[Pulmonary atinomycosis: a great clinical polymorphism]. / Actinomycose pulmonaire: un grand polymorphisme clinique.

BACKGROUND: Pulmonary actinomycosis is a rare bacteriological disease, caracterized by local suppuration and an extensive fibroinflammatory process, with a possible pseudotumoral outcome. AIM: To report a new observation of a pulmonary actinomycosis. CASE REPORT: A 52-year-old patient, smoker, admitted in our department for infectious pneumopathy complicated by purulent pleurisy. Clinical and radiological findings were not contributive.Fiberoptic had evocate the diagnosis of bronchopulmonary cancer. Evolution had been marqued by abondant hemoptysia indicating right low lobectomie. The diagnosis of actinomycosis was obtained by the pathology of the surgical resection. CONCLUSION: Diagnosis of pulmonary actinomycosis can be difficult because it can mimic the presentation of lung carcinoma.If the diagnosis is no late established, and if the patient is correctely treated medically, the prognosis still excellent.

[Neoplasic vena cava syndrome]. / Le syndrome cave supérieur néoplasique.

BACKGROUND: Vena cava superior syndrome results of an obstruction of superior vein cava(SVC)and/or brachiocaphalic venous troncs by extrinsic compression and/or by tumoral or cruoric thrombosis. The bronchopulmonary cancer represents the most frequent aetiology. AIM: The aim of this study is to establish clinical, radiological, evolutive profiles and modalities of treatment of neoplasic vena cava superior syndrome independently of its histological type. METHODS: It is a retrospective study about 20 patients presenting vena cava superior syndrome complicating primary bronchopulmonary cancer, hospitalised between January 2000 and December 2007 in Ibn Nafiss department in Abderrahmen Mami hospital. RESULTS: All patients were males with an average of 57,8 years. Vena cava superior syndrome had revealed cancer in 60% of cases. It was metachrone in 40% of the patients. The most frequent histological type was small cell lung cancer. Treatment was proceeded in 2 steps, symptomatic and etiologic for the bronchopulmonary cancer. CONCLUSION: The bronchopulmonary cancer is the most frequent aetiology of vena cava superior syndrome. Its treatment is actually well codified.

[Rare localization of sarcoma in an adolescent: thoracic Ewing sarcoma]. / Localisation rare du sarcome de l'enfant: sarcome d'Ewing thoracique.

BACKGROUND: Ewing Sarcoma is considered as primitive neuro ectodermic tumor. It's the most frequent osseous tumor in children and adolescent. It was localised frequently at long osseous and pelvis, however, it can be arising from the rib. AIM: this article aimed to show that Ewing sarcome could arise twely from thorax. CASE REPORT: We report the case of 15-year-old girl, admitted in our hospital because of left scapular pain with important weight loss. Chest X ray showed dense left latero tracheal opacity with mediastinal limits. Bronchofiberoscopy was performed and it showed no abnormalities. Thoracic CT scan and MRI noted left posteroir expansif mediastinal process infiltrating D2, D3 and homolateral conjugation's canal. This process was associated at vertebral metastasis in D1, D4 and D8.Rapid clinical aggravation, with installation for medullar compression was noted. The patient had benefit for three cures of decompress radiotherapy and treated by laminectomy of dorsal vertebras in neurosurgery department. Morphologic aspects and immunohistochimical study for the operator piece concluded at Ewing sarcoma of the children considered as primitive neuro ectodermic tumor. Six cures of chemotherapy had been prescribed with well recuperation of the motor failure. She still on life since 7 months. CONCLUSION: Even rare, thoracic localisation of Ewing sarcoma in not exceptional, it is necessary to evocate it in front of mediastinal mass.