Hemoptysis: From Diagnosis to Treatment.

Management of hemoptysis begins with an angio-CT to identify the location, the bleeding vessel, mapping of systemic arteries and the cause of the hemoptysis. Endovascular treatment is the first-line therapy, in 90% of cases by embolization of the systemic arteries and in 10% of cases by occlusion of the pulmonary arteries.

[Pseudo tumoral bronchial tuberculosis]. / Tuberculose bronchique pseudo tumorale: a propos de 4 cas.

Bronchial lesion is a rare site for tuberculosis. It can mimic lung cancer especially when sputum- smear is negative, and this be a cause of a delay in diagnosis, that can be made later on by a culture of Koch bacillus or after a bronchial biopsy. Through these 4 cases reports, the authors recall the ethiopathogenic hypotheses of this lesion and review the radiologic, clinical and prognostic features of these unusual forms of TB.

[Bronchectasis in Horton's disease: fortuitous association?]. / Bronchectasies au cours de la maladie de Horton: association fortuite?

Respiratory manifestations in Horton's disease are uncommon. We report the case of 63 year-old man with Horton disease diagnosed 2 months before, who was hospitalised for fever, deterioration in general health, cough and hemoptysis. Chest X-ray showed an infiltrate in the right upper lobe and bilateral cystic opacities predominant on basal suggesting bronchectasis who was confirmed secondary in CT-scan. Even though cortico sensible clinical manifestations and radiologic infiltrate were previously described in Horton's disease, association with bronchectasis was never been reported in literature and her etio pathogenic mechanism must be clarified.

[Diagnosis of non-severe pulmonary embolism by a decision analysis-based strategy in pulmonary hospital recruted-patients]. / Application d'un algorithme decisionnel au diagnostic de l'embolie pulmonaire non grave en milieu pneumologique: Résultats d'une étude prospective de 40 cas.

We have study prospectively cases of non severe pulmonary embolism in a pulmonary department by an analysis based strategy associating radio-clinical probability, venous ultra sonography, D-Dimers value followed, if no performed diagnosis, by pulmonary scintigraphy or angio-CT scan. 64 cases of pulmonary embolism suspicion have been hospitalised in our department between October 1998 and July 2001; 40 patients was included in our study and have been classified in 3 groups regarding pre test clinical probability. Anticoagulant treatment has been initialised only in the third group (probability >80%) Clinical probability associated with venous ultra sonography and D- Dimeres value allow or exclude pulmonary embolism diagnosis in 27 patients. In the others, scintigraphy and angio CT scan were necessary for establishing diagnosis. Application of this algorithm allow diagnosis of pulmonary embolism in 29 patients and exclude this pathology in the other 11. None of this patient complained from recurrent thrombo embolic accident during 17 to 42 months observance period.