[Behcet's disease and iatrogenic arterial complications: importance of pre-operative noninvasive explorations]. / Maladie de Behçet et complications artérielles iatrogènes: intérêt des explorations pré-opératoires non invasives.

We report a case of Behçet's disease complicated with a popliteal aneurysm, which appeared 8 years after first etiologic diagnosis. The points of interest of this observation are the pre-operative explorations and particularly the Magnetic Resonance Angiography (RMA). This last seems to be particularly safe for aortic and lower limbs aneurysms explorations, and can be performed without arterial functions. In fact the risk of arteriogram is effective in Behçet's disease with secondary false aneurysms. RMA and US-Doppler scan must be first proposed in Behçet's disease in case of aortic and peripheral aneurysms.

Primary central nervous system malignant non-Hodgkin's lymphomas from HIV-infected and non-infected patients: expression of cellular surface proteins and Epstein-Barr viral markers.

The increased incidence of primary central nervous system malignant non-Hodgkin's lymphomas (PCNSL) in HIV- and non-HIV-infected patients and the demonstration of Epstein-Barr virus (EBV) in these tumours may indicate relationships between PCNSL and EBV. Consequently expression of EBV-induced antigens and cellular markers were studied in 11 HIV-infected and seven non-infected patients by in situ hybridization (ISH) and immunocytochemistry in monoclonal B cell PCNSL. In HIV-infected patients EBV genome was present in 9/11 cases, LMP in 11/11 cases and EBNA2 in 10/11 cases. The expression of adhesion and activation molecules was low or absent. In HIV non-infected patients, EBV genome was present in 5/7 cases, with LMP in 4/7 cases. EBNA2 was never detected. All these lymphomas expressed LFA1beta. Whatever the population, no lytic cycle EBV markers were detected. Compared with other types of EBV lymphomas, our results suggest a different EBV latency state in primary B cell lymphomas of the CNS from HIV-infected or non-infected patients.

Simultaneous progressive multifocal leukoencephalopathy, Epstein-Barr virus (EBV) latent infection and cerebral parenchymal infiltration during chronic lymphocytic leukemia.

We report a non-HIV patient who had B chronic lymphocytic leukemia (CLL) with progressive multifocal leukoencephalopathy (PML) and diffuse cerebral leukemic parenchymal infiltration in the presence of JC virus and Epstein-Barr virus (EBV) cerebral co-infection. Multiple subcortical hypodensities lining the cortico-subcortical junction were present within the white matter on computerized tomography (CT) scan, with large areas of high signal intensity on T2-weighted sequences on magnetic resonance imaging (MRI). JCV DNA was identified in peripheral blood nuclear cells and cerebrospinal fluid polymerase chain reaction (PCR) DNA/DNA hybridization plus Southern blot analysis. Frontal stereotactic biopsy confirmed the diagnosis of PML by immunocytochemistry, in situ hybridization (ISH) with JC Enzo probe and electron microscopy. Leukemic B cells with the same phenotype as leukemic blood cells were disseminated in the demyelinated areas. They were labeled by anti-latent membrane protein and by BamHl W EBV probe after ISH. Adhesion and activation molecules were positive for CD23. Autopsy showed diffuse visceral leukemic infiltration without acutization. EBV-transformed B lymphocytes would favour JCV penetration and/or intracerebral reactivation of previously latent JCV infection with further development of simultaneous PML and cerebral CLL infiltration in an immunosuppressed patient.

[Pulmonary infection with Mycobacterium szulgai]. / Infection pulmonaire à M. szulgai.

Mycobacterium szulgai is a newly recognised species of mycobacteria whose pathogenicity in man can only be confirmed following certain criteria. We report a new observation comprising three points of interest. M. szulgai appears to be directly responsible for pulmonary infection and the clinical and radiological progress is very rapid. The human disease probably comes from infected water in aquaria. We have reviewed other cases of M. szulgai in the literature and for two out of three amongst these there is pulmonary involvement resembling tuberculosis; in the other cases cutaneous disease, synovial disease and bone disease have been described.