[Adrenal metastasis of a papillary thyroid cancer]. / Métastase surrénalienne d'un cancer papillaire de la thyroïde.

Adrenal metastases of the papillary thyroid carcinoma (PTC) are very rare. We report one case. A 63-year-old woman had undergone 15 years earlier left lobo-ishmectomy for a papillary thyroid cancer (PTC) and 7 years earlier right adrenalectomy for a tumor. Histologic examination showed a benign cortical tumor. In 1999, when the patient was admitted for worsening of glycemic control, a recurrence of the adrenal mass was detected. According to the hormone evaluation it was a non-functional tumor. Adrenalectomy was performed in June 2002 because the patient had initially declined surgery. Histologic examination and thyroglobulin immunochemistry identified metastatic PTC. Re-reading the histology slide of the first adrenalectomy agreed with the diagnosis. Thyroidectomy was completed in March 2003. Although iodine-131 therapy and thyroxine treatment were given, bone metastases were detected in August 2004. PTC usually spreads to the cervical and mediastinal lymph nodes. Distant spread may occur to bone or lung, but exceptionally to the adrenal gland. The adrenal localization is often associated with lung or bone metastasis. In our patient, the adrenal metastasis remained isolated for many years. It has been reported that survival rate decreases considerably after appearance of a distant metastasis. Although given delayed radical treatment, our patient remained alive 13 years after.

[Bronchiectasis in a patient with ulcerative colitis]. / Bronchectasies chez un patient porteur d'une rectocolite ulcéro-hémorragique.

Bronchopulmonary involvement is uncommon in ulcerative colitis. Bronchiectasis is a rare manifestation of the disease. We report a case of a 65-year-old patient with ulcerative colitis in whom we diagnosed bronchiectasis. The evidence of a relationship between bronchiectasis and ulcerative colitis was established on the basis of 3 criteria: the late occurrence of bronchiectasis in a patient without pulmonary history, their appearance after the ulcerative colitis developed and their improvement after inhaled corticosteroid treatment. This observation points out that ulcerative colitis investigations should be extended to the respiratory structures. The respiratory involvement is not always concomitant with the bowel disease. This observation suggests the efficiency of the inhaled corticosteroids in this disease.

[A symptomatic choroid plexus cyst in the lateral ventricle]. / Kyste symptomatique du plexus choroïde du ventricule latéral.

Choroid plexus cyst is generally small and a relatively common finding at autopsy. Huge and symptomatic cysts are rare. Few cases are reported in the literature. We report one case of symptomatic choroid plexus cyst of the right lateral ventricle in a six month baby who presented with epilepsy. Cerebral CT scan and MRI showed a large cyst in the right lateral ventricle compressing the adjacent structures. Total removal of the cyst has been performed by a parieto-temporal approach. The course was uneventful.

[Sub-pleural lipoma: apropos of a case]. / Le lipome sous-pleural: à propos d'un cas.

Lipomas are rarely observed in a subpleural localization. Clinical signs are uncommon and most are an incidental discovery at x-ray. We report a case of an incidentally discovered lipoma in the subpleural area observed in a 56-year-old patient. Physical examination showed normal respiratory function. An extrapulmonary intrathoracic opacity situated in the right axillary area was observed on standard chest x-ray. Computed tomography established the diagnosis of a subpleural fatty mass. This case draws attention to this uncommon localization of lipomas and illustrates the contribution of computed tomography for diagnosis. The CT pattern allowed us to avoid transmural or surgical biopsy.

[Disseminated tuberculosis in non-immunocompromised host: three case reports]. / Tuberculose disséminée sur terrain non immunodéprimé: à propos de trois cas.

INTRODUCTION: Disseminated tuberculosis, i.e., tuberculosis involving lung, liver, spleen, bone marrow and lymph nodes is rare (2.8%), particularly when immunocompromised diathesis is lacking. EXEGESIS: We report three cases of disseminated tuberculosis confirmed by bacteriology or histology, which occurred in non-immunocompromised patients. Disease evolution under antituberculous treatment was favorable in two cases and fatal in the third one. CONCLUSION: Disseminated tuberculosis must be suspected when miliary pulmonary lesions are associated with hematologic abnormalities, even in non-immunocompromised host. Early treatment is mandatory to avoid fatal outcome.

[Ion transports across the respiratory epithelium]. / Les transports ioniques à travers l'épithélium respiratoire.

The electrolytes and water transport across the respiratory epithelium have aroused particular interest for 20 years ago, with regard to the essential role they play in the regulation of the bronchial mucus composition and volume. The development of new in vitro and in vivo, techniques, allow better knowledge of these transport systems and their regulation. Transport involves two main ionic movements: chloride secretion and sodium absorption by the epithelial cells, associated with parallel water movements. In cystic fibrosis, the modification of bronchial mucus results from a defective protein-kinase dependent regulation of chloride secretion. This defect blocks water and chloride secretion by the respiratory epithelium causing dehydration of the mucus.

[Giant lobar emphysema. The cause of a compressive hemithoracic opacity in a newborn infant]. / Emphysème lobaire géant. Cause d'une opacité hémithoracique compressive chez le nouveau-né.

The authors describe a case of congenital lobar emphysema of the upper right pulmonary lobe discovered at birth with an opaque hemithorax and a shift of mediastinum. The diagnosis was confirmed by a CT-scan. A lobectomy was performed at 6 weeks of age. The different diagnosis and physiopathological mechanisms are discussed.