[Lung biopsy by thoracotomy. 23 cases (author's transl)]. / Biopsie pulmonaire par thoracotomie. 23 cas.

This series of surgical lung biopsies performed for diffuse lung disease indicates the excellent tolerance of the procedure and the high diagnostic rate. It is indicated above all in the presence of bilateral reticulo-nodular radiological appearances, suggestive of focal lesions not identified by the usual means. The surgical procedure was felt to be justified on the one hand because of the time gained in reaching a precise diagnosis whilst the results of usual laboratory investigations, even the most sophisticated, remain uncertain, and secondly in view of the discovery by the method of malignant lesions which are still curable and which it would have been impossible to identify otherwise, except by awaiting the development of more accessible lesions. Whilst percutaneous needle biopsy found favour amongst many, it would now seem to have been virtually abandoned, particular in France, in view of its risks and it's poor diagnostic rate. By contrast, open surgical biopsy provides in all cases not only lung but also pleural and mediastinal tissue. Its risks are confined to those of any surgical procedure under general anaesthesia, but appear to be sufficiently slight (mortality of 0,5 to 2%) that the technique may be used successfully in intensive care units to obtain a diagnosis in cases of certain types of respiratory distress.

[Eosinophilic pleurisy. Apropos of 35 cases]. / Les pleurésies a éosinophiles. A propos de 35 observations.

Eosinophilic pleuritis are inflammatory effusions containing more than 10% of eosinocytes. More frequent in men, the course of illness is acute our subacute but pleural sequelae are seldom. They can be due to all inflammatory process, thoracic trauma, tuberculosis and viral diseases are predominant. Unexplained etiology represents 25% of cases, so "called autonomous pleuritis". Pleural eosinophilia could be explained by eosinophilotactic action of red cells or by activating products induced during hypersensibility reaction.

[Spontaneous pneumothorax in women]. / Le pneumothorax spontané chez la femme

Among cases of spontaneous pneumothorax, female cases are extremely rare. They represent only about 10% of observed cases and form a special clinical type. The authors discuss 20 cases out of a total of 261 cases of pneumothorax observed over a period of 7 years. A certain number of facts were noted which distinguished the female forms from the male forms of this disease. Although there is no difference in the symptoms, the disease tends to occur later in women, in the fourth decade of life, and only three of the 20 cases in this series were idiopathic. On the other hand, among the secondary cases, the frequency of E.N.T. or respiratory disease is remarkable for it concerned 75% of cases. None of the cases observed responded to the usual criteria of menstrual pneumothorax although seven occurred during the menstrual period. However the forms which relapse during the periods should lead to a search for pelvic endometriosis. Finally the proportion of rib malformations is not negligible. These facts emphasise that pneumothorax in women, contrary to men, appears much more as a complication of another disease than as an autonomous pleural disease.