Evaluation of accuracy of fine needle aspiration cytology in BI-RADS3 category breast lesions: cytohistological correlation in 337 cases.

OBJECTIVE: To evaluate the accuracy of fine needle aspiration cytology (FNAC) in BI-RADS3 breast lesions. METHODS: Between January 2004 and December 2007, 337 cases from BI-RADS3 lesions underwent FNAC. Three to six needle passes were made on each patient. In 67 cases (20%) a histological biopsy was performed. Cytological and histological interpretations were performed by the same pathologist. RESULTS: The histological diagnosis showed that 88% (59/67) of BI-RADS3 breast lesions were benign. Only 6% (4/67) were malignant, consisting of ductal carcinoma in situ and infiltrating ductal carcinoma. CONCLUSION: BI-RADS3 lesions remain disruptive in their management. However, the correlation between cytology and histology showed that most of these lesions were benign and that finally FNAC remains a useful and accurate test in the management of these lesions.

Primary mammary tuberculosis presenting as a voluminous abscess.

We present a case of primary mammary tuberculosis (MT), an extremely uncommon pathology, revealed by a voluminous tubercular abscess mimicking a recurrent pyogenic abscess. It was correctly diagnosed after a while because of partial response to antibiotics with a disappearance of the diffuse inflammatory components explained by the effect held concurrently by some antibiotic on a probable staphylococcic superinfection and its bactericidal effect against BK. This is the most common presentation of the mammary forms of the MT and the diagnosis particularly makes sense in this case matching several risk factors: female gender, lactation, young age, and origin from an endemic area. Furthermore the persistence of an abscess after a well driven medical treatment should always make search the presence of BK.

Connatal Pelizaeus-Merzbacher disease in two girls.

We report the clinical, radiological and electrophysiological signs in two unrelated girls with the connatal form of Pelizaeus-Merzbacher disease (PMD). MRI plays an important role in the diagnosis, demonstrating the virtual absence of myelination. PMD is classically described as an X-linked leukodystrophy. Our two cases reinforce the hypothesis of a possible autosomal recessive transmission of the connatal form of PMD in some families, as recently presented.

[Value of brain MR imaging in infants with a severe idiopathic apparent life threatening event]. / Apport pronostique de l'irm cerebrale chez les nourrissons rescapes d'un malaise grave.

OBJECTIVE: Prognostic value of a magnetic resonance imaging (MRI) scoring system in infants with a severe apparent life threatening event (ALTE). METHODS: Ten infants with an ALTE (aged between 6 and 31 weeks) were clinically graded according to the PRISM score and evaluated with EEG, evoked potentials and MRI. The 18 MRIs obtained were distributed in 3 classes according to the delay after which they were obtained; class A (n=5): within the first 48 hours after the event, class B (n=7): between day 3 and 8 and class C (n=6): between day 9 and 50. The 18 MRIs were evaluated retrospectively using a scoring system based on 3 categories of lesions: edema, basal ganglia injury and watershed injuries. Five infants died between day 2 and day 15 after the event. The five surviving infants had follow up neurodevelopmental testing after 38 to 77 months. RESULTS: There was no correlation between the 5 MRIs of class A and the neurological outcome. For the MRIs of class B and C, the scoring system can be of great value when combined with the scores of EEG, EP and PRISM. CONCLUSIONS: The scoring system for MRI performed within 48 hours after the event is falsely reassuring. MRI can be helpful as early as 3 days after the event when combined with the score of the electrophysiological investigations and the PRISM.

Hemorrhage in the cavum septi pellucidi in a full-term neonate.

A case of hemorrhage in the cavum septi pellucidi presenting as macrocephaly secondary to hydrocephalus in a full-term neonate is described. This condition has only been reported previously in one premature infant. This unusual location of intracranial bleeding has been demonstrated by ultrasonography and MRI. We discuss the pathophysiology.

[Diagnosis of an 'apple-core' lesion in the course of a small bowel enema]. / Découverte d'une virole au transit grêle.

We describe a case of gallbladder carcinoma observed fortuitously during small bowel enteroclysis as an "apple-core" lesion. This case illustrates the non-specificity of the clinical manifestations as well as the usual pitfalls in the diagnostic step.