[Rapid outpatient diagnostic pathways for lung cancer: Evaluation after one year]. / Parcours de diagnostic rapide du cancer du poumon : évaluation à un an.

INTRODUCTION: The introduction of coordinated care pathways for lung cancer diagnosis and treatment is a complex process. The purpose of the French Cancer Plan 2014-2019 was to improve referral to treatment waiting times in people with suspected malignancy. The aim of this study was to assess a rapid outpatient diagnostic program for lung cancer established in 2016. METHOD: This retrospective study was carried out in the Pulmonology Department at Tenon Hospital, Paris, France between May 2016 and May 2017. RESULTS: During this period, 118 patients (60%) of patients in the pathway were diagnosed with lung cancer. The median waiting time to first consultation (D1) was 4 (2-7) days. The median waiting time between diagnosis and treatment decision (D4) was 4 (0-8) days. The median waiting time to the first treatment (D5) was 10 (4-15) days for chemotherapy and 27 (16-34) days for surgery. The median waiting time between the first abnormal chest X-ray and the first treatment (D6) was 49 days (34-70). CONCLUSION: Referral to treatment waiting times was consistent with international recommendations. Coordinating nurses improved care pathways in lung cancer patients.

[Neurologic paraneoplastic syndrome with anti-CV2/CRMP5 antibodies revealing a small cell lung cancer. Effectiveness of the lung cancer treatment]. / Syndrome neurologique paranéoplasique à anticorps anti-CV2/CRMP5 révélateur d'un cancer bronchique à petites cellules. Efficacité du traitement du cancer bronchique.

INTRODUCTION: Paraneoplastic neurological syndrome associated with anti-CV2/CRMP5 antibodies are rare. Various clinical manifestations can occur, cerebellar ataxia, polyneuropathy, optic neuritis with NORB or uveitis. Small cell lung carcinoma is generally responsible. CASE REPORT: We report the case of a 64-year-old man who developed visual symptoms with papilledema, cerebellar signs, polyneuropathy confirmed with a neurophysiological studies. Anti-CV2/CRMP5 antibodies were present. A small cell lung carcinoma was responsible for this paraneoplastic syndrome revealing the cancer. The paraneoplastic syndrome improved with radio chemotherapy of the cancer alone. CONCLUSION: A paraneoplastic neurological syndrome must be evoked in case of an atypic neurological syndrome. This diagnostic can be confirmed by the presence of anti-neuronal antibodies. In this case, a small cells cancer of the lung must be research.

[Endobronchial lipoma: imaging findings. A case report]. / Lipome endobronchique: apport de l'imagerie. A propos d'un cas.

Endobronchial lipoma is a rare benign bronchial tumour. A search should be carried out on submillimetre MDCT scan slices in patients presenting segmental or lobar collapse or recurrent pulmonary infection in the same bronchial territories. The authors report MDCT and MR imaging in a patient with endobronchial lipoma discovered on an MDCT scan.

[Lung cancer in HIV-positive patients]. / Le cancer broncho-pulmonaire chez les patients séropositifs pour le virus de l'immunodéficience humaine.

Since 1996, AIDS-related mortality has declined considerably with the introduction of tritherapy (HAART). This decline in mortality has been associated with an increase in the proportion of deaths caused by cancers unrelated to AIDS, particularly lung cancer. The risk of developing lung cancer is higher in the HIV-seropositive population than in the aged-matched general population, undoubtedly because of the high rate of smoking, particularly among drug abusers, but also because of other reasons which remain to be determined. Mean age at the discovery of lung cancer in HIV+ patients is 45 years, and most are symptomatic. The diagnosis is established at a locally advanced or metastatic stage in 75-90% of patients, as in the general population. Adenocarcinoma is the most common histological type. The prognosis is worse in HIV+ patients than in patients with an undetermined HIV status. Evidence on the efficacy and toxicity of chemotherapy is insufficient to draw any conclusions. Surgery remains the treatment of choice for locally advanced disease if allowed by the clinical status and respiratory function. Prospective clinical studies are needed to define a better management strategy for lung cancer in HIV-positive patients.

[Yellow nail syndrome. Three cases]. / Le syndrome des ongles jaunes. A propos de trois observations.

Yellow nail syndrome is an uncommon diagnosis established on the basis of clinical presentation with slow-growing yellow discolored nails, lymphedema, and pulmonary manifestations. We report 3 new cases with their pulmonary component.

[Should the extended evaluation of bronchial adenocarcinoma be different from that of non-small cell lung carcinoma?]. / Le bilan d'extension des adénocarcinomes bronchiques doit-il différer de celui des autres cancers bronchiques non à petites cellules (CBNPC)?

The records of 132 patients explored for initial evaluation of non-small cell lung cancer (NSCLC) were reviewed to find out whether the evaluation of extrathoracic extension could be influenced by anatomicopathological data. Brain, liver and bone metastases were found to be significantly more frequent in adenocarcinomas than in NSCLCs. This relative frequency was observed at all stages, including stages I and II as defined by computerized tomography of the chest, and in asymptomatic patients. We therefore recommend to evaluate fully the tumoral extension in patients with bronchial adenocarcinoma irrespective of its stage, and to do so even in the absence of clinical symptoms.

[Serum neuron-specific enolase in small cell bronchial cancers]. / L'énolase neurono-spécifique sérique au cours des cancers bronchiques à petites cellules.

Despite its very good specificity, serum neuron-specific enolase (SNE) cannot be relied upon to diagnose small cell carcinoma. However, this marker is of interest owing to the double correlation observed between it and tumoral extension and between its rapid elevation under chemotherapy and clinical response to chemotherapy. Repeated SNE assays help in determining this response when SNE returns to normal level, and in predicting the progression of the disease several weeks in advance when SNE levels increase. Early and later SNE assays therefore have prognostic value.

[A new diagnostic approach in lymphangiomatosis. Apropos of a case]. / Nouvelle approche diagnostique de la lymphangiomyomatose. A propos d'une observation.

Lymphangiomyomatosis is a rare disease affecting exclusively women usually in child-bearing age. It is characterized by proliferation of an atypical smooth muscle involving the pulmonary, mediastinal and retroperitoneal lymph system. The case reported here concerns a 53-year old woman presenting with an interstitial pulmonary lesion giving a characteristic image at CT. The patient also had recurrent chylothorax and a renal angiomyolipoma explored by CT and magnetic resonance imaging. The diagnosis of lymphangiomyomatosis was made on a cluster of arguments, without having recourse to surgical lung biopsy.