[Association of tracheobronchopathia osteochondroplastica and ozène]. / Association trachéobronchopathie chondro-ostéoplastique et ozène.

INTRODUCTION: We report a case of tracheobronchopathia osteochondroplastica associated with Ozena (atrophic rhinitis). OBSERVATION: Fibreoptic bonchoscopy showed irregular tracheal stenosis and histopathological examination displayed zones of bone metaplasia in the tracheal submucosa. We isolated the bacteria Klebsiella pneumoniae sp ozaenae from bronchial aspirate. CONCLUSION: This organism is frequently isolated in both conditions suggesting some link between the two diseases.

[Tracheocele: a rare cause of pharyngeal disorders]. / Trachéocèle: une cause rare de gêne pharyngée.

A 40-year-old woman with an uneventful history consulted for an episode of cervical swelling and pharyngeal disorders with sensation of a foreign body. Cervical and ENT examination was normal. The barium swallow showed a normal esophagus and the CT scan showed an air image in the right side of the trachea. The diagnosis of tracheocele was made at surgery and was confirmed by histology. Clinical, endoscopic, and radiologic outcome was favorable three months after surgical resection of the diverticulum. Tracheocele is rarely reported in the literature. It results from a congenital or acquired weakness of the tracheal wall. The right side is involved more frequently. No specific signs or symptoms have been identified. Diagnosis is often based on CT findings. Surgery confirms the diagnosis and allows resection.

[Wegener's disease mimicking acute infectious pleurisy]. / Pleurésie aiguë d'allure infectieuse au cours d'une maladie de Wegener.

A 75-year-old woman followed for Wegener's disease was hospitalized for pleural effusion. The clinical presentation and cytology of the pleural fluid suggested the diagnosis of purulent pleurisy in this immunodepressed patient. The final diagnosis was a pleural involvement of Wegener's disease, a rarely described localization, as proven by the typical pathology findings.

[An unusual variant of urothelial carcinoma: the "nested variant of urothelial carcinoma." Report of two cases]. / Une variante particulière de carcinome urothélial: le "nested variant of urothelial carcinoma". A propos de deux cas.

We report two cases of a poorly known variant of transitional cell carcinoma, the "nested variant of urothelial carcinoma". This tumor is composed of small islands or nests of transitional cells, presenting little atypia and mimicking von Brünn's nests. This low grade tumoral variant seems to behave as a high grade tumor of the same stage. Deep biopsies are necessary to display tumoral invasion, which allows the diagnosis. Importance of the knowledge of this entity is highlighted in order to avoid misdiagnoses that could delay appropriate therapy.

[Primary intramedullary melanoma. Apropos of a case]. / Mélanome intra-médullaire primitif. A propos d'un cas.

Primary melanoma is a rare spinal tumour first reported by Hirschberg in 1906. Since then, only 34 cases have been reported. When present here a new case of primary intramedullary thoracic melanoma developed in a 64-year old male patient. MRI showed a paramagnetic signal with reactive cysts. Macroscopy and histology confirmed the diagnosis. Spinal cord melanoma is presumed to be primary when no other melanoma is found outside the CNS. The tumour is often located in the middle or lower thoracic cord, may be intra- or extra-medullary and leptomeningeal or extradural. It frequently progresses slowly. MRI is the essential examination as it demonstrates a lesion with paramagnetic properties. Its image is not specific and may correspond to other pigmented tumours (meningeal melanocytoma, melanotic schwannoma), to a lipoma or to a vascular or tumoral haemorrhagic lesion. Treatment is uncertain, but surgery is frequently associated with radiation. Postoperative follow-up aims at detecting a local regrowth of the tumour or leptomeningeal dissemination which affects the prognosis.

[Endocervical adenocarcinoma in situ. A histological entity to know]. / Adénocarcinome in situ de l'endocol. Une entité histologique à connaître.

We report diagnosis and treatment problems encountered in 4 cases of adenocarcinoma in situ (AIS) of the uterine cervix. The patients' ages ranged from 24 to 45 years. In 2 cases, Pap smears revealed strips of cells showing crowded nuclei and pseudostratification of AIS. In 3 cases, the diagnosis of AIS was confirmed from a colposcopically directed biopsy and, in the last case, from a surgical cone biopsy. In 3 cases, AIS was found to be associated with cervical squamous intraepithelial neoplasia. In all cases, it was difficult to rule out an early invasive adenocarcinoma. Three patients underwent total abdominal hysterectomy. The topographic data of lesions, notably the presence of endocervical AIS in hysterectomy specimen realised 4 years after conization, and a review of literature lead us to propose hysterectomy as a basic treatment. If conization is chosen, it should be cylindrical with adequate diameter and height.

[Chronic course of reactive bronchial dysfunction syndrome. Apropos of 6 further cases]. / Evolution chronique du syndrome de dysfonction réactive des bronches. A propos de 6 nouveaux cas.

The reactive airways dysfunction syndrome (RADS) occurs as a persistent bronchial hyper-reactivity with asthmatic-type dyspnoea and occurs after a single and massive inhalation of irritant gases, smoke or vapours, in subjects who had previously had no respiratory disease. We report six cases in patients without any previous asthmatic history or history of atopy who had developed RADS after being exposed to different irritants. The symptoms evolved over 5-84 months after the initial accident. Only moderate airflow obstruction was found, but all subjects had bronchial hyper-reactivity to methacholine. A bronchial biopsy was performed in a patient and this showed moderate sub-epithelial mononuclear inflammatory infiltrate. A specific feature of this syndrome is the facility to inaugurate a susceptibility to asthma after the initial accident and for this to progress of its own accord with secondary aggravation, even in the absence of new exposure to the irritating agent. Its frequency is probably under-estimated because it remains little known in France. It is very important both to recognise and notify inhalational accidents at work to be able, should the nedd arise, to identify the worker and to enable a move to a different job if necessary.

Cell abnormalities associated with human papillomavirus-induced squamous intraepithelial cervical lesions. Multivariate data analysis.

One hundred ninety-six cervical scrapings were obtained for simultaneous research of cell abnormalities in Papanicolaou smears and detection of genital human papillomavirus (HPV) genotypes by polymerase chain reaction in extracted DNA from each clinical sample. The samples described by six discriminant cytologic parameters, and a synthetic HPV-presence/absence parameter provided an efficient matrix for multiple correspondence analysis. This statistical analysis displayed a plurality of HPV-related cell abnormalities in squamous intraepithelial lesions, and a high correspondence between HPV infection and the presence of multinucleated squamous cells, morphologically transformed keratinocytes (dyskaryotic cells), koilocytes, and cellular changes related to epithelial maturation. Because of the low proportion of detectable koilocytes in the HPV-infected scrapings, the authors also inferred that cellular changes related to epithelial maturation and morphologically transformed keratinocytes are the most accurate and efficient cell abnormalities, in terms of frequency and correlation, for cytodiagnosis of HPV-induced or associated squamous intraepithelial cervical lesions.

[Pulmonary siderosis and long-term respiratory risks of arc welders]. / Sidérose pulmonaire et risques respiratoires à long terme du soudage à l'arc.

Pulmonary siderosis and bronchial cancer are respiratory risks in the long term in arc welders. We report a case of siderosis discovered from radiological abnormalities in a patient of 56 who had been an arc welder for 30 years. An analysis of the broncho-alveolar lavage liquid and transbronchial biopsy confirmed an iron overload and revealed patchy interstitial fibrosis. The toxic risks in arc welders arise from the gaseous fumes produced and inhaled particles at the alveolar level. The pulmonary siderosis is currently considered as a simple pneumoconiosis with a good prognosis. Some recent studies suggest the possibility of a more serious outcome with fibrosis even in the absence of any associated silicosis. The risks of bronchial cancer seem to be principally linked to exposure to chrome. A better understanding of these risks could be furnished by data from epidemiological studies which are still lacking.

[Primary malignant dysembryoma of the mediastinum]. / Dysembryomes malins primitifs du médiastin.

The primary malignant dysembryomas of the mediastinum are highly malignant tumours, which originate from embryonal cells. This name excludes seminomas and dysgerminomas which derive from non-fecund germinal cells. In this general review only the dysembryomas will be touched on. They are relatively rare tumours found in young men and are characterised by the rapidity of their spontaneous growth. The absence of a gonadal tumour is sufficient to confirm the primary mediastinal character of malignant dysembryomas. There is little specific in the clinical data. The tumour markers, Beta HCG and above all alpha feto-protein play, at the same time, a leading role not only for diagnosis but also for therapeutic decisions and follow up under treatment. In spite of the appalling reputed prognosis of this disease, the malignant dysembryomas have benefited from the considerable therapeutic progress which has been made in recent years. It is vital to achieve a rapid and accurate diagnosis and to start on treatment without delay with a regime incorporating Cisplatin. As radical surgery as possible usually follows the initial chemotherapy. Post operative treatment depends on the anatomical observations made at the time of surgery.

[Histopathology of the vein of Galen]. / Histopathologie de la veine de Galien.

Histology of cerebral arteries and veins are reviewed to show variances with extracerebral blood vessels. Muscles fibers even in large cerebral veins are easily overlooked. The thick wall of the vein of Galen grossly and microscopically resembled dura mater fed by microscopic blood vessels and capillaries. The authors reported 4 cases of arteriovenous aneurysms of the great vein of Galen. When compared to the rest of the histological reports on this subject published till now, it is obvious that this new cases bring new facts. First is the presence of an irregular muscle coat in the aneurysmal wall suggesting early hemodynamic troubles. The second and most important data is the association of multiple malformations of the pineal gland, of the vascular elements of the tela choroidea of the third ventricle between which the aneurysm of the great cerebral vein is found. These unusual data suggested complex congenital malformation in the early stages of development.

Immunocytological study of the distribution of C-cells calcitonin in the thyroid gland of the normal adult gerbil.

The distribution of C-cells in the thyroid gland of the gerbil (Meriones inguiculatus) was studied on serial sections in the cranio-caudal direction. C-cells were visualized by immunofluorescence with an anti-calcitonin immune serum. A very heterogeneous distribution was found. C-cells first appear in the posterio-interior position. Then they progressively occupy the whole posterior part and finally are confined to the posterio-exterior position. No C-cells at all were detected in the upper and lower poles. According to the species, there is a wide variation in the relative distribution of C-cells in the thyroid gland. Our results add to the information available about the distribution of C-cells and its bearing on phylogenic evolution.