[Thoracic endometriosis complicated with pneumopericard and iterative pneumothorax due to bullous dystrophy]. / Endométriose thoracique compliquée de pneumopéricarde et pneumothorax itératifs sur dystrophie bulleuse.

Thoracic endometriosis is a rare entity characterized by presence of endometrial tissue in pleura, lung parenchyma or airways. Most frequent manifestations are catamenial pneumothorax, hemothorax, hemoptysis and pulmonary nodules. We report here a rare case of a woman with thoracic endometriosis who developed iterative pneumothorax and pneumopericardium on bilateral bullous pulmonary dystrophy. She was a 37-year-old woman without any tobacco exposure and with previous history of pleural tuberculosis treated 5 years earlier. She was first referred to our centre for right pleuro-pneumothorax and hemorrhagic ascites. Pleural fluid examinations did not show any tuberculosis relapse, the evolution was favorable after thoracic drainage and there was no parenchymal lung abnormality on CT scan after surgery. Celioscopic peritoneal examination revealed stage IV peritoneal endometriosis. One year later, she was admitted for left catamenial pneumothorax. Thoracic CT scan showed apparition of large subpleural bulla. She underwent thoracotomy for bulla resection and left partial pleurectomy. Two years later, she was hospitalized for right pneumothorax and compressive pneumopericardium. Surgical lung biopsies confirmed pleuropulmonary endometriosis. Thoracotomy was performed for talcage pleurodesis and diaphragmatic leakages sutures. Lung bulla are rare in thoracic endometriosis, mechanism of their formation remains unknown. Pericardial involvement is rare in endometriosis; we report here a unique case of pneumopericardium.

[Severe pulmonary embolism revealed by status epilepticus]. / Embolie pulmonaire révélée par un état de mal épileptique.

INTRODUCTION: High-risk pulmonary embolism (PE) is associated with high mortality rate (>50%). In some cases, diagnosis of PE remains a challenge with atypical presentations like in this case report with a PE revealed by status epilepticus. CASE REPORT: We report the case of a 40-year-old man without prior disease, hospitalized in ICU for status epilepticus. All paraclinical examinations at admission did not show any significant abnormalities (laboratory tests, cardiologic and neurological investigations). On day 1, he presented a sudden circulatory collapse and echocardiography showed right intra-auricular thrombus. He was treated by thrombolysis and arteriovenous extracorporeal membrane oxygenation. After stabilization, computed tomography showed severe bilateral PE. He developed multi-organ failure and died 4days after admission. CONCLUSIONS: Pulmonary embolism revealed by status epilepticus has rarely been reported and is associated with poor prognosis. Physicians should be aware and think of the possibility of PE in patients with status epilepticus without any history or risk factors of seizure and normal neurological investigations.

[Pulmonary MALT lymphoma and paraneoplastic syndromes]. / Lymphome du MALT pulmonaire et syndromes paranéoplasiques.

INTRODUCTION: Primary pulmonary lymphoma is a rare disease; diagnosis is often delayed because of atypical clinical presentation and slow progression. OBSERVATION: A 42-year-old woman consulted because of haemoptysis. Chest CT-scan showed multiple nodular calcified masses. A lung biopsy led to the diagnosis of pulmonary amyloidosis with pulmonary MALT lymphoma (mucosa-associated lymphoid tissue). The patient developed two paraneoplastic syndromes: a hypertrophic osteoarthropathy and mucinosis. CONCLUSION: Multiple nodular amyloidosis can be a mode of presentation for pulmonary lymphoma. Paraneoplastic syndromes must be systematically considered and can help in early diagnosis of the disease and its relapse.

[Massive haemoptysis revealing bilateral sequestration in an adult: 3-year follow-up after embolization and surgery]. / Hémoptysie massive révélatrice de séquestration pulmonaire bilatérale chez un adulte : évolution à 3ans après embolisation et chirurgie.

Pulmonary sequestration is a rare vascular malformation which is most of the time unilateral. We report here the case of a 35-year-old male admitted for severe haemoptysis revealing bilateral pulmonary sequestration: one type 1 of Pryce in the right lower lobe and one type 2 of Pryce in the left lower lobe. Bilateral embolization was performed followed by a segmental resection of the left lower lobe sequestration by thoracotomy. After 3-year follow-up, the patient was asymptomatic and had no recurrence of haemoptysis. Enhanced computed tomography scan showed proximal occlusion of the right lower lobe sequestration systemic artery.