[Transthoracic puncture and excavated pulmonary lesion. Diagnostic contribution and value of the extemporaneous cytologic test]. / Ponction transthoracique et lésion pulmonaire excavée. Apport diagnostique et intérêt de l'examen cytologique extemporané.

Twenty-six cases of excavated pulmonary masses are reported. In 18 cases malignancy was proven by transparietal needle aspiration. A false-negative result was due to the needle being introduced too centrally and bringing pus, whereas the tumour was an epidermoid carcinoma. The seven non-malignant lesions consisted of abscess in 4 cases, tuberculosis in 1 case and pulmonary embolism in 2 cases. The sensitivity and specificity of the technique were similar to those observed in large series of transparietal needle aspiration of solid masses. Using thin needles and extemporaneous cytology reduced the number of complications: haemothorax 6 percent, haemoptysis 0.4 percent. The authors conclude that in excavated pulmonary masses transparietal needle aspiration provides a diagnosis of malignancy when the radiological and clinical courses and bronchial fibroscopy are inconclusive. Transparietal needle aspiration avoids the need for other investigations, such as exploratory thoracotomy, thereby reducing the cost of diagnosis.

[Transparietal pulmonary puncture in the diagnosis of excavated pulmonary masses. Apropos of 18 cases]. / Apport de la ponction pulmonaire transpariétale au diagnostic des masses pulmonaires excavées. A propos de 18 cas.

The aetiological diagnosis of excavated pulmonary opacities is sometimes uneasy, hovering between squamous cell carcinoma and abscess. Normal results at bronchoscopy and two weeks of antibiotic therapy do not always provide a definite answer. The authors report 18 cases of such excavated masses and conclude that transparietal needle aspiration can establish the diagnosis provided some technical procedures are followed and the samples obtained are examined by skilled cytologists.

[Pleuropulmonary localizations of non-typhoid Salmonella infections]. / Localisations pleuro-pulmonaires des salmonelloses non typhoïdiques.

Non-typhoid salmonella infections are extremely common, usually taking the form of a benign toxi-infection. In the context of the rare extra-digestive manifestations, the authors report 3 cases of pleuro-pulmonary involvement, in infections due to Salmonella Dublin. In 2 cases, the organism was identified from blood cultures, whilst in the 3rd case it was isolated from pleural fluid. As with other extra-digestive sites, pleuro-pulmonary involvement is favored by underlying pathology, accounting for the grave nature of the problem (amongst the 3 cases, gastrectomy and acute myeloblastic leukemia in one case and obliterative arterial disease in another case). Non-typhoid salmonella infections are sensitive to Sulfamethoxazole-trimethoprim which diffuses well in the respiratory system. They are also sensitive to Amoxicillin and to Chloramphenicol.

[Acute cardiac liver following a pulmonary embolism. Apropos of 2 cases]. / Foie cardiaque aigu secondaire à une embolie pulmonaire. A propos de 2 cas.

The authors report 2 cases of acute hepatic failure secondary to a pulmonary embolism, the [atypical] symptomatology of which considerably interfered with diagnosis. A review of the literature confirms the rarity of embolic pathology as causing acute cardiac liver. The authors emphasize the importance of echotomography (cardiac and abdominal) in seeking dilatation of the right heart cavities, as well as of the inferior vena cava and hepatic veins.