[Unusual presentation of pulmonary alveolar proteinosis]. / Lipoprotéinose alvéolaire pulmonaire de présentation inhabituelle.

Pulmonary alveolar proteinosis is a rare disease characterized by the accumulation of granular lipoproteinaceous material within the alveoli; the interstitium is preserved. We report the case of a 27-year-old patient hospitalized for exploration of asymptomatic bilateral interstitial syndrome. Neither the radiographic signs nor the aspect of bronchoalveolar lavage was typical. The diagnosis was confirmed by pathology examination of surgical lung biopsy specimen which revealed lesions of interstitial fibrosis and cholesterol granulomas in association with pulmonary alveolar proteinosis. Since there was no functional deterioration, therapeutic abstention was decided.

[Idiopathic pulmonary hemosiderosis in adults]. / Hémosidérose pulmonaire idiopathique de l'adulte.

Idiopathic pulmonary hemosiderosis (IPH) is a rare cause of diffuse alveolar hemorrhage characterized by abnormal deposition of hemosiderin iron in the macrophages of alveoli. Most cases occur in children. In adults, IPH is rare: almost 10 cases reported during the late 10 years. We report the case of a 20-year-old-girl with IPH. There was no evidence of pulmonary vasculitis or capillaritis. Long-term treatment with systemic corticosteroids was followed by clinical remission lasting 4 years.

[Radiological and clinical aspects of bronchogenic lung cysts: 4 case reports]. / Aspects radio-cliniques des kystes bronchogéniques pulmonaires. A propos de 4 cas.

Bronchogenic lung cysts are exceptional. We report four cases which raised a problem of differential diagnosis. Our patients included four women and a young boy (age range 12 - 36 years). The first patient consulted for bloody purulent sputum in a context of an infectious syndrome. The second patient had lower right-sided chest pain. The cyst was a fortuitous discovery in the other two cases. In one case, the chest x-ray disclosed a thin-walled cavity of the upper right lobe, confirmed on the CT scan which also evidenced intracavitary partitions. In two other cases, the chest x-ray showed a liquid-filled opacity (one in the lower right lobe and the other in the upper right lobe) and no further specificity on the CT scan. In the last case, a liquid-air cavity was evidenced. Upper right lobectomy was performed for the case with an air-filled cavity and tumorectomy for the other cases. Pathology reported bronchogenic cyst in all cases. The radiological and clinical presentations observed in patients with bronchogenic lung cysts, with or without tracheobronchial communication, are polymorphous, often raising problems of differential diagnosis.

[Hydatid pulmonary embolism. Two case reports]. / Embolies pulmonaires hydatiques. A propos de deux cas.

Hydatid pulmonary embolism is an uncommon condition resulting from the rupture of a hydatid heart cyst or the opening of a visceral hydatid cyst (often in the liver) into the venous circulation. We report two cases of hydatid pulmonary embolism following rupture of a hydatic cyst in the right ventricle. One case progressed to chronic cor pulmonale. We examine the pathophysiological mechanisms as well as the clinical, therapeutic and evolutive aspects.