[A rare cause of cauda equina syndrome: primary epidural lymphoma]. / Une cause rare de syndrome de la queue de cheval: Le lymphome epidural primitif.

INTRODUCTION: Primary epidural lymphoma is generally manifested by isolated epidural involvement. On rare occasions it can lead to cauda equina syndrome. CASE: A 56-year-old man was hospitalized for lumbago, weakness in the legs and sphincter problems. A dorsolumbar MRI revealed that the anterior and posterior peridural space from D11 to L3 was filled by a mass compressing the marrow and compacting the roots. The L2 to L4 laminectomy revealed an extradural tissue leading to the diagnosis of large B-cell lymphoma. Metastatic workup demonstrated unremarkable findings. DISCUSSION: Primary epidural lymphoma accounts for less than 10% of epidural tumours and less than 1% of non-Hodgkin lymphomas. Its clinical manifestations are related to the tumoral process or involvement of medullar vessels. It can be, but rarely is, manifested by cauda equina syndrome. Diagnosis is based on histological analysis of tissue taken during the decompression laminectomy. Prognosis is relatively good.

[Giant cutaneous squamous cell carcinoma of the nose with subsequent brain extension]. / Carcinome épidermoïde cutané géant du nez avec extension cérébrale secondaire.

INTRODUCTION: Cutaneous squamous cell carcinoma is an invasive and destructive tumor, and may cause death by local extension or because of metastasis. We report the case of a patient with a giant squamous cell carcinoma of the nose and extension to the brain and discuss the main risk factors from this extension. OBSERVATION: Resection of a giant squamous cell carcinoma was performed of the nose in a 45 year-old man after debulking radiotherapy. Histological examination disclosed a well-differentiated tumor and perineural involvement, with at least a 6 mm margin. A first relapse occurred on the orbital edge of the initial resection, the lesion was removed revealing an involvement of the infra-orbital nerve. Whilst the patient was receiving chemotherapy, a second relapse occurred responsible for ophthalmoplegia and loss of vision, with involvement of the left orbital apex, cavernous sinus and temporal lobe. The patient died from grand mal seizures. DISCUSSION: Brain extension of cutaneous squamous cell carcinoma of the head is rare. It develops along the anatomic pathways, especially perineural spread. Main risk factors for such a poor course are discussed, including the size of tumor, the anatomic site, the depth and perineural invasion.

Hepatic and splenic involvement in cat-scratch disease: imaging features.

Hepatosplenic involvement in cat-scratch disease, probably underdiagnosed, is characterized by multinodular lesions throughout the liver and spleen. Radiologic features of ultrasound, computed tomography, and magnetic resonance imaging are not specific. The key of the diagnosis relies on a history of cat or kitten contact. A specific serological test can confirm the diagnosis without invasive procedures such as biopsy.

Pancreatic pseudocyst located in the liver: a case report and literature review.

Pancreatic pseudocyst in the liver is a rare complication of acute or chronic pancreatitis. However, its frequency seems to be increasing with modem imaging procedures. The authors report a case of pancreatic pseudocyst involving the left lobe of the liver that occurred in a patient who never showed clinical evidence of pancreatitis or pancreatic injury. Complete screening led to the discovery of alcoholic chronic pancreatitis. The pseudocyst was treated successfully by radiologic drainage. The pancreatic pseudocyst location and therapeutic approaches are discussed. A literature review uncovered 26 cases of hepatic pancreatic pseudocysts. Clinical presentation, imaging characteristics, and treatment of these cases are analyzed.

Hodgkin's and non-Hodgkin's hepatic lymphoma: sonographic findings.

The sonographic studies of 72 patients with pathologically proven Hodgkin's or non-Hodgkin's hepatic lymphoma were retrospectively reviewed. Sixty-eight patients (94%) had secondary hepatic lymphoma (nine of them had AIDS-related lymphoma) and four patients (6%) had primary lymphoma of the liver. Forty-six of 72 patients (64%) had diffuse hepatic involvement, and 26 of 72 patients (36%) had focal liver lesions as demonstrated by sonography. Four patterns of disease were identified: (a) hepatomegaly was depicted by sonography in 26 of the 59 patients with secondary hepatic lymphoma not related to AIDS, in two of the nine patients with AIDS-related secondary hepatic lymphoma, and in one of the four patients with primary hepatic lymphoma; (b) multiple rounded well-delineated hypoechoic liver lesions were found in 22 of the 68 patients with secondary hepatic lymphoma; (c) a large heterogeneous echoic mass, which was an evocating clue to the diagnosis of primary lymphoma of the liver, was found in the four patients with primary lymphoma of the liver; and (d) an absence of sonographic abnormalities was found in 20 of the 59 patients with secondary lymphoma not related to AIDS. Liver involvement with lymphoma should be considered in any patient who develops multiple homogeneous hypoechoic liver masses, even in the absence of known underlying lymphomatous disease.