Severe pulmonary arterial hypertension as initial manifestation of intravascular lymphoma: case report.

Intravascular lymphoma (IVL) is a rare and usually fatal disease that belongs to the class of high-grade malignant lymphomas and which is characterized by proliferation of neoplastic lymphoid cells exclusively within the lumina of small blood vessels. Its polymorphic and nonspecific clinical manifestations make antemortem diagnosis very difficult. We report herein a case of IVL revealed by fatal, precapillary, pulmonary arterial hypertension and associated with long-lasting fever.

Tricuspid aseptic endocarditis revealing right endomyocardial fibrosis during an unrecognized Behçet's disease. A case report.

Introduction: Aseptic endocarditis or/and endomyocardial fibrosis are rarely reported in Behçet's disease.

Observation: We report on a case of a 21-year-old man living in Algeria, revealed by verrucous tricuspid valvulitis extending to the ventricular endomyocardium and complicated with right heart failure, initially misdiagnosed and treated as infective endocarditis occurring on rheumatic cardiac after-effects. DISCUSSION; We discuss the lack of specificity of Jones criteria and emphasize the need to include cardiac involvement in Behçet's disease in the differential diagnosis of rheumatic fever carditis.

[Pourfour du Petit syndrome: a rare aetiology of unilateral exophtalmos with mydriasis and lid retraction].

Introduction: Pourfour du Petit syndrome, rarely reported, is the opposite of Claude Bernard-Horner syndrome.

Exegeses: A 67 years old female is hospitalised for dysphagia, allowing the discovery of oesophagus carcinoma with mediastinal, pleural and costal extension. The discovery of left unilateral mydriasis associated with exophthalmos and eyelid retraction suggest Pourfour du Petit syndrome; this diagnosis is confirmed by CT-scan, finding pedicular lysis of high dorsal vertebras and intra-canalar tumoral extension.

[Crowned dens syndrome: three new cases].

Introduction: Crowned dens syndrome is due to a microcrystalline infringement (hydroxyapatite or calcium pyrophosphate) of the retro-odontoidal ligament of atlas, often leading to the erroneous diagnosis of meningitis or spondylitis. We report on three new cases diagnosed from 1996 to 1999.

Exegesis: The patients complained of cervicalgies, headaches or fever.

[What vasoactive agent should be chosen in rupture of esophageal varices in cirrhosis?].

Variceal esophageal bleeding is a frequent and severe complication of portal hypertension. Balloon compression was the standard therapy for many years. Currently, endoscopic hemostasis with sclerosis or ligation appears to be more effective but requires an experienced operator who is not always present at emergency situations.

[Acute cerebellar syndrome after treatment with 5-fluorouracil].

We report on a case of 5-fluorouracil induced neurotoxicity during 5-fluorouracil cisplatin combination chemotherapy for advanced head and neck squamous cell carcinoma. The initial manifestations included an acute cerebellar syndrome and peripheral neuropathy. Computed tomography of the brain was normal.

[Para-septal emphysema].

Paraseptal emphysema is characterised by a sub-pleural distribution of the lesions along the interlobular septa. It is most often clinically silent and chest radiography is neither sensitive nor specific. Pulmonary function tests are normal or show simple bronchial obstruction.

Raynaud's phenomenon in chain saw users. Hot and cold finger systolic pressures and nailfold capillary findings.

To gain insight into the physiopathology of Raynaud's phenomenon of occupational origin, finger systolic pressures under heat and cold, and results of nailfold capillary microscopy, were examined in 29 lumberjacks with Raynaud's phenomenon vibration syndrome (pathological group) and 24 lumberjacks without it (non-pathological group), and compared with the same values in 26 healthy matched manual workers not using a vibrating tool (controls). Vibration syndrome physiopathology seemed multifactorial, combining 5 features: a rise in brachial diastolic and systolic pressures in the pathological group compared with the two other groups. In lumberjacks with Raynaud's phenomenon, these rises seemed to be acquired, since they were not found when the workers were engaged; a reduction in the number of nailfold capillaries (9.

[Raynaud's syndrome, Dupuytren's disease, force of prehension and sensitivity of the hand. Study of age-related changes].

The prevalence of Raynaud's syndrome, of arterial calcifications and of Dupuytren's contracture was studied in 155 subjects of both sexes, decade by decade from 20 to 90 years. Moreover the force of prehension and two-point discrimination were measured separately. The prevalence of Raynaud's syndrome was 9% independent of variations in age or of sex.

[Several aspects of osteoarticular aging of the hand].

The articular amplitudes (abduction of the thumb, flexion/extension of the digital joints), arthritic localizations and the mineralization of the bones of the hand were studied in 155 subjects of both genders and classified by decades from 20 to 90 or more years old. There was a significant decrease in articular amplitudes with age and a considerable increase of arthritis especially after 70 years. Arthritic changes were seen most frequently in the distal interphalangeal joints, then with an equal prevalence, arthritis was encountered in the metacarpophalangeal and in the proximal interphalangeal joints.

[Tuberculosis in the immunodepressed patient].

Tuberculosis is one of the opportunist infections which may complicate the course of many immunodepressive conditions generally those affecting cell-mediated immunity as the Koch bacillus is an organism which develops intracellularly provoking the activation of the cellular type of defence reaction. Recently, patients with malignant disease and immunosuppressive therapy have been joined by those with the acquired immunodepressive syndrome. It is important to understand that the frequency of tuberculosis in immunodepression is a reflection of the frequency of the disease in the general population.

[Raynaud's syndrome in lumberjacks using chain saws. Epidemiology, clinical and capillaroscopic findings].

The overall incidence of Raynaud's syndrome in lumberjacks using a mechanic chain saw in France is at least 45%; workers exposed to the risk for more than 3 years have an incidence of about 60%. Vibrations are probably directly responsible for the disease, while among the other favorizing factors the different winter climatic conditions do not appear to be relevant, and this is the case with conventional vascular risk factors, apart perhaps for hypertension. A history of injury to hands is significantly more frequent in affected subjects possibly related to a relative digital cutaneous hypo-esthesia.

[Sarcoidosis of the hand].

A case of a tumor-like lesion (pseudotumor) of sarcoidosis is reported. It was a recurrence of a soft tissue tumor in the hand. Diagnosis was made by pathological examination and led to the detection of the general disease.

[Endobronchial non-Hodgkin's lymphoma].

The authors report a case of endobronchial non-Hodgkin lymphoma, in a 48-year-old woman. This is an exceptional localization. When it reveals the disease, as was the case in the index patient, clinical presentation is usually atelectasis with fever.