[Endobronchial metastases of rectal adenocarcinoma].

Introduction: Diagnosis of endobronchial metastases is facilitated by immunolabeling techniques on bronchial biopsy samples.

Case: Endobronchial tumors appeared in a 70-year-old woman with an adenocarcinoma of the crypts of Lieberkuhn, diagnosed two years previously. Immunohistochemical examinations made it possible to diagnose endobronchial metastases of the rectal adenocarcinoma.

[Accelerated atheroma with prednisone and clopidogrel].

Introduction: Several mechanisms may explain the aggravation of atheroma lesions in patients receiving corticosteroid treatments.

Case: This 68-year-old man, a smoker with high cholesterol levels and a history of two transient ischemic attacks, also had severe Horton disease (giant cell arteritis) requiring treatment by corticosteroids and azathioprine. After a new transient ischemic accident, clopidogrel treatment was initiated.

Acute meningitis owing to phlebotomus fever Toscana virus imported to France.

Acute lymphocytic meningitis, seen in France in summer, is often due to enteroviruses. Arboviruses as West Nile and tick-borne encephalitis do exist in Europe, but other viruses are rarely considered in patients unless they have had recent tropical travel. Toscana virus infection, which is endemic, especially in Italy,1-3 has been documented in some European travelers returning from Italy,4-6 but surprisingly was not documented in France until recently.

[Rofecoxib-related cutaneous vasculitis].

Introduction: Drugs are at the origin of around 10% of the cases of vasculitis involving the small vessels. Recent cases report vasculitis related to the administration of nonsteroidal antiinflammatory selective inhibitors of cyclo-oxygenase 2.

Case: Vasculitis associated with ketoprofen appeared in a 76 year-old man: the symptoms disappeared when treatment stopped.

[Langerhans cell histiocytosis in an adult patient associated with sclerosing cholangitis and cerebellar atrophy].

Langerhans' cell histiocytosis is a disorder in children or young adults, characterized by clonal proliferation of histiocytic cells, staining for CD1a, with uni or multifocal organ involvement. It's a rare condition in adults. We report a case of Langerhans' cell histiocytosis in an adult with sclerosing cholangitis which rapidly progressed to fatal liver failure and progressive cerebellar atrophy.

[Right diverticular colitis revealing an Ehlers-Danlos syndrome].

Introduction: Colic diverticulosis rarely occurs in the young and, in such cases, therefore requires search for a predisposing affection.

Observation: A 25 year-old woman was hospitalised for abdominal pain and fever predominating in the right iliac fossa and leading to the diagnosis of right diverticular colitis. The clinical examination revealed features suggestive of an Ehlers-Danlos syndrome.

[Upper mesenteric venous thrombosis revealing familial resistance to activated protein C].

Introduction: Mesenteric venous thrombosis is a rare disease but potentially severe because of the prognosis of intestinal infarction with high mortality rate (60%).

Observation: We report the case of a 55 year-old man who presented with an upper mesenteric venous thrombosis related to a familial resistance to C reactive protein through factor V Leiden mutation.

Comments: The discovery of a mesenteric venous thrombosis requires aetiological research that is usually multifactorial.