[Acquired ichthyosis revealing an Hodgkin's disease]. / Ichtyose acquise révélant une maladie de Hodgkin. Une nouvelle observation.

INTRODUCTION: Acquired ichthyosis is a rare condition that usually reveals malignant diseases. CASE REPORT: A 70-year-old man was admitted with weight loss, diffuse ichthyosis, lymphadenopathy of the inguinal lymph nodes and elevated inflammatory markers in peripheral blood. Histology of the lymph node revealed mixed-cellularity Hodgkin disease. The evolution was fatal in spite of the chemotherapy. DISCUSSION: Acquired ichthyosis is a cutaneous paraneoplastic syndrome, generally related to hematologic malignancies. A possible pathomecanism is the stimulation of epidermal growth secondary to the production of epidermal growth factor (EGF) by tumour cells. Acquired ichtyosis can rarely reveal systemic or infectious diseases. It can also be drug-induced or idiopathic.

[Isolated pseudo-tumoral tuberculosis of the spleen. A case report]. / La tuberculose splénique pseudotumorale isolée. (A propos d'un cas).

INTRODUCTION: The tuberculosis isolated tumoral spleen is rare, even in the countries to strong tubercular endemic. EXEGESIS: From an observation, concerning an important, tumoral and isolated splenomegaly in 48-year-old-man. The authors put the accent on his tumorous variety by the clinic, the imagery and on macroscopic appearance of the operative piece. Are discussed the isolated character, the way of dissemination, the site of initial infestation and the deceitful character of haematological manifestations. A splenectomy to diagnostic and therapeutic goal have been realised, associated to the chemotherapy. CONCLUSION: This is an expression of the profound organ's tuberculosis rich on endothelial reticular system. It's mean a singular topography of the bacillary lesion and a great distribution of the tubercular affect.

[Cardiac localization of non Hodgkin's lymphoma: a study on four cases]. / Localisations cardiaques du lymphome non hodgkinien: à propos de quatre cas.

INTRODUCTION: Cardiac localization of non-Hodgkin's lymphoma is rare and usually seen in the latest phase of the disease. However, its frequency is certainly under-estimated because 20% of patients who die of lymphoma have a heart involvement at autopsy. EXEGESIS: We report four cases of cardiac involvement of non-Hodgkin's lymphoma with various revelation modalities. Features of cardiac lymphoma are multiple and not specific. Echocardiography can be helpful in finding cardiac localizations, which can involve every cardiac structure. Histological proof of such an involvement is sometimes difficult to obtain. CONCLUSION: Prognosis of cardiac lymphoma remains poor despite the real progress in the treatment of lymphomas.

[Digestive malacoplakia]. / Malacoplakie digestive.

INTRODUCTION: Malacoplakia, a chronic granulomatous disease, rarely involves the digestive tube and, when it does, takes on a pseudotumoral aspect. OBSERVATION: A 37 year-old man was hospitalized for chronic diarrhea that had progressed over 15 years. He exhibited an edematous-ascitic syndrome and bilateral pleurisy together with, biologically, a malabsorption syndrome. The endoscopic examinations (fibroscopy and colonoscopy) revealed polypoid tumor-like formations. An image of tumoral stenosis of the sigmoid-colic junction was revealed on barite lavage. Histological examination of the surgical sample (wide left colectomy of one third of the transverse) was suggestive of malacoplakia (histiocytes with characteristic Michaelis-Gutmann bodies). DISCUSSION: Malacoplakia is an inflammatory disease predominantly affecting the urogenital tract. Other organs can be involved. Its clinical symptomatology is highly disparate. The interest of this disease is in its pathogenesis, on which, in fact, its treatment is based.

[Does emergency tropical medicine exist? The physician's point of view]. / Existe t-il des urgences médicales tropicales? Le point de vue du medecin.

The existence of tropical medical emergencies is a recurrent issue that joins the debate over the definition of tropical medicine. Is it medicine practiced in warmer climates, medicine practiced with poor diagnostic and therapeutic facilities or medicine involving only tropical diseases? Presentation of a few case reports provides a better response to this question than a long speech. The first case involves a 57-year-old man presenting a complicated attack of Plasmodium falciparum malaria and severe respiratory distress. The second case involves a pregnant AIDS patient presenting multifocal miliary tuberculosis associated with renal abscess and bacteremia. The third case involves a 34-year-old soldier hospitalized for right hilar pneumonia in whom work-up demonstrated co-infection by HIV 1 and 2, thick drop tests revealed uncomplicated Plasmodium falciparum malaria, and cytobacterial examination of sputum samples identified Salmonella enteritidis and acid-alcohol resistant germs. The fourth case involves a 60-year man hospitalized for febrile collapse in whom work-up revealed amebic pericarditis. These four case reports illustrate the main features of tropical medical emergencies: adult patients (frequently young), associated deficiencies or immunocompromise (HIV infection/AIDS), severe or complicated tropical disease, severe advanced stage disease because of inability to pay for care, multiple pathology, poor diagnostic/therapeutic facilities, and high mortality.