[The occurrence of Churg-Strauss syndrome in two patients with remitted asthma].

We report two patients with Churg-Strauss syndrome (CSS) which occurred on the remission stage of bronchial asthma. Case 1 of a 64-year-old woman suffered from asthma in June, 1997, and got relief with treatment. In February, 1998, dysesthesia, pain and severe muscle weakness occurred in the extremities and erythematous rashes appeared on the extremities and back. She was transferred to our hospital on March 3. Peripheral blood eosinophilia was observed and a diagnosis of CSS was made. Eosinophilic tissue infiltration and vasculitis was found in the skin biopsy specimen. She was treated with prednisolone (60 mg/day) with moderate improvement. But the dysesthesia in the extremities, bilateral foot drop and the weakness of the left hand grasping power continued. Case 2 of a 62-year-old woman suffered from asthma in 1995, which improved by treatment. In March 1998, dysesthesia and pain in the lower extremities occurred and progressed. Erythematous rashes appeared on the feet and she was admitted to our hospital in May. Peripheral blood eosinophilia and eosinophilic tissue infiltration in the skin biopsy specimen were observed and a diagnosis of CSS was made. The treatment with prednisolone (60 mg/day) improved the pain but the dysesthesia continued. It is important to know the occurrence of CSS on the remission stage of bronchial asthma.

[Bronchocutaneous fistula after treatment for breast cancer: a case report].

We describe a case of bronchocutaneous fistula that developed after surgery and radiotherapy for breast cancer. A 69-year-old woman presented with fever and the leakage, on expiration, of bubbles from a site on the left chest wall where a Halsted mastectomy and radiotherapy (60 Gy) had been performed 19 years earlier. Computed tomography and magnetic resonance imaging revealed a fistula bridging a bronchus and the skin. Repeated biopsies of the fistula failed to disclose any malignancy. The fistula closed after treatment with antibiotics, and has remained closed for 9 months, as disclosed by identical tomographic images. The paucity of literature describing the diagnostic imaging of bronchocutaneous fistula prompted this report.

[A patient operated for occlusion of the superior mesenteric artery].

A 40-year-old woman presented with fever, dysarthria, and left hemiparesis. Diagnostic imaging detected an infarction in the right cerebrum; lupus anticoagulant was positive. A T4N3M0 adenocarcinoma coexisted in the left lung, which was irradiated once. Two days later, the superior mesenteric artery was occluded. The bowel was widely resected but she died of hepatic infarction. The lung cancer may have triggered catastrophic antiphospholipid syndrome.

[Non-small cell lung cancer metastatic to the stomach and the jejunum causing intussusception: a case report].

We report a case of lung cancer metastatic to the stomach and the jejunum. Adenocarcinoma of the lingula (T 4 N 2 M 0) was diagnosed in a 45-year-old man, who then underwent chemoradiotherapy. Bowel obstruction later developed due to jejunal metastasis. Another metastasis was detected in the stomach. Laparotomy revealed jejuno-jejuno-jejunal intussusception caused by the two lesions. The jejunal and gastric lesions were identified as metastatic large cell carcinoma arising from the lung. One month postoperatively, the patient died due to disease. The literature has demonstrated that large cell carcinoma of the lung tends to metastasizes. However, the complex bowel invagination and gastric metastasis seen in our case are rare.