Mondor's disease of the breast: a case series.

BACKGROUND: Mondor's disease of the breast (MDB) is a rare and benign disorder of the breast. It is characterized by thrombophlebitis of the superficial veins of the chest wall. Clinically, it manifests as a cord-like induration of the breast area. MDB resolves spontaneously without sequela. CASE PRESENTATION: We report cases of three Caucasian African patients aged 29, 40 and 34, respectively. One patient was under progestative contraception. All the patients had a cord-like induration on the chest wall. Ultrasonography was performed in all patients and was normal in two cases and showed a thrombotic vein in one case. All the patients had symptomatic treatment with total resolution of symptoms within 1 to 4 weeks. No relapse was observed. CONCLUSION: MDB is benign in most cases. However, it is not to be taken lightly, because it can be the manifestation of an underlying disease such as breast cancer. The diagnosis is based on clinical findings; ultrasonography can be helpful for the diagnosis. Treatment is based on analgesic and anti-inflammatory drugs.

[Mammary tuberculosis: a retrospective study of 65 cases]. / Tuberculose mammaire: étude rétrospective de 65 cas.

OBJECTIVES: Remember the clinical, morphologic and histological particularities of mammary tuberculosis. Discuss clinical and radiological diagnostic problems caused by this localization, as far as breast cancer is concerned. PATIENTS AND METHODS: This is a retrospective study concerning 65 women suffering from mammary tuberculosis, diagnosed at Salah Azaiez Institute between January 1980 and December 2001. RESULTS: In this series, mammary tuberculosis represents 0.2% of the declared tubercular localizations and 0.3% of the mammary pathologies treated at the institute. The mean age of our patients was 36 years (19 to 79). Clinical findings were misleading. In 60% of cases the aspect was of a malignant tumor, in 24.6% of cases of a benign nodule and in 16.4% of cases of an abscess. The mammography concluded to a malignant lesion in 49% of cases. The fine needle aspiration achieved at 8 patients was negative in 6 cases and brought back the caseum in the 2 others. The diagnosis has been made, for all our patients, after histological study when we found typical tuberculosis lesions on pieces of tumorectomy, or biopsy. The diagnosis of tuberculosis was established; all patients had an anti-tuberculosis medical treatment in a department of infectious diseases out of the institute. DISCUSSION AND CONCLUSION: Clinical and radiological features of mammary tuberculosis are very confusing and cause a diagnostic problem with breast cancers. In front of symptoms evoking tuberculosis, biopsies must be done to eliminate an eventual cancer.

[Pulmonary scintigraphy with MAA-Tc 99m perfusion in the diagnosis of pulmonary embolism]. / La scintigraphie pulmonaire de perfusion AU MAA-TC 99M dans le diagnostic de l'embolie pulmonaire.

Perfusion lung scintigraphy is vital to guide the diagnosis even without a ventilation scintigraphy. A customised strategy could be useful to optimise the use of perfusion scintigraphy when not coupled with a ventilation scintigraphy. We report about a retrospective study on 300 patients received in our department for suspected lung migrations. The patients underwent a perfusion scintigraphy only: a normal scintigraphy would discard the diagnosis when achieved between 6 and 72 hours after the accident. On the other hand, the evidence of one or two perfusion defects would allow to maintain the pulmonary embolism suspicion and establish an effective heparinic treatment. A second control comparative scintigraphy, a few weeks after the first one, very often confirms the diagnosis, allows the assessment of the heparinotherapy and if necessary, indicate to stop it.

[Male secondary breast cancer after treatment for Hodgkin's disease. Case report and review of the literature]. / Cancer du sein secondaire chez l'homme après traitement pour maladie de Hodgkin. A propos d'un cas et revue de la littérature.

Hodgkin's disease is now curable in more than 50% of cases, due to its chemo- and radio-sensitivity. However, treatment exposes to a risk of secondary cancer varying from 1 to 10% depending on chemoradiotherapy doses and schedules. We report a case of secondary breast cancer associated with a secondary thyroid cancer observed in a 24-year-old man treated when he was 13 years old by vinblastin and radiation for stage IIA, a Hodgkin's disease.

Comparison of 6-hour infusion versus bolus furosemide in premature infants.

STUDY OBJECTIVE: To compare the renal, hemodynamic, and pulmonary effects of a 6-hour infusion of furosemide versus conventional bolus administration in premature infants. DESIGN: Prospective, blinded, placebo-controlled, randomized study. SETTING: Two level III, university-based neonatal intensive care units. PATIENTS: Thirty premature infants with significant lung disease, requiring furosemide after a red cell infusion. INTERVENTIONS: Infants received furosemide 1 mg/kg over 2 minutes, followed by a 6-hour placebo infusion, or a small loading dose of 0.1 mg/kg, followed by a slow infusion of 0.9 mg/kg over 6 hours. Serum and urine were collected to determine percentage fractional excretion of sodium (FENa). MEASUREMENTS AND MAIN RESULTS: Urine output and blood pressure were measured every 2 hours after furosemide administration. Percentage FENa was measured immediately before furosemide and compared with pooled urine from an 8-hour collection after furosemide administration. Serum sodium, creatinine, and calcium were measured before and 24 hours after drug administration. Mean airway pressure and percentage inspired oxygen were compared before, 1-4 hours after, and 4-12 hours after drug administration. No significant differences were detected between the two methods of drug administration. CONCLUSION: Our data suggest that a 6-hour infusion of furosemide does not offer substantial clinical advantage over conventional bolus administration in premature infants when focusing on urine output, blood pressure, FENa, or pulmonary effect.

Administration of granulocyte colony-stimulating factor to neutropenic low birth weight infants of mothers with preeclampsia.

Nine low birth weight infants with neutropenia born to mothers with preeclampsia were treated with granulocyte-colony stimulating factor, 10 micrograms/kg intravenously, within 24 hours of birth and at 24-hour intervals for a maximum of three doses if neutropenia persisted. The absolute neutrophil count increased significantly in eight of the nine infants within 6 hours, and neutrophilia was sustained for at least 72 hours after administration of a single dose of granulocyte-colony stimulating factor.

[Linitis plastica disclosed by cervical cutaneous metastasis]. / Linite gastrique révélée par des métastases cutanées cervicales.

INTRODUCTION: A case of a cutaneous metastasis as a first sign of a linitis plastica is reported. CASE REPORT: A 57 year-old man presented for a cervical infiltrated skin plaque. Histological examination and immunohistochemical staining gave the diagnosis of metastasis probably of gastrointestinal origin. Gastric endoscopy and biopsy confirmed the diagnosis of a linitis plastica. DISCUSSION: Cutaneous metastases from gastric carcinoma are uncommon and exceptionally the first sign of the disease. Their clinical and histological aspects are reviewed.

Increased incidence of sepsis at birth in neutropenic infants of mothers with preeclampsia.

Neutropenia is often found at birth in infants born to mothers with preeclampsia, and is most likely present in utero. To determine whether this neutropenia is associated with an increased incidence of early-onset sepsis, we reviewed the hospital records of 301 low birth weight infants of mothers with preeclampsia. Early-onset sepsis was proved if the result of a culture of blood or cerebrospinal fluid in the first 48 hours of life was positive, or presumed if culture results were negative but two or more clinical signs of sepsis were present and the attending neonatologist believed that an infant was infected and needed at least 7 days of antibiotic therapy. Forty-eight percent of low birth weight infants of mothers with preeclampsia had neutropenia at less than 12 hours of age. Infants with neutropenia had mothers with more severe preeclampsia, were more premature (30 weeks vs 32 weeks), weighed less (1097 gm vs 1615 gm), and were more likely to be small for gestational age. Although maternal and obstetric risk factors for infection were less common in the group with neutropenia, rates of proven or presumed early-onset sepsis were higher (14% vs 2%; p < 0.001). Sepsis was proved in 6% of infants with neutropenia and in none of the infants without neutropenia (p = 0.03). A logistic regression analysis of the relative effects of birth weight, gestational age, and absolute neutrophil count on the incidence of sepsis revealed that only a low absolute neutrophil count correlated significantly with an increased risk of early-onset sepsis in infants with neutropenia.