the tube. Metallic tracheostomy tubes, which are often used in developing countries, are predisposed to such a complication essentially because of corrosion from prolonged used. We report 2 cases of a fractured tracheostomy tube inserted into the central airways, with different clinical presentations. Fractured pieces were successfully removed using a flexible bronchoscope under topical anesthesia.