[Predicting prostate cancer with dynamic endorectal coil MR and proton spectroscopic MR imaging]. / Détection du cancer de la prostate par IRM endorectale dynamique et spectroscopique-proton.

PURPOSE: Determine the feasibility of dynamic gadolinium enhanced MRI and spectroscopic imaging in routine clinical practice using standard equipment and its usefulness for patients with negative biopsies and high degree of suspicion of prostate cancer. PATIENTS AND METHODS: Fifty five patients underwent endorectal MRI using T2W spin echo (SE) imaging, dynamic gadolinium enhanced imaging and proton spectroscopic imaging before repeat US-guided transrectal biopsies. The statistical analysis consisted in the correlation of the results obtained with each of the two MRI techniques and the results of the biopsies in the corresponding prostate lobe. RESULTS: 32 patients were included in the analysis. Biopsies revealed cancer for 15 patients. The statistical analysis showed a lack of significant correlation between T2W-SE imaging and biopsy results. A correlation with statistical significance was found between dynamic gadolinium enhanced imaging and biopsies (p=0,0018) and between spectroscopic imaging results and biopsies in the corresponding lobe (p=0,0001). CONCLUSION: Endorectal MRI with a standard clinical equipment using dynamic gadolinium enhanced imaging and spectroscopic imaging may be used in clinical routine to improve detection and localization in prostate cancer compared to T2 weighted spin echo imaging.

[Actinomycosis presenting as a chronic excavated pneumonia in a young woman]. / Pneumopathie abcédée chronique chez une jeune femme, révélant une actinomycose thoracique.

INTRODUCTION: Pulmonary actinomycosis is an anaerobic bacterial infection occurring primarily in debilated patients with poor oral hygiene. Before the penicillin era, thoracic actinomycosis looked like tuberculosis or neoplasia with chest wall invasion and fistula formation. OBSERVATION: We report the case of a 39 years old woman presenting with a chronic lung abscess of the left upper lobe hospitalised after several unsuccessful courses of antibiotics. The diagnosis was made after thoracic surgery. Three years after lobectomy, which had been followed by three months of amoxycillin and multiple dental extractions, there was no sign of relapse of the infection. CONCLUSIONS: We review the role of thoracic surgery, antibiotic treatment and diagnosis in pulmonary actinomycosis.

[Antenatal cerebral artery occlusions (4 new cases)]. / Occlusions artérielles cérébrales anténatales (4 nouvelles observations).

Cerebral arterial occlusion, occurring during monozygotic twin pregnancies, is a well known entity, specially when one twin is stillborn or macerated. Most of the authors consider that the aetiology is either embolization from the dead fetus or intravascular coagulation causing embolization in the surviving co-twin via placental vascular connections. Some data suggest an infectious endarteritis on the basis of angiographic and histological findings. Clinical features may appear several weeks after birth. CT scan and pathological findings depend on the date of the arterial occlusion. Four recent cases are described, two of them concerning monozygotic twin pregnancies. Pathological, CI scan, clinical features and pathogenesis are discussed taking account of the others data in the literature.

[Liver tumors and oral contraceptives. Anatomo-clinical and etiologic considerations on the subject of three case histories]. / Proliferations hepatiques et contraception orale. Considerations anatomo-cliniques et etiologiques a propos de trois observations.

PIP: The case histories of 3 young women with liver tumors using oral contraceptives (OCs) for at least 4 years are presented. The authors report the clinical and pathological features of this recently described disease. The most dramatic complication is rupture with hemoperitoneum. The pathologists categorize these tumors into 2 benign types, hepatocellular adenoma, and focal nodular hyperplasia, and 1 malignant type, hepatocellular carcinoma. Epidemiologic and pathogenic features are presented and the low incidence of these tumors is not a contraindication to OC usage. (author's modified)^ieng

Role of computed tomography in vertebrobasilar ischemia.

Precise delineation of vertebrobasilar ischemia by computed tomography (CT) appears difficult due to the numerous variations in distribution of the posterior fossa arterial supply. While pontine and upper brainstem infarctions can be readily demonstrated, medullary infarction remains beyond the scope of present CT scanners. CT findings in cases of basilar artery occlusion include bilateral pontine infarction or extensive brainstem ischemia, associated with cerebellar and posterior cerebral vascular damage. Demonstration of basilar artery occlusion using routine CT is only rarely achieved. In cerebellar ischemia, CT, in conjunction with clinical syndromes, helps in the recognition of the arterial territory involved. CT provides useful guidelines for the treatment of cerebellar stroke, leading to surgery in cases of massive cerebellar infarction.

Warthin-Finkeldey-like cells in benign and malignant lymphoid proliferations.

Multinucleate giant cells resembling Warthin-Finkeldey cells have been described in various lymphoid disorders. These Warthin-Finkeldey-like cells (WFLC) with as many as 50 nuclei are of three main types: reticular, lymphocyte and intermediary. In reactive lymphoid proliferations (34 cases) WFLC were mainly observed inside germinal centres and to a lesser extent in the interfollicular zones. In neoplastic lymphoid proliferations (33 cases) WFLC were most commonly found in the lymphocytic predominance type of Hodgkin's disease (16/25 cases). All non-Hodgkin's lymphomas (13 cases) in which WFLC were detected proved to be of low grade malignancy (lymphocytic: one case, lymphoplasmacytic-plasmacytoid: six cases; and centroblastic-centrocytic, six cases). They were also found in two cases of angioimmunoblastic lymphadenopathy. Immunoperoxidase and electron microscopic studies could not elucidate the exact histogenesis of these cells, but it is assumed that they are associated with B cell proliferations.