[Cystic mucinous pulmonary tumor of borderline malignancy. Report of a case]. / Tumeur kystique mucineuse pulmonaire de malignité frontière. A propos d'un cas.

A cystic mucinous borderline tumor was discovered in a sixty two year old man, presenting as a cystic mass in the right lower lobe. A first diagnosis of bronchiolo-alveolar carcinoma was made on bronchial biopsies. Surgical specimen examination revealed a lung mucinous cystic borderline proliferation similar to ovary borderline mucinous tumors. Such an unusual localisation has been already reported. The diagnostic difficulties are reviewed.

[Post-transplantation of Hodgkin's disease. Clinico-pathologic study of 3 cases]. / Maladie de Hodgkin après transplantation d'organè. Etude anatomoclinique de 3 observations.

As a frequent complication of immunosuppression, lymphoproliferative disorders affect approximately 2 % of allorgan transplant recipients. Most of them are EBV-associated-B-cell-lymphoproliferations. Other types of non Hodgkin's lymphomas and Hodgkin's disease, as observed in general population, have only rarely been reported in this group of patients. We report three cases of Hodgkin's disease, which were diagnosed in two renal transplant recipients and one heart transplant patient. They were associated with Epstein-Barr virus, as demonstrated by immunohistochemistry and in situ hybridization. EBV is frequently associated with Hodgkin's disease in the general population, and always implicated in AIDS-related Hodgkin's disease. However in transplant patients the rarity of Hodgkin's disease argues against a direct oncogenic role of this virus.

[Reversible acute renal failure with tubular oxalosis. Possible role of nutritional factors]. / Insuffisance rénale aiguë réversible avec oxalose tubulaire. Rôle possible de facteurs nutritionnels.

Intratubular deposits of calcium oxalate crystals can be responsible for acute renal failure. The present report concerns two cases for which none of the known causes of oxalate nephropathy were found. Both patients had common features: chronic alcoholism and denutrition. Except for early lumbar and abdominal pain, the renal failure picture was without any peculiarity. Renal biopsy showed tubular epithelium alterations with marked luminal deposition of birefringent crystals consistent with calcium oxalate. In one patient serum oxalate level was high, and in the other urinary oxalate excretion rose above normal when diuresis resumed. Renal function recovered spontaneously (follow-up of four years for one patient). Neither intoxication nor intestinal disease could be detected. Given the key role of pyridoxine in oxalate metabolism, we suggest that vitamin B6 deficiency secondary to alcoholism and denutrition could cause a rise in oxalemia leading to oxalate nephropathy. Experiments in animals support this hypothesis.

[Acute agranulocytosis after treatment by levamisole. 2 cases (author's transl)]. / Agranulocytose aiguë après traitement par le lévamisole. 2 observations.

We describe two patients who had a typical levamisole-induced agranulocytosis and a severe infection; the view of other cases found in the literature shows a fundamental fact: the complication can occur after a variable time of prescription (from thirteen days to eleven months), continuous or intermittent. The accidents are imprevisible, and circonspection must be used, not for its antihelminthic properties, but for its prolonged use for immunological purposes, even if some authors have not observed any cases of agranulocytosis in large series. Naturally, the purpose is quite different in the case of a severe rheumatoid arthritis or inesthetic warts, and our two observations are very demonstrative. Mechanism of agranulocytosis has not been totaly clarified: we have observed biological stigmates of immunological process against levamisole (responsible of agranulocytosis?), but essentially medullary lesions (successive regenerative aspects and necrosis) as has been described with pyramidon, and this could explain why the other blood cells are affected in an apparently isolated agranulocytosis.

[Silicone deposits in macrophages of patients on chronic hemodialysis]. / Dépôts de silicone dans les macrophages chez les patients en hémodialyse chronique.

A retrospective study was carried out in search of silicone deposits in 11 periodic hemodialysis patients (1 liver biopsy, 4 splenectomies and 6 autopsies) treated between 12 and 60 months with equipment containing a silicone pump segment. Silicone particles were found in the macrophage cells of all patients, especially in the liver and spleen, but also in lymph nodes, bone marrow and even an artery wall. In some cases, macrophage response had formed sarcoid-like granulomas. Silicone deposits in 3 patients were associated with a hypersplenism syndrome totally or partially improved by splenectomy. No relationship could be established between foreign material in the liver and clinical or biological abnormalities. Three patients who had died subsequent to peritoneal dialysis or hemodialysis involving polyvinyl chloride materials served as controls. No silicone inclusions were found in their tissues at autopsy.

[Prognosis of hemolytic uremic syndrome in children. Importance of extrarenal involvement]. / Pronostic du syndrome hémolytique et urémique chez l'enfant. Importance de l'atteinte extra-rénale.

The prognosis of hemolytic uremic syndrome was studied in 37 children hospitalized between January 1980 and January 1985. 75% of affected children were less than 3 years of age. Twenty-two (60%) presented with anuria or oliguria (mean duration of anuria: 10.7 days). In this last group, severe extrarenal manifestations occurred: 12 cases of neurological involvement (6 involving hypervolemia), gastrointestinal involvement in 5 cases, including a case of ileal necrosis; pancreatic involvement in another. Three children died during the first month of the disease (overall death-rate: 8%). Thirty-two children were followed with a mean 24 months follow-up (6 months to 60 months). Six (19%) presented with sequellae, of which 3 were severe: one severe arterial hypertension and two with chronic renal failure of which one terminal with severe neurologic sequellae. The existence of extrarenal manifestations implies a poor prognosis. Among the 22 children with anuria or oliguria, 8 had no extra-renal manifestations. All of these recovered. Three of 11 children with one extrarenal manifestation had an unfavorable outcome. The course was unfavorable in the 3 cases with multiple extrarenal involvement.

[Osteomedullary amyloidosis with osteolytic lesions. Apropos of 4 cases]. / Amylose ostéomédullaire avec lésions ostéolytiques. A propos de 4 observations.

Amyloidosis of bone and bone marrow is rarely symptomatic and is generally limited to deposits diagnosed by histological examination. Four cases with lytic bone lesions are reported. In 2 cases, amyloidosis was associated with Waldenstroem's Macroglobulinemia, in one case with multiple myeloma and in 1 case with solitary plasmocytoma. These 4 cases are compared to 14 cases already published in the literature, including 2 cases of plasmocytic dyscrasias. The role of amyloidosis in the genesis of bone lesions is discussed.

[Anatomo-clinical correlations in Berger's disease: evaluation of the prognosis by analysis of one hundred and one cases (author's transl)]. / Corrélations anatomo-cliniques dans la maladie de Berger. Evaluation du pronostic par analyse de cent un cas.

In order to evaluate the prognosis of IgA nephropathy semi-quantitative analysis of tubulo-interstitial and vascular alterations was performed. Three groups of patients are described. In the first group the prognosis has remained favourable until the present time. The prognosis is variable in the second group. In the last group the prognosis is always unfavourable. However, the limited duration of the study may elicit certain reservations concerning the long-term prognosis for the first and second groups.