[Performances of the Amplified Mycobacterium Tuberculosis Direct Test in non respiratory specimens (study about 1538 samples)]. / Performances du test "Amplified Mycobacterium Tuberculosis Direct Test" sur les échantillons extrarespiratoires (étude sur 1538 échantillons).

From March 1998 to August 2009, 1538 non-respiratory samples collected from 1182 patients, were tested using the Gen-Probe Amplified Mycobacterium Direct Test™ (AMTD). After decontamination procedure, every sample was tested by AMTD and by culture on solid and liquid media. The "Gold-standard" was considered by the combination of culture results and clinical diagnosis. Tuberculosis was present in 17,59 % (208 patients). For theses 1538 non-respiratory samples (225 culture positive samples, 248 AMTD positive), 279 corresponded to tuberculosis. After resolving the discordant results, the sensitivity, specificity, positive and negative values were 89, 99, 99,6 and 97,3 %.

[Evaluation of the SD BIOLINE TB Ag MPT64 Rapid® for the diagnosis of tuberculosis]. / Évaluation du kit SD BIOLINE TB Ag MPT64 Rapid® dans le cadre du diagnostic de la tuberculose.

The purpose of this study was to evaluate the SD Bioline Ag MPT64 Rapid(®) for identification of the Mycobacterium tuberculosis complex. The method uses an immunochromatographic assay and needs 100 µl of sample taken from liquid culture or colonies suspended. The sensitivity was determined using 99 strains of M. tuberculosis complex and the specificity using 10 nontuberculous mycobacteria and 85 strains other than mycobacteria genus. The test showed excellent sensitivity (99%) and specificity (100%). This technique displays several advantages and is destined to spread in all laboratories and particularly in endemic areas.

[A rare splenic lesion, the splenoma or splenic hamartoma]. / Une lésion rare de la rate, le splénome ou hamartome splénique.

We report a new case of splenoma in a previously healthy adult. A 52-year-old man was admitted for a splenomegaly with thrombocytopenia. The computed tomographic scan showed a tumor which measured 56 mm in diameter. A splenectomy was performed. Histologic examination of the splenectomy specimen revealed a splenoma. Splenoma or splenic hamartoma is a rare primary splenic tumor most often incidentally discovered, radiologically. It can also meet in a particular pathological context, evoking more a coexistence rather than an association or a complication, underlying the role of the pathologist in its diagnosis.

[Solitary fibrous tumor of the retroperitoneum]. / Tumeur fibreuse solitaire du rétropéritoine.

Solitary fibrous tumour is unusual, arising most commonly in the pleura and can also occur in a large number of other sites. We report the case of a 34-year-old man with a retroperitoneal solitary-fibrous tumour, revealed by abdominal pain and hypoglycaemia. We describe the histopathological and immunohistochemical features. Solitary-fibrous tumour should be included in the differential diagnosis of spindle cell tumours in this location. Despite complete local excision, local recurrence and metastasis are seen. The behaviour of theses tumours is unpredictable and patients with solitary fibrous tumour require careful and long-term follow-up.

[A rare pulmonary tumour, primary malignant melanoma]. / Une tumeur rare du poumon, le mélanome primitif.

INTRODUCTION: Malignant melanoma most commonly presents as a primary neoplasm of the skin, but has been described in other mucosal sites. Rarely, malignant melanomas have been reported as primary visceral neoplasms, including the lung. Most such lesions have been dismissed as metastases from undocumented or regressed primary cutaneous or ocular melanomas. CASE REPORT: We report an original observation of an 82-year-old man with a pulmonary nodule presenting with chest pain. The diagnosis of melanoma was established on biopsies carried out under computerized tomography scanning and confirmed after right upper lobectomy two months later. DISCUSSION: Melanomas of the respiratory tract are usually metastatic in origin and a primary melanoma in very rare. Strict criteria must be applied before a diagnosis of primary malignant melanoma of lower respiratory tract can be accepted. Melanoma may be confused with more conventional types of lung cancer and other pigmented tumours.

[Solitary fibrous tumour of the pleura: five cases]. / La tumeur fibreuse solitaire pleurale : à propos de cinq observations.

Solitary fibrous tumours are unusual mesenchymatous tumours, most often found on the pleura. The authors report five cases hospitalised between 1998 and 2003. With the greatest occurrence in the fifth decade, they are often accidentally found but sometimes associated with a paraneoplastic syndrome such as refractory hypoglycaemia. The diagnosis is based on computed tomography and complete surgical resection is the best treatment. Adjuvant therapy is proposed for the histologically aggressive forms. Because of the possibility of local or distant recurrence and malignant transformation, long-term monitoring is strongly recommended.

[Pleuro-pulmonary manifestations disclosing hepatic amoebiasis]. / Manifestations pleuropulmonaires révélatrices de l'amibiase hépatique.

During a mission in ex-Yugoslavia between 2001 and 2004, three French soldiers were sent home because of right pneumopathy, right pleurisy after appendicectomy, haemoptysis and liver haematoma, respectively. They previously were stationed in Africa and/or South America. The initial diagnosis was quickly modified: pleuropulmonary manifestations of amoebic hepatic abscess in two cases, and pleuropulmonary amoebiasis in the last case. The outcome was favourable with standard anti-amoebic treatment. The reports illustrate the possibility of hepatic amoebiasis with local pleuropulmonary manifestations and an exceptional case of pleuropulmonary amoebiasis with hepatobronchial fistula. The authors report this experience because it demonstrates that amoebiasis in European countries remains an often forgotten diagnosis. Although known for a long time in developing countries, amoebiasis in the military or in tourists should be systematically considered.

[Ectopic sebaceous glands in the esophagus]. / Ectopie oesophagienne des glandes sébacées.

Ectopic sebaceous glands have been detected in many tissues of ectodermal origin, but their presence in the esophagus remain, until now, a very rare anomaly. We report two new cases diagnosed by endoscopic biopsy.

[A rare primary tumor of the cerebellopontine angle: melanotic schwannoma, a pigmented tumor with unpredictable prognosis]. / Une tumeur primitive rare de l'angle pontocérébelleux: le schwannome mélanocytique, une tumeur pigmentée au pronostic réservé

Schwannomas are common ubiquitous benign tumours of the nervous sheaths. Among the various histopathological types, the pigmented schwannoma has to be distinguished from melanoma. We report a case of melanotic schwannoma of the cerebellopontine angle in a 52-year-old man with a slowly progressive cerebellar syndrome since 1978, who presented with a posterior cerebral fossa bleeding. Melanotic schwannoma is a rare form of schwannoma. The diagnosis remains difficult and melanotic schwannoma has been described as a part of the Carney complex. Distinguishing melanotic schwannoma from malignant melanoma is of paramount importance in planning the management, but these two tumours are probably sharing the same origin. It must be distinguished from classic schwannoma because its behaviour is unpredictable, requiring long-term follow-up.

[A rare lesion of the central nervous system: inflammatory pseudotumor]. / Une lésion rare du système nerveux central: la pseudotumeur inflammatoire.

Inflammatory pseudotumor is an uncommon tumor, initially described in the lung, but which can involve various organs. It is a controversial entity. We report the case of a 19-year-old-man with an inflammatory pseudotumor localized in the central nervous system, revealed by epilepsy. Characteristically, the inflammatory pseudotumor is an inflammatory mass leading to manifestations related to its localization. Relatively ubiquitous, this tumor is seldom described in the central nervous system. This uncommon lesion is part of a heterogeneous group of entities which are difficult to diagnose for both surgical pathologists and clinicians.

[Late mediastinal metastasis of Ewing's sarcoma of tibia]. / Métastase médiastinale tardive d'un sarcome d'Ewing du tibia.

Peripheral neuroectodermal tumors constitute a large spectrum of small round cell tumors among which Ewing's sarcoma is the most undifferentiated type. They are rare tumors which often concern young people and generally occur in bone tissue. Their metastatic potential is high, generally early, and rarely after five years. We report the case of a 45-year-old woman who presented a mediastinal metastasis eight years after the primitive tumor of tibia. The diagnosis was made on small core biopsies obtained by CT punction, and was based on morphologic analysis, immunohistochemistry, and confirmed by molecular biology. The presence of metastasis is the main prognostic factor. Despite therapeutic progress, the global survival rate of metastatic patients is still poor.

[A case of atypical pericarditis]. / Une péricardite atypique.

INTRODUCTION: An acute viral pericarditis may reveal a congenital pericardial abnormality. CASE HISTORY: We report the case of a young man of 29 years in whom the development of rapidly progressive dyspnoea and fever led to the echocardiographic diagnosis of a pericardial tumour. The thoracic CT scan showed a mass arising in the superior mediastinum with no evidence of spread. Surgical exploration allowed the excision of a soft mutilobular mass adherent only to the aorta. Histological examination revealed an intrapericardial bronchogenic cyst. CONCLUSION: After a review of bronchogenic cysts we point out the properties of this rare intra-pericardial localisation, one of which is the frequently observed secretion of CA 19-9.

[A rare case of diminished visual acuity: neurohypophyseal granular cell tumor]. / Une cause rare de diminution de l'acuité visuelle: la tumeur à cellules granuleuses neurohypophysaire.

A neurohypophyseal granular cell tumor was found in a 60-year-old man who presented diminished visual acuity. Neuronavigation resection via a fronto-pteronial approach removed split up material. The diagnosis was established by histology and immunochemical studies. Granulous cell tumors, which are common, are rarely located in the neurohypophysis. Their origin remains a subject of debate, but unlike the other localizations, these tumors in the sellar and/or supra-sellar area are always considered benign. The clinical course depends on the quality of the surgical resection; there is no consensus on appropriate management.

[Three-year survival after treatment of a primary pulmonary angiosarcoma]. / Trois ans de survie après traitement d'un angiosarcome pulmonaire primitif.

We report an observation of angiosarcoma of the pulmonary artery in a 65-year-old man hospitalized for acute dyspnea revealing a left mass hilaire which arose from the pulmonary artery before the development of obstructive endobronchial extension. The therapeutic sequence associated removal of the lobar bronchus obstruction by interventional endoscopy, chemotherapy using ifosfamide-doxorubicin, complete left pneumonectomy and auxiliary chemotherapy with 2 additional cycles. The patient was free of tumor relapse at nearly 3 years follow-up.

[Primary pleural lymphoma: a late complication of pleural decortication for tuberculosis: two cases in western countries]. / Lymphome pleural primitif: une complication tardive de la collapsothérapie chez des anciens tuberculeux. A propos de deux nouveaux cas.

Pleural lymphomas after a long standing pyothorax due to pleuropulmonary tuberculosis are now well identified, but rarely observed in Europe. We report two new cases in a non-immunocompromised patients. The two cases occurred 5455 years following artificial pneumothorax for pulmonary tuberculosis. The patients presented with a localized pleural tumor mass. Histology revealed high-grade lymphomas, diffuse large B-cell lymphoma and anaplastic lymphoma. Serology for Epstein-Barr virus was positive. Pleural lymphomas are an established complication of artificial pneumothorax. Epstein-Barr virus is known to play a crucial role in the pathogenesis, but despite the large number of artificial pneumothorax operations, these lymphomas remain rare, suggesting additional oncogenic factors.

[Filling the thymic space after treatment of Hodgkin's disease: rebound or relapse]. / Comblement de la loge thymique après traitement d'une maladie de Hodgkin: rebond ou rechute?

We report the case of a 36-year-old women with Hodgkin's disease treated with polychemotherapy and bone marrow autograft. Progressive growth of a thymic mass suggested possible relapse four months after treatment withdrawal. This mass did not exhibit gallium-67 uptake but showed strong affinity for 18-FDG (SUV=6.8). Surgical biopsy ruled out recurrence of Hodgkin's disease of the thymus and led to the diagnosis of thymic rebound. The aspect of the thymic compartment returned to normal spontaneously at one year.

[Pseudotumoral presentation of American pulmonary histioplasmosis]. / Présentation pseudo-tumorale de l'histoplasmose pulmonaire américaine.

In France, American pulmonary histoplasmosis is an imported deep mycosis, caused by inhalation of Histoplasma capsulatum. Clinical and radiological features of this exotic disease are multiple, simulating tuberculosis or cancer. We report two cases of American histoplasmosis with pseudo-tumoral form, in immunocompetent subjects working in Venezuela, with a multinodular pulmonary presentation.

[Osteochondroplastic tracheobronchopathy: 5 cases]. / Trachéobronchopathie ostéochondroplastique: cinq observations.

Five new cases of tracheobronchopathia osteochondroplastica (TBOCP) are reported and clinical, radiological and pathological features are reviewed. TBOCP is a rare disease characterized by cartilaginous and bony nodules lining the mucosa of the trachea and major bronchi. The endoscopic features realize pathological evolution by stadiums. The prognosis is usually favourable. The etiology of TBOCP remains unknown, even though some cases were reported in association with amyloidosis.

[Mediastinal lymphatic filariasis]. / Filariose lymphatique médiastinale.

Wuchereria bancrofti gravid adult female worms were detected in a mediastinal lymph node in a 76-year old man. The patient also had lung carcinoma. A blood cell counts did not show any eosinophilia, and three consecutive night blood samples were also negative for microfilariae. Filariasis and neoplasm association was purely coincidental. Epidemiological and histopathological aspects of adult filariasis are described.