Epiglottis involvement in a visceral leishmaniasis.

The visceral form of leishmaniasis caused by Leishmania infantum is frequently observed in Mediterranean countries, however otorhinolaryngeal involvement has only rarely been reported in the literature. We report here the case of a 23-year-old Cameroon man, resident in France since 1991, and presenting with recurrent epistaxis and an epiglottis tumoral lesion. The visceral form of leishmaniasis with hepatosplenomegaly and pancytopenia was diagnosed. Culture of the epiglottal lesion revealed L. infantum. Serological test for human immunodeficiency virus was negative and the patient was not on immunosuppressive drugs. Dramatic improvement was observed with antimony.

Lymphomatoid papulosis associated with both severe hypereosinophilic syndrome and CD30 positive large T-cell lymphoma.

BACKGROUND: Previous reports have found an association between lymphomatoid papulosis and hypereosinophilic syndrome, as well as lymphomatoid papulosis and lymphoma. In the current study the authors report what to their knowledge is the first reported case of these three diseases occurring simultaneously in the same patient. METHODS: The authors followed the clinical course of a 64-year-old man with lymphomatoid papulosis associated with severe hypereosinophilic syndrome complicated by involvement of the lungs and heart. RESULTS: After 6 years of follow-up, the patient developped a large T-cell, CD30 positive lymphoma. The bone marrow biopsy was typical of hypereosinophilic syndrome associated with fibrosis, with focal lymphomatous infiltrates comprised of large cells resembling the type A cells of lymphomatoid papulosis. Complete remission of the lymphoma was obtained with chemotherapy. CONCLUSIONS: This exceptional case report suggests a link between the three diseases. Lymphomatoid papulosis belongs to the spectrum of CD30 positive lymphoproliferative disorders and CD30 positive lymphocytes of lymphomatoid papulosis are known to have a Th2 profile with possible secretion of eosinopoietic cytokines.

[Multiple and bilateral nodular opacities revealing primary pulmonary lymphoma of the Burkitt-like type in AIDS]. / Opacités nodulaires multiples et bilatérales révélatrices d'un lymphome pulmonaire primitif de type Burkitt-like au cours du SIDA.

We report the observation of AIDS patient with a history of cough, dyspnea, fever, cachexia and bilateral nodular opacities at the chest X-ray. Infectious etiologies were initially suspected but the recovery was not obtained with their treatment. Only lung biopsy established the precise diagnosis of primary pulmonary Burkitt's-like lymphoma (BBL). The sole extranodal site of BBL at the lungs is an unusual finding. Generally, this lymphomatous proliferation is observed at the early period of the HIV infection. Immunodepression and Epstein-Barr virus (EBV) infection are the major pathogenic basis for BL as indicated by the high prevalence of EBV genomes found in malignant cells. The lack of EBV sequences in a significant proportion of Burkitt's lymphoma or BBL and AIDS-associated non-Hodgkin malignant lymphoma suggest that alternative pathogenic mechanisms may be involved. This observation permit to show the difficulties observed before the multiple and bilateral opacities whom the etiologies are varied. The prognosis of AIDS-associated BLL is very severe.

Unusual chromosome abnormalities in primary central nervous system lymphoma.

Primary central nervous system (PCNS) lymphoma is a relatively rare disease. The Epstein-Barr virus (EBV) has often been implicated in the development of lymphomas. Few cytogenetic. studies on PCNS lymphomas have been reported. We describe here an unusual case of PCNS B cell lymphoma, centroblastic polymorphic type without coexistent immune deficiency. The cytogenetic study showed unusual abnormalities: t(l;9) (q25;p21); del (6) (q14 q25), trisomy 12 and in addition one clone with trisomy 7 and loss of chromosome X. We did not observe any chromosome 14 abnormality, which is more commonly reported in PCNS lymphomas.