[Splenic metastasis from a bronchial carcinoma]. / Métastase splénique d'un cancer broncho-pulmonaire.

INTRODUCTION: Isolated splenic metastases from a bronchial carcinoma, without other visceral metastatic involvement, are exceptionally uncommon. CASE REPORT: The authors report the finding of an isolated splenic metastasis 21 months after a left pneumonectomy for an undifferentiated large cell carcinoma, initially staged pT3N1M0. The splenic metastasis presented as a major deterioration in general health and sharp pains in the left hypochondrium. Splenectomy confirmed the metastatic nature of the splenic tumour and relieved the severe abdominal pains. Two years after the splenectomy and with out adjuvant treatment the patient remains in complete remission. CONCLUSION: Splenectomy for a metastasis from a bronchial carcinoma should avoid the later complications of this type of metastasis: severe abdominal pain, splenic rupture and compression of neighbouring vessels. If the bronchial carcinoma is controlled locally and the splenic metastasis is isolated, splenectomy offers, perhaps, a further chance of prolonged survival.

[The association of cryptosporidiosis and isosporosis in a patient with acquired immunodeficiency syndrome (AIDS)]. / Association d'une cryptosporidiose et d'une isosporose chez un sujet atteint du syndrome d'immunodépression acquise (SIDA).

We describe one case of AIDS patient who have excreted simultaneously oocysts of Isospora belli and Cryptosporidium species for ten months. These parasites were noticed with qualitative and quantitative changes. Different treatments were successless about these parasites. This double infestation in tropical AIDS patients appear to have a conspicuously frequency.

Winter pollinosis in Paris.

Pollen is rarely investigated as a cause of winter respiratory symptoms. Infectious coryza and asthma are particularly common during winter, and it has been shown that environmental antigens can cause at least some cases in Paris. Recent experimental data from Calhoun et al. (1991) indicate that pollen may act synergistically with viral respiratory infections, which are particularly prevalent in winter. In the present study, we investigated, in 130 consecutive patients presenting with winter aggravation of asthma or rhinitis, winter pollinosis by skin test, radioallergosorbent test (RAST), and specific endonasal challenge test. Totals of 35, 24, and 21 patients reacted positively in skin, RAST (> 0.70 PRU/ml), and endonasal tests, respectively. Clinical features during the season established the diagnosis of winter pollinosis in 20 cases; it was due to alder pollen in 10 patients and hazel pollen in 12. The positive predictive value of the skin test was only 0.57, as compared with 0.86 for the specific endonasal test, which had a negative predictive value of 1. Our results indicate that hazel and alder pollens should be prick-tested for more often as causes of winter respiratory symptoms in Paris, even if similar manifestations were absent during previous winters, were previously present during spring or summer, or were both absent in previous winters and present in spring or summer.