[Hodgkin's disease with bone marrow involvement. The role of positron tomography]. / Maladie de Hodgkin avec atteinte médullaire. Intérêt de la tomodensitométrie par émissions de positons.

INTRODUCTION: Hodgkin's disease with initially predominant bone marrow involvement is observed in 1% of cases. OBSERVATION: A case of Hodgkin's disease with massive bone marrow invasion, manifested by pancytopenia in the context of fever and alteration in general status of health, with little or non superficial peripheral lymph nodes. The bone marrow biopsy revealed extensive myelofibrosis with rare Reed-Sternberg cells. DISCUSSION: This case report is inscribed within the framework of the exceptional massive bone marrow forms of Hodgkin's disease, described by Duhamel et al. in 1979. We believe that metabolic imaging with 18F-FDG positron emission tomography (PET) is a valid examination in orienting diagnosis and post-therapy assessment.

[Pseudo-parasites in histology and cytopathology]. / Les pseudo-parasites en anatomie et cytologie pathologiques.

When interpreting smears and specimens, histologist and cytopathologists can be misled by images mimicking micro-organisms especially parasites such as protozoa, mycotic agents or helminths. Although some of these pitfalls are well-known, others can be problematic especially if nature of the contaminant is the same as that of the parasite that it mimics. False protozoa parasites can correspond either to exogenous agents such as spores, remnants of human cells, or inert exogenous particles. Pseudo-yeast images can be due to pollen, starch or soot but especially to cells such as macrophages, spermatozoids, and neurons or to various inert bodies such as pigments or calcifications. Pseudomycotic filaments can result from vegetable silk, asbestos bodies, radiate granules or fibrin. Curschmann's spirals and vegetable fibers can be confused with helminths and bacterial particles or pollen with helminth eggs.

[Round pulmonary lesions after returning from French Guyana. Six cases of american pulmonary histoplasmosis]. / Image ronde pulmonaire au retour de Guyane française. A propos de six cas d'histoplasmose américaine pulmonaire.

From 1989 to 1994, 71 patients were hospitalized for diagnosis of round lung lesions including 49 servicemen under the age of 45 years who had been stationed in tropical areas. In 6 of these servicemen, the diagnosis was pulmonary histoplasmosis at the tertiary stage of histoplasmoma. All had done duty in French Guyana and were negative for human immunodeficiency virus. The subpleural lung opacity was the only lesion in 5 out of 6 patients and was calcified in 4 out of 6 patients. Since skin tests with histoplasmin and serologic testing for histoplasmosis failed to achieve definitive diagnosis, surgical biopsy was performed by conventional thoracotomy in 2 cases and video-assisted thoracic surgery in 4 cases. The specimens obtained confirmed diagnosis of histoplasmosis on mycologic criteria in 3 cases and on a combination of findings including compatible histologic evidence in 3 cases. Treatment consisted in surgical excision of the nodules, for which video-assisted thoracoscopic surgery proved to be an excellent technique because of its simplicity and rapidity.

[Research on three parasitic infestations in rats captured in Marseille: evaluation of the zoonotic risk]. / Recherche de trois infestations parasitaires chez des rats capturés à Marseille: évaluation du risque zoonosique.

A cross sectional survey was carried out on a population of 82 rats (Rattus norvegicus and Rattus rattus alexandrinus) trapped in Marseille. The main histopathological finding was the presence of adults or eggs of Capillaria hepatica in 44% of the animals. 21% were found with fleas (Xenopsylla cheopis). There was no evidence of trichinosis in any of the rats examined. Hepatic capillariasis is a zoonosis seldom described in human beings. About 30 human cases have been reported in the world. Human infestation occurs first by consumption of raw rat liver containing un-embryonated eggs causing only pseudoparasitism without disease. The genuine mode of infestation is the consumption of sullied soil with rats feces containing embryonated eggs. Therefore parasites provoke, true as in rat inflammatory lesions, necrosis and fibrosis of the liver. The treatment associates antiparasitic drugs such as ivermectine, disophenol or pyrantel tartrate. The presence of a large population of infested synanthropic rats requires epidemiological monitoring and extermination of rats. All physicians must be informed of this potential risk.

[Benign mediastinal opacity: Castleman disease, apropos of a case and review of the current literature]. / Une opacité médiastinale bénign. Maladie de Castleman, á propos d'une observation et revue récente de la littérature.

We report a case of fortuitously observed Castleman's disease. An mediastinal opacity was observed on the chest x-ray. At surgery, the apparently benign tumor was well individualized. Pathology reported Castleman's disease. Pathogenesis is unknown. Recent data on localized and more diffuse forms of this disease are presented. Diffuse forms occur more readily in immunodepressed patients.

[A tropical pulmonary nodule]. / Un nodule pulmonaire "tropical".

The authors report a case of american pulmonary histoplasmosis discovered by chance on a chest radiograph in a non immunocompromised patient, back from a stay in French Guyana. Confronted with the negativity of usual mycotic research, diagnosis has been made thanks to wedge excision by video-assisted thoracic surgery. The authors briefly sum up the recent facts regarding this imported infection, stressing the interest of a direct approach by surgical practices not very invasive that allow to eliminate with certainty neoplasm or tuberculosis.

[Bone and joint sites of African histoplasmosis (Histoplasma duboisii). Apropos of a case and review of the literature]. / Localisations ostéo-articulaires de l'histoplasmose africaine (Histoplasma duboisii). A propos d'un cas et revue de la littérature.

The authors report a case of disseminated African histoplasmosis with bone and joint involvement in a black 28-year-old citizen of the Central African Republic who presented with a 17-month history of multiple osteoarticular lesions (sternoclavicular joints, humerus, ribs), cutaneous lesions (face, scalp, thorax), and lymphadenopathy. Clinical manifestations resolved rapidly under treatment with ketoconazole (600 mg/d for 10 days then 400 mg/day for nine months). Persistent yeast cells were then found upon examination of a lymph node biopsy specimen. The characteristics and diagnosis of osteoarticular lesions due to African histoplasmosis are discussed on the basis of a review of the literature. Bone and joint lesions due to African histoplasmosis have not yet been reported in patients with the acquired immunodeficiency syndrome. However, the expanding epidemic of human immunodeficiency virus infection in Africa can be expected to result in an increase in the incidence of African histoplasmosis. Imidazole derivatives are easier to use on a long-term basis than amphotericin B and have significantly improved our ability to treat African histoplasmosis.

[Practical use and interpretation of viral hepatitis B markers and hepatic biopsy in HBs Ag carriers and at the chronic hepatitis stage]. / Utilisation pratique et interprétation des marqueurs de l'hépatite à virus B et de la biopsie hépatique chez le porteur d'Ag HBs et au stade d'hépatite chronique.

Practical significance of serologic markers for hepatitis B virus and interpretation according to clinical stage and liver biopsy pattern in HBs Ag positive patients with or without chronic liver disease. Vidarabine is the treatment of choice actually available for patients with chronic persistent or chronic active hepatitis who demonstrate active replication of the virus. The authors review the technics actually necessary: to diagnose chronic hepatitis, to screen for hepatitis B virus, to demonstrate active replication of the virus. They report that these actually routine technics can be available in any biochemistry or pathology laboratory including those in tropical areas.