[Idiopathic chylothorax: usefulness of aetiologic survey and the follow-up]. / Chylothorax spontané idiopathique: intérêt de l'enquête étiologique et du suivi.

Chylothorax is an uncommon condition. It's characterized by the presence of chyle in the pleura. The most common causes are malignancy and trauma. When an underlying cause is excluded, the chylothorax is called idiopathic. We report a case of a 68 aged woman, admitted for abundant chylothorax. Thoraco-abdominal computed tomography, magnetic resonance imaging of the chest and thoracotomy showed no lesion of the lymphatic duct. Fibrothorax has developed after pleurodesis. Stable clinical and radiological condition was noticed during 3 years. We discuss the difficulty in the exclusion of a malignancy and the necessity of the follow up for these patients.

[Acquired isolated factor VII deficiency and bronchogenic carcinoma. A case report]. / Deficit acquis, isole en facteur VII et cancer bronchique. A propos d'un cas.

An acquired factor VII deficiency was identified in a 63-year-old man with bronchogenic carcinoma. Initial studies indicated a normal activated partial thromboplastin time and a prolonged prothrombin time. The factor VII level was 6%. No evidence of a factor VII inhibitor or inactivator was demonstrable. However, on account of the initial normal laboratory test of emostases, the partial correction of the prothrombin time with 50% normal plasma in vitro and the family history, the congenital deficiency in factor VII was ruled out. Whatever the mechanism involved, this factor VII deficiency was related to malignancy.

[An unusual lesion of the mediastinum: angiomatosis or diffuse hemangioma]. / A propos d'une lésion inhabituelle du médiastin: l'angiomatose ou hémangiome diffus.

Angiomatosis are rare benign vascular lesions representing almost 4% of vascular tumours in children and adolescent. These lesions occur in soft tissue and are clinically extensive, covering large parts of the body in a continuous pattern. Limbs are classically involved. The incidence is high in childhood and adolescence. The authors report an original case of angiomatosis or diffuse haemangioma located in the anterosuperior part of the mediastinum in a 17 year old girl. The patient consulted for increasing dyspnoea starting two years earlier. At medical imaging, calcified tumoral mass measuring 60 mm situated in the anterosuperior mediastinum was objectivated. The mass did not involve bony nor chondral structure. Teratoma or thymoma was suspected. At operation the whole tumor was resected with adherent pericardium. At histological examination, the lesion showed the presence of vascular structures inside fibro muscular and fatty tissue mixed with multiple nerve sections. In the lesion, venous walls were remarkably thick and sometimes picked or surrounded by multiple micro vessels. A Hamartomatous or proliferative origin may be discussed. The multiple components supports a hamartomatous origin, especially because of the unexpected presence of nervous elements. A proliferative process trapping preexisting vascular and nervous elements may be also considered. Furthermore, the lesion may represent a diffuse mesenchymatous proliferation as suggested by the presence of adipose tissue or glomic cells. Additional studies based on cytogenetics could surely improve the understanding of this lesion.

[Acral acanthosis nigricans paraneoplastic: about one case]. / Acanthosis nigricans acral paranéoplasique: à propos d'un cas.

The paraneoplastic acanthosis nigricans occurs in association with visceral neoplasms. We report a case of acanthosis nigricans that seat at a dorsal face of the second, third and fourth right toe of a 63 year-old patient. The exploration has been put in evidence a carcinoma of the right lung. The acanthosis nigricans has been nearly disappeared after resection of the pulmonary lobe. The relapses of the acanthosis nigricans in a same sit after five years has been reveal a carcinoma of the bladder. The resection of the bladder tumour has been followed by disappearance of the acanthosis nigricans.

Calcifying fibrous pseudotumor of the pleura: a rare location.

Calcifying fibrous pseudotumor is a rare lesion recently reported in the literature. We report a new case occurring in the pleura, which is an unusual location. The patient, a 38-year-old woman, had a left pleural mass revealed by chest roentgenograms. The tumor was resected by video-assisted thoracotomy. Only 26 cases have been reported in the literature to date, but only 4 cases have been reported in the pleura. The pathogenesis is discussed but remains uncertain. Tumor resection appears to be the best option and the clinical course is benign. However, the number of cases to date is insufficient to establish therapeutic recommendations.

Pulmonary hydatid and other lung parasitic infections.

The lung may be infested by a great number of parasites. Hydatidosis is the most frequent parasitic lung disease. Diagnosis of lung hydatidosis is usually easy on chest radiography, ultrasonography, and CT scan, and immunodiagnosis may help in dubious cases. Surgery is necessary in most cases, but it must be conservative. Complex forms, such as disseminated disease and secondary lung hydatidosis (metastatic or bronchogenic) are difficult to treat and may be considered malignant. Medical treatment may be helpful in complex forms, in poor surgical risk patients, and in cases of preoperative spillage of hydatic fluid. Prevention programs are necessary in endemic areas, and research must be directed toward vaccination against the parasite. Other parasitic diseases are reported less frequently in the literature, and the majority of published articles are either case reports or only report a small number of cases. Clinical presentation is variable according to the great variety of parasites that may involve the lungs.