[Peripheral subpleural intrapulmonary lymph nodes. Apropos of a clinical case and an anatomical case]. / Ganglions intrapulmonaires périphériques sous-pleuraux. A propos d'une observation clinique et d'un cas anatomique.

The authors report the case of a round, peripheral radiographic opacity ("coin lesion" of English-language authors) which after surgical excision was found to be an intrapulmonary lymph node. In an anatomical study on the lymphatic drainage of pulmonary segments in adults, a similar lesion was found among 483 injected segments. A review of the literature yielded 27 similar cases which are described in detail. These lymph nodes are probably more frequent than is generally believed, as shown by an experimental radiolymphographic study. Such clinical findings will no doubt be rendered more numerous by the improved sensitivity of new medical imaging techniques. Despite hypotheses put forward by the authors, the presence of these lymph nodes, which seem to be acquired by the adult lung, has not yet been explained.

[Staged bronchial biopsies in the preoperative evaluation of primary bronchial cancer]. / Les biopsies bronchiques etagées dans le bilan pré-opératoire du cancer bronchique primitif.

The systematic biopsying of the carina overlying a tumour, the main carina and of a contralateral carina was made a part of the work up in some patients with bronchial carcinoma, to assess operability. Different studies show that despite a normal macroscopic appearance these biopsies often reveal sub-mucous invasion. This microscopic extension might modify the resection planned, and even end in inoperability in the case of tracheal or contralateral tracheal invasion. We have studied the notes of 110 patients with primary bronchial carcinoma who have had systematic biopsies. All had a normal endoscopic appearance in the carinas biopsied and none revealed invasion by tumour. Of 110 patients, 37 had operations. In 1/3 (13/37) there was a discordance between the pre-operative bronchoscopic assessment and the local extension at thoracotomy, since 7 patients were subjected to a more extensive dissection than planned, 4 were exploratory thoracotomies only and in 4 the bronchial stumps were found to be invaded. Thus negative biopsies of healthy carinas overlying a tumour have proved to be false security and did not allow us to confirm the absence of tumour extension at peri-bronchial level in the local lymph nodes or in the mediastinum.

[Topographic diagnosis of urinary infection by determination of fraction 5 of lactate dehydrogenase]. / Diagnostic topographique de l'infection urinaire par dosage de la fraction 5 de la lactico-déshydrogénase.

Amongst the various methods suggested for the topographical diagnosis of urinary tract infection, the study of various fractions of lactico-dehydrogenase in the urine would appear to be particularly valuable. Study of 44 subjects with a significant urinary infection, compared with an identical group of subjects free of urinary infection, showed that in those with pyelonephritis fraction 5 was significantly (p less than 0.001) higher than in those with a lower urinary tract infection. However this was valid only in the absence of renal insufficiency. Combined study of immunological techniques (urinary antibodies revealed by immunofluorescence and serum antibodies) shows that these techniques are complementary and make it possible to exactly localise the site of a urinary tract infection. In relation to immunology, enzymology has the advantage of being suitable for use during periods at which bacteriological examination of the urine is negative, and hence is useful in following the influence of treatment.