[A case of multifocal cavernous haemangiomas of the lung, spleen and bone]. / Hémangiomatose multifocale bronchique, ganglionnaire, splénique et osseuse.

INTRODUCTION: Haemangiomas are vascular malformations, frequently cutaneous, hepatic and splenic. Respiratory involvement and multiple localisations are uncommon. CASE REPORT: We present a rare case of multiple cavernous haemangiomas in a 35 year old woman presenting with repeated haemoptysis. Thoracic CT scanning showed a mass in the left lower lobe associated with lymph node enlargement above and below the diaphragm, heterogeneous splenomegaly and a single spinal lesion without hypermetabolism on PET scanning. Enbronchial ultrasound-guided trans-bronchial needle aspiration was not contributory. Histopathological diagnostic was made firstly by splenectomy with lumbar-aortic curettage and then by lobectomy for haemostasis. A final diagnosis of multiple cavernous haemangiomas involving lung, lymph nodes, spleen and bone was made. CONCLUSIONS: Bronchopulmonary cavernous haemangiomas associated with extra-thoracic lesions are exceptionally rare and their presentation, suggesting, a malignant cause, often leads to surgical resection for diagnostic and, eventually, therapeutic management. We report an original case of cavernous haemangiomas involving lung, lymph nodes, spleen and bone.

[Post-infectious autobullectomy]. / Autobullectomie post-infectieuse.

INTRODUCTION: Bullous emphysema is defined as an airspace of more than 10mm in diameter. The spontaneous regression or disappearance of a bulla is unusual, described as an "autobullectomy". CASE REPORT: We report the case of a 37-year-old man with a 10-pack/year history of smoking, a history of pneumothorax surgically treated in 2005, and emphysema with a bulla in the right upper lobe. In September 2010, the patient was hospitalized for a community-acquired pneumonia associated with an air-fluid level in the bulla. Clinical symptoms improved with a course of antibiotics (levofloxacin, ceftriaxone) for 3 weeks. Chest X-rays showed a progressive decrease in the size of the bulla. In June 2011, a chest CT scan showed complete regression of the bulla in the right upper lobe. CONCLUSIONS: We report the complete regression of a bulla after infection, leading to an "autobullectomy". It can be hypothesized that the mechanisms might involve fibrosis of the walls and/or the obstruction of the bronchus supplying the bulla.

[Bronchial atresia. A case report]. / Atrésie bronchique.

Bronchial atresia with mucocele and focal hyperinflation of the lung is a rare anomaly. We report the observation of a 12-year-old girl which presented a right hilar opacity on chest X-ray. The thoracic computed tomography identified an atretic segmental bronchus of the middle lobe with mucocele and focal hyperinflation of the lung. Bronchial endoscopy ruled out any acquired etiology of bronchial obstruction. The definitive diagnosis was bronchial atresia with mucocele and focal hyperinflation of the lung. This uncommon malformation is usually a radiological description. Eighty-four cases were collected in the main series in 1989. Nowadays, about 12 new cases have been published.

[A rare cause of hemoptysis]. / Une cause rare d'hémoptysie.

The existence of a bronchial foreign body is an unusual cause of haemoptysis. We observed a sixty two year-old women who presented several medium-abundance haemoptysis. They were associated with a systematic alveolar-interstitial radiological picture of the ventral upper right lobe. A right upper lobectomy showed that an old bronchial foreign body (piece of bone) was responsible for the systematic intra-alveolar bleeding. Though most of the breathed foreign bodies are expressed into immediate symptoms, some of them remained undiagnosed and may be responsible for haemoptysis, infectious complications, atelectasis and for bronchiectasis. Their extraction through endoscopy or most often surgery is necessary for a proper recovery. In spite of histopathological differences between foreign bodies, broncholithiasis and lung tumor the diagnosis may be difficult clinically and on radiology.