[Familial cancer of the colon without polyposis and the familial cancer syndrome. Apropos of 2 cases over 3 generations]. / Cancer familial du côlon sans polypose et syndrome familial de cancer. A propos de deux observations portant sur trois générations.

Two cancer-prone families are reported. In the first one four first-degree relatives over three generations presented a colonic carcinoma, three of them at a proximal anatomic site. For grandmother and father these occurred at ages of 43 and 54 years, respectively, for the son and the daughter at ages of 26 and 22. The grandmother underwent a palliative ileotransversostomy, surgery typically associated with a bad prognosis, but she survived for forty years that initial neoplasm and had an hysterectomy with oophorectomy at age of 63 for endometrial malignancy; she deceased at age of 83 a few days after surgical treatment of tumoral small bowel obstruction: pathological evaluation disclosed a fourth cancer on first duodenum. The second kindred shows over three generations 11 cancer-affected individuals, three of them with double primary cancer: breast and sigmoid, breast and endometrium, colon and Hodgkin disease. This pedigree includes 8 colorectal neoplasms occurring at 47 years of mean age. These findings are consistent with the cancer-family syndrome and hereditary non-polyposis colon cancer described by Henry Lynch upon four criteria: high frequency of adenocarcinoma, excess of multiple primary malignancies, synchronous or metachronous, early age of onset of cancer and autosomal dominant inheritance. Moreover the hereditary colon cancer is usually localised to the proximal colon, not associated to polyposis coli and allows a prolonged survival. Up to day such families are only identified by pedigree data. The identification of a cancer-prone family calls for an active follow-up of relatives putatively at risk starting at the age of 15 to 20.

[Autochthonous Plasmodium falciparum malaria and the malarial liver]. / Paludisme autochtone a Plasmodium falciparum et foie palustre.

When P. falciparum malaria is diagnosed in France in a patient who has not travelled to an endemic area, transmission by blood transfusion or direct contact with an infected person, and indigenous malaria should be considered. With reference to the observation reported in this paper, the manifestations of malarial hepatitis are recalled and their diagnostic significance is discussed. In P. falciparum malaria, malarial hepatitis indicates the development of a complete cycle including the pre-erythrocytic phase; this is strongly in support of indigenous malaria, and against malaria following blood transfusion or direct contact in which there is no pre-erythrocytic phase.

[Fulminating pneumococcal septicemia (author's transl)]. / La septicémie fulminante à pneumocoque.

Two cases of fulminating pneumococcal septicemia (FSP) are reported, and 47 confirmed cases were discovered after a review of the published literature. The syndrome is that of a malignant infection with fever, collapse, and disseminated intravascular coagulation, with a rapid mortal outcome in most cases. Etiologically, FSP is usually the consequence of functional or anatomical asplenia, and the relative frequency of this affection after splenectomy following trauma confirms this observation. Lack of a splenic filter and a deficiency in the phagocytic system are the reasons for microbial proliferation in the blood, and the lymphocytic defence mechanisms are inactive because of the absence of any focus of infection.