[Cystic dystrophia of the duodenal wall with aberrant pancreas. Value of magnetic resonance imaging for diagnosis]. / Dystrophie kystique de la paroi duodénale sur pancréas aberrant. Intérêt de l'imagerie par résonance magnétique pour le diagnostic.

BACKGROUND: Cystic dystrophy of the duodenal wall is characterized by the development of cysts in heterotopic pancreatic tissue localized in the duodenal wall. Diagnosis is difficult and endosonography is considered as the most useful investigation. CASE REPORTS: A 40-year-old man was hospitalized for abdominal pain triggered by ingestion of alcoholic beverages and for vomiting after food intake. The diagnosis of acute atypical cephalic pancreatitis was initially made. Magnetic resonance cholangiography then magnetic resonance imaging suggested the diagnosis of cystic dystrophy of the duodenal wall in a heterotopic pancreas which was confirmed by endosonography. DISCUSSION: Magnetic resonance imaging evidenced several cystic formations within a thickened duodenal wall leading to the correct diagnosis. MRI appears to provide all the elements necessary for the diagnosis of cystic dystrophy of the duodenal wall, avoiding the need for invasive investigations.

[Superficial bone metastases: report of two cases from colonic origin]. / Les métastases osseuses superficielles: à propos de deux cas d'origine colique.

Two cases of superficial bony metastases from colonic adenocarcinoma are reported. The plain film, CT and MR features are presented. The diagnostic imaging features and differential diagnosis are discussed. Superficial bony metastases are rare (2% of bony metastases) and only the characteristics of cortical bone vascularization allow to understand the superficial origin at the level of the cortex or subperiosteum. Magnetic resonance imaging is the modality of choice to characterize the tumor site and local extension. Diagnosis is suspected by clinical history and confirmed at biopsy.

[Whipple disease: a single or multiple origin?]. / Maladie de Whipple: un responsable ou plusieurs?

After having been considered as an essentially digestive disease, Whipple's disease has appeared more and more to be a multivisceral disease with two main characteristics: on one hand Whipple's disease yields a diffuse infiltration of tissues by abnormal macrophages without any other inflammatory reaction; on the other hand, aspects of microbial invasion by intra or extracellular unique rod-shaped Gram+bacteria are found. This unusual pathological complex has alternatively been considered as suggestive of an immunological defect or as a very unusual type of bacterial infection. Though recent studies support the hypothesis of a primary microbial infection due to a hitherto undescribed bacterium (Tropheryma whippelii) or more or less related bacteria belonging to the actinomycetes family, they do not totally exclude a primary or acquired impairment of antigen processing by macrophages. Speculations about this fascinating pathophysiological model and about its optimal therapeutic modalities are not likely to reach a conclusion in the near future.

[Tricuspid insufficiency disclosing carcinoid syndrome]. / Une insuffisance tricuspidienne révélatrice d'un syndrome carcinoïde.

The authors present a case of tricuspid regurgitation which reveals a carcinoid syndrome in an 68 year-old woman discovered in view of right heart failure. This carcinoid heart disease is early without symptoms of the primitive or the liver metastatic tumors. We see a good evolution with somatostatin's analogue. We review the diagnosis features in trans-thoracic and trans-oesophageal echocardiography, and the possibility of surgical treatment of these lesions.

[Genetic hemochromatosis disclosed by isolated increase of aminotransferases]. / Hémochromatose génétique révélée par une élévation isolée des aminotransférases.

The authors report five cases of genetic hemochromatosis in asymptomatic patients with elevated serum aminotransferases. They precise the interest of liver biopsy and hepatic iron concentration especially of hepatic iron index.