[An uncommon cause of dyspnea in children. Plexiform neurofibroma of the larynx]. / Une cause rare de dyspnée: neurofibrome plexiforme du larynx.

Plexiform neurofibroma is a rare benign tumor developed from cells of the sheath of Schwann peripheral nervous system often associated with neurofibromatosis type 1 or Von Recklinghausen disease. Laryngeal involvement in neurofibromatosis is rare and usually presents with obstructive respiratory symptoms. Imaging including CT and MRI provides the diagnosis as well as the staging of this lesion, whose treatment is primarily surgical. We report the case of a plexiform neurofibroma of the larynx found in a 4-year-old child revealing a mass completely obstructing the laryngeal vestibule.

[Diffuse infiltrative lung disease in scleroderma. Analysis of radio-clinical and functional semiology]. / Pneumopathie infiltrante diffuse (PID) de la sclérodermie. Analyse de la sémiologie radioclinique et fonctionnelle.

Scleroderma (SD) is a systemic disease that predominantly affects the skin. Diffuse infiltrative lung disease (DILD) is rare and occurs most often in the course of the disease. We analyzed seven cases of DILO of SD recorded between 2003 and 2010 among 196 PID (3.6%). Functional signs were limited to respiratory dyspnea, it was associated to dysphagia in six cases, dry syndrome in five cases and Raynaud's phenomenon in four cases. Clinical examination found crackles in the bases of the thorax in all cases and specific cutaneous signs in six cases. The chest radiograph showed that interstitial disease predominates at the lung bases in all cases with a large aspect of the pulmonary arteries in two cases. The chest CT scan confirmed the predominance of basal and peripheral damage with signs of fibrosis in six cases. The pulmonary function objectified a severe restrictive ventilatory defect in all cases. Bronchoscopy showed a normal macroscopic appearance in all cases, the broncho-alveolar lavage was predominated by neutrophilic formula in four cases. SCL 70 antibodies were positive in four cases. All patients were treated by steroids with improvement of dyspnea and stabilization of radiographs. A patient had died in an array of acute respiratory failure and one patient was lost to follow-up. DILD in scleroderma is rare and seldom reveals the disease, it affects the patient's prognosis especially when associated with arterial pulmonary hypertension.

[Pott's disease (about 16 cases)]. / Mal de Pott (à propos de 16 cas).

INTRODUCTION: Pott's disease or spinal tuberculosis is rare, but represents the most common form of osteo-articular tuberculosis in endemic countries. MATERIAL AND METHODS: [corrected] From January 2000 to December 2010, we collected 16 cases of Pott's disease. We analyzed clinical and radiological profile, means of confirmation and treatment. RESULTS: Spinal and chest pain were the most frequent signs. Four patients had neurological signs. The diagnosis was made by the detection of bacillus in the pus of paravertebral abscess in six cases, by histological study of vertebral biopsy in five cases, biopsy of another associated lesion in one case and in front of radio-clinical arguments with good clinical evolution under antibacillary treatment in four cases. The antibacillary treatment associating four drugs was indicated and correctly followed by all patients. Surgical drainage was associated in five cases. The evolution was good in all cases. DISCUSSION: Diagnosis of Pott's disease is late when there is no neurological sign. Imaging allows to make early diagnosis with MRI. Prognosis is good when treatment is started early.

[Malignant pilomatrixoma of head and neck. A case report]. / Le pilomatricome malin cervical métastatique : à propos d'un cas.

We report the case of a 66-year-old patient with a pilomatrix carcinoma from the right submandibular region with pulmonary and cerebral metastases. The histological confirmation of the diagnosis has been based on the biopsy of the submandibular tumefaction which was rapidly growing. We tried at first a doxorubicine and cisplatine chemotherapy because of the considerable locoregional extension and the existence of pulmonary metastases. The patient response to three cures of chemotherapy was spectacular with a partial clinical response (75%) and a partially cleaned-up chest observed in the radiological evaluation. In the 5th cycle of chemotherapy following the same protocol, the patient presented a relapse with cerebral metastases. The patient received hypofractionated radiotherapy on the brain followed by etoposide and cisplatine chemotherapy, then oral vinorelbine. The patient died of progressive disease after 32 weeks.

[Maxillary cementoblastoma. A case report]. / Cémentoblastome maxillaire. A propos d'un cas.

Cementoblastoma is a rare benign odontogenic neoplasm. Its cause is unknown. It represents less 6 % of all odontogenic tumors. The aim of our work is to present a rare case of maxillary cementoblastoma involving an included central incisor. A 32-year old man consulted for a left maxillary swelling to projection under nostril. A panoramic radiographic examination revealed an included tooth 21 with a radiopaque lesion around its root. The computed tomography revealed the included tooth 21 with a process around its root. This process is well-defined, high-dense and is surrounded by a radiolucent halo. The treatment should consist of complete removal of the lesion with the tooth 21. Histological examination concluded to the diagnosis of a cementoblastoma. The cementoblastoma occurs most frequently in young persons and predominantly among men. The mandibular premolar and molar are the more frequently reached. The maxillary localization remains rare. This tumor occurs around the roots of the posterior and lower teeth. Radiographically, the lesion is well-defined and attached to the root of the tooth, radiopaque dense and surrounded by a radiolucent halo. The cementoblastoma evolves slowly and has the tendency to blow the cortical. The prognosis is good.

[Malignant stromal tumors of the small intestine: report of 9 cases]. / Les tumeurs stromales malignes du grêle: à propos de 9 cas.

PURPOSE: Analysis of imaging features of malignant stromal tumors of the small bowel and review of literature. MATERIAL AND METHODS: 9 cases of malignant stromal tumor of the small bowel with histological proof were imaged at US (8 cases), small bowel series (9 cases) and CT scan (3 cases). RESULTS: There were 6 cases of leiomyosarcoma and 3 cases of malignant schwannoma. Tumors involved the jejunum in 3 patients, the ileum in 4 patients, and the duodenum in 2 patients. The main clinical presentation was an abdominal mass (8 cases), which appeared heterogeneous and hypoechoic with eccentric lumen at US confirming its GI origin (7 cases). Small bowel series showed a bulky cavitary mass opacified via a thin fistula (7 cases), an ileo-ileal intussusception (1 case) and enlarged duodenal lumen (1 case). CT performed in 3 cases showed an intraperitoneal mass with soft-tissue density. A communication with the GI tract was noted in 1 case, and in another case, it showed an intestinal intussusception. US guided biopsy performed in 3 cases provided diagnosis in 2 cases (malignant schwannoma, leiomyosarcoma). Tumor growth was exophytic in 8 cases and dumbbell-shaped in 1 case. CONCLUSION: The imaging features of malignant stromal tumors of the small bowel are similar. It varies with the type of tumor growth and its size. The diagnosis may be suggested based on imaging features.

[Intracranial hydatid cyst: contribution of scanography]. / Kyste hydatique cérébral. Apport de la scanographie.

We reviewed 14 cases of intracranial hydatid cysts, describing the clinical features and radiographic findings. The clinical presentation was dominated by signs of increased intracranial pressure and neurological manifestations. Diagnosis was established on the basis of CT findings, most valuable as a diagnostic tool.

[Cavernous sinus dermoid cyst with unusual parapharyngeal development]. / Kyste dermoïde de la loge caverneuse à développement inhabituel parapharyngé.

We report a case of dermoid cyst arising in the cavernous sinus and parapharyngium areas through the foramen lacerum. A 12-year-old girl was hospitalized in October 1966 for progressive intracranial hypertension. CT before a prior surgical intervention in 1994 showed an intracranial process suggesting a dermoid cyst. CT performed in October 1996 showed a temporal process at the left side measuring 8 cm x 5 cm and well circumscribed with a thin wall. This process extended towards the parapharyngium area through the foramen lacerum. The exocranial part measured 4 cm in diameter. The density of the process strongly suggested a mature dermoid cyst with fatty and calcium components. The histology study confirmed the diagnosis of dermoid cyst. The frequency of intracranial dermoid cysts is 2 to 3 times less than that of epidermoid cysts. This is an uncommon process accounting for 1% of intracranial tumors occurring in children. In the sustentorial spaces, the process occurs more frequently in the parasellar area. To our knowledge, exocranial extension has not been reported to date.

[Centrosomatic spinal tuberculosis: radiographic features in 10 cases]. / Tuberculose rachidienne centrosomatique: aspects radiologiques. A propos de 10 cas.

We report a series of 10 cases of centrosomatic tuberculosis of the spine. The mean age of the patients was 36 years. Plain x-rays of the spine showed isolated defects in 3 cases, a defect with wedge fracture in 3 and a wedge fracture alone in 2. A sequestrum was found in 2 cases and bony condensation around the defect in 6. A CT scan performed in 3 cases showed, in addition to the bone lesions, a perilesional bony condensation in all cases. Soft tissue abscess formation was noted in 1 case and epidural involvement in the 2 others. MRI performed in 2 cases evidenced an alteration of the vertebral body signal with localized anterior epiduritis at the site of a small epidural abscess. CT scan and MRI contribute usefully to the radiographic diagnosis of centrosomatic tuberculosis, evidencing sequestra, bony condensation at the periphery of defects, and the presence of soft tissue abscesses and or epidural involvement. When these signs are absent, the differential diagnosis may be difficult with other causes of tumor formation, requiring vertebral biopsy.

[Comparison of scanners and porto-scanners, both in helical mode, for the study of hepatic metastases. Prospective study in 12 patients]. / Comparaison du scanner et du porto-scanner, tous deux en mode hélicoïdal, pour l'étude des métastases hépatiques. Etude prospective chez 12 malades.

PURPOSE: The aim of this study was to compare helical CTAP and helical CT-scan in the preoperative assessment of liver metastases. METHODS: A prospective unicentric study in 12 patients was performed with helical CTAP and helical CT-scan. All patients underwent partial hepatectomy with intraoperative palpation and sonography within 19 days (mean: 9 days). RESULTS: Examination of resected liver specimens found 38 metastases, from colorectal cancer in 36 cases. The sensitivity was 92.1% for helical CTAP and 79% for helical CT-scan. This sensitivity was 85% for helical CTAP and 60% for helical CT-scan for nodules 1 cm or less in diameter (P = 0.08). CONCLUSION: In the preoperative screening of liver metastases, helical CT-scan should be performed as the first choice examination. When hepatic lesions seem to be curable by resection based on helical dynamic CT-scan results, helical CTAP should be performed to increase the sensitivity of detection of lesions 1 cm or less in diameter.

[Ultrasound-guided transparietal thoracic puncture biopsy]. / Les ponctions biopsies thoraciques transpariétales échoguidées.

UNLABELLED: Transthoracic needle biopsy is a reliable method for the diagnosis of thoracic lesions, specially when they are peripleral. AIM: The main objective was to evaluate the results of US guidance for thoracic needle biopsy in 159 cases. RESULT: Overall sensitivity was 83% as tissue was obtained in 132/159 cases. In 24 cases, 2 or 3 biopsies were necessary. In 17 cases, analysis was made on cytology only with a 70.6% sensitivity. One pneumothorax and two cases of hemoptisies were encountered. COMMENTARY: US guidance is a useful method for the diagnosis of peripheral thoracic masses, yielding a high sensitivity and a very low complication rate.

[Cystic lymphangioma of the pancreas. Apropos of a case]. / Lymphangiome kystique du pancréas. A propos d'un cas.

A new case of pancreatic cystic lymphangioma is reported in a young woman. The authors discuss its clinic and histologic features and emphasize the complementary findings of ultrasonography and CT scan which are similar to the other sites of cystic lymphangioma in adults.

[Appendiceal mucocele. Apropos of 6 cases]. / Les mucoceèles appendiculaires. A propos de six cas.

Appendicular mucocele is a rare lesion presenting a combination of several histological lesions. It generally ruptures into the peritoneum and rarely into the retroperitoneum. The objective of this study was to examine the various radiological appearances of appendicular mucocele and to report three cases of mucocele which ruptured into the retroperitoneum. This retrospective series of 6 cases of histologically confirmed appendicular mucocele was collected by the Central Radiology Department of Ibn Rochd University Hospital in Casablanca. The mean age of the patients was 61.6 years (33 years-77 years) and the sex ratio was 4/2. A plain abdominal X-ray and ultrasonography were performed in all patients. Five patients were examined by CT scan and two underwent a barium enema. Five out of six mucoceles ruptured: into the peritoneal cavity in 2 cases with gelatinous ascites and into the retroperitoneum in 3 cases. The plain abdominal X-ray showed a mass in the right flank, which was calcified in 2 cases. Ultrasonography and CT scan were suggestive of the diagnosis of appendicular mucocele in only two cases. The case of non ruptured mucocele consisted of a clearly delimited, thin-walled collection. A loculated effusion with scalloping on the liver was observed in the two cases of gelatinous ascites. In the three cases of mucocele rupturing into the retroperitoneum, ultrasonography and CT scan showed a loculated retroperitoneal collection. This collection extended into the right psoas in 2 out of 3 cases. Gelatinous ascites is the usual complication of appendicular mucocele; but in rare cases of mucocele of a retrocaecal appendix, the mucus may enter the retroperitoneum.

[Contribution of ultrasonography in thyroid diseases. Apropos of 100 cases]. / Apport de l'echographie dans la pathologie thyroïdienne. A propos de 100 cas.

Thyroid disease is a very common disease, essentially affecting women, and raises diagnostic and therapeutic problems. The objective of this study was to specify the value of ultrasonography in the diagnosis and aetiological orientation of these lesions, based on a retrospective study of 100 patients. The results of ultrasonography were compared to the histological results. The aetiologies detected were dominated by benign lesions, particularly adenomas (56 cases), dystrophic goitres (32 cases) and cancers (7 cases). Ultrasonography allowed the detection of clinically impalpable nodules with no isotope scan signs in 11% of cases. The ultrasonographic appearance of benign nodules was variable. Solitary nodules were detected in 63 cases. They were hyperechoic in 15 cases, isoechoic in 8 cases, cystic in 9 cases, and mixed in 31 cases. A peripheral clear halo was revealed in 25 cases and macrocalcifications were present in 17 cases. Malignant lesions were visualized in 7 cases and were solitary in 5 cases. Solitary lesions had a hypoechoic echostructure in 1 case, an isoechoic echostructure in 2 cases and a mixed echostructure in 2 cases. The margins were poorly demarcated in 3 cases, and circumscribed without peripheral halo in 2 cases. Cervical lymphadenopathy was detected in 2 cases. Graves' disease, diagnosed in 2 patients, showed a diffuse hypoechoic appearance of the entire thyroid gland. Ultrasonography is a sensitive morphological method for the diagnosis of thyroid lesions. A detailed and precise analysis of the ultrasound signs of the lesion can suggest that benign or malignant nature of the lesion, which can be completed by Doppler-ultrasound and especially ultrasound-guided needle biopsies.

[Mesenteric infarction secondary to antithrombin III deficiency]. / Infarctus mésentérique secondaire à un déficit en anti-thrombine III.

AT III is a physiologic inhibitor of blood clot formation: its deficiency is manifested by venous thrombosis. The authors reported case of mesenteric venous infarction in a 42-years-old woman. AT III deficiency was transient and caused by an oral contraceptive. In patients with AT III acquired deficiency it is necessary to suppress any risk factors of venous thrombosis.

[Percutaneous treatment of abdominal collections. Apropos of 135 cases]. / Traitement percutané des collections abdominales. A propos de 135 cas.

The authors reviewed 135 abdominal collections, collected at the Radiologic Central Service over four years. The average age of the patients was 40 years. The abscesses sit especially in the liver (54 cases) and the psoas muscle (43 cases). The percutaneous management was guided by ultrasonography in all the cases. The results were successful in 74%. Only 15 cases needed surgical therapy. The literature results are similar. The authors underline the percutaneous treatment interests, its efficacy, its complications and their therapy.

[Contribution of imaging in malignant non-Hodgkin lymphomas of the small intestine. Apropos of 32 cases]. / Apport de l'imagerie dans les lymphomes malins non hodgkiniens du grêle. A propos de 32 cas.

The authors report a retrospective study concerning 32 cases of non Hodgkin lymphoma of the small intestine, histologically confirmed. All patients underwent digestive opacification. Ultrasonography was performed in 15 cases and CT scan was performed in 6 cases. The average age was 36 years and the sex-ratio was 3.4. The classical radiological signs described in the literature were found in our patients. The diagnosis of lymphoma was easily suggested in the presence of polymorphic and multifocal lesions, and especially the aneurysmal appearance. Abdominal sonography and computed tomography contributed to the diagnosis and also helped to relate an abdominal mass to its digestive origin, by showing a classical "sandwich" appearance.