[Acute diffuse interstitial pneumopathy following docetaxel (Taxotère). Apropos of 2 cases]. / Pneumopathie interstitielle diffuse aiguë sous docétaxel (Taxotère). A propos de 2 observations.

Docetaxel, a new chemotherapeutic agent, has demonstrated activity in non-small cell lung cancer and breast cancer. Toxicities associated with treatment using docetaxel include hypersensitivity reactions and fluid retention, which can be prevented by pretreatment with corticosteroids. We describe herein two cases of acute interstitial pneumonitis after administration of docetaxel to patients suffering from metastatic non-small cell lung cancer. A pulmonary toxicity of docetaxel from an hypersensitivity reaction is likely because of symptoms course, radiological demonstration of an interstitial pneumonitis, lack of an infectious etiology and of clinical response to antibiotic treatment, and rapid recovery with corticosteroids. This unusual pulmonary toxicity has been rarely described with docetaxel, as transient pulmonary infiltrates have been observed during treatment with paclitaxel. The possibility of an hypersensitivity pneumonitis must be taken into account when a patient with docetaxel treatment presents pulmonary infiltrates.

[Percutaneous closure of an right-left interatrial shunt acquired after pneumonectomy]. / La fermeture percutanée du shunt droit-gauche interauriculaire acquis après pneumonectomie.

Right to left shunt through a patent foramen ovale after pneumonectomy is a rare complication. Its clinical presentation is a severe dyspnea with posture dependency. The diagnosis is easily confirmed by contrast echocardiography. The purpose of this article is to expose the interest of interventional catheterization and transcatheter closure. This method appears to be a viable alternative to surgery for those patients with precarious respiratory function.

Early diagnosis of lentivirus-induced infiltrative lung disease in sheep by high resolution computed tomography.

The visna-maedi lentivirus can induce an interstitial pneumonitis in sheep, and provides a convenient example to study natural or experimental lentiviral pathology. We wanted to determine whether high resolution computed tomography (HRCT) is able to detect early morphological changes following lentiviral infection in the lungs. Spontaneously infected adult sheep (n=3) and experimentally infected lambs (n=5) were compared to uninfected controls (n=4). The HRCT scans generally showed abnormal features in infected animals, including: increased parenchymal density; alveolar oedema; thickened interlobular septa; and increased density in peribronchiolar areas. HRCT was more sensitive than chest radiography for the early diagnosis of interstitial pneumonitis, although one sheep with advanced disease and radiographic and histopathological abnormalities had a paradoxically normal scan. One control animal showed minor abnormalities on scanning, which were probably due to the procedure used for anaesthesia. The HRCT observations were confirmed by postmortem histological examination of the lungs. In conclusion, high resolution computed tomography provides a noninvasive means of following the development of lung pathology in a natural ovine model of lentiviral disease.

Genomic heterogeneity in the pol region of ovine lentiviruses obtained from bronchoalveolar cells of infected sheep from France.

In order to determine the genomic heterogeneity of ovine lentiviruses, we analysed eight isolates from naturally infected sheep from one geographical region of France. A 475 nt fragment in the region of the pol gene coding for reverse transcriptase was amplified by RT-PCR from RNA directly extracted from uncultured bronchoalveolar lavage cells. The resulting PCR fragments were analysed by restriction enzyme digestion, cloned in a TA vector and sequenced. Restriction enzyme analysis showed distinct patterns from the eight isolates, and sequencing showed them to be closely related in both nucleotide (2.3-8.1% variation) and deduced amino acid (0-6.2% variation) sequences. Their amino acid sequences differed from that of visna-maedi virus complete viral genome sequence K1514 by 12.5-15.3%, but from that of caprine arthritis encephalitis virus (CAEV) viral genome sequence Co by only 4.2-6.9%. Phylogenetic analysis showed that the French isolates form a group related to CAEV Co and distant from previously reported ovine lentivirus sequences from different origins.

[Mediastinal-pulmonary sarcoidosis with unilateral pseudotumorous presentation. Apropos of a case]. / Sarcoïdose médiastino-pulmonaire à forme pseudo-tumorale unilatérale. A propos d'un cas.

We report a case of a patient of forty two years who was admitted with a chronic cough and had a left hilar "tumour". Scanning showed a hilar opacity with an air bronchogram. Fibreoptic bronchoscopy did not succeed in achieving a precise diagnosis, the biopsies showed no sign of malignancy. An open lung biopsy was necessary to establish the diagnosis of pulmonary mediastinal sarcoidosis with a pseudo-tumoral presentation and localised unilateral disease involving a segmental bronchus and the left upper lobe. There was a rapidly favourable outcome after treatment with steroids.