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Biomedical subjects

F Vaylet

Publications and source records attributed to F Vaylet.

68 records · Page 4Linked to original sources

[Malignant primary intrathoracic histiocytofibroma].

Malignant primary intrathoracic fibrous histiocytoma (MFH) is a rare tumour: since it was first described in 1979, hardly more than 80 cases have been published. We present a large MFH which had started in the pleura and was intrathoracic. The tumour was typical, being comprised of malignant fibroblastic and histiocytoid cells in storiform arrangement. It was revealed by spinal bone metastases which multiplied over the whole skeleton in spite of chemotherapy. The patient died of cerebral metastasis developed 8 months after the onset of the disease. The cases found in the literature are gathered together and commented.

Bone Neoplasms↗

[Primary bronchial cancer in subjects aged 40 or younger].

Between 1985 and 1989, 395 patients with primary lung cancer were treated at the Percy military teaching hospital, Paris. Among them were 16 patients (4%) aged between 29 and 40 years (mean: 34 years) and smokers (mean cumulative tobacco consumption 24 P.A.). Six of these (37%) had lung parenchyma dystrophy with bilateral apical bullae of emphysema, 1 had a clean cavity left by a previous lung abscess and 1 had microcytic fibrosis resulting from histiocytosis X of the lungs and bones. In all cases cancer had developed in contact with bullous lesions or sequelae. Cancer was discovered during radiological mass screening in 6 cases (37.5%), on the finding of systemic or thoracic symptoms in 5 cases and because of a distant metastasis in 5 other cases. Pathological examination revealed an adenocarcinoma in 8 out of 16 patients and only one small-cell carcinoma. Nearly two-thirds of the patients had reached an advanced stage: 3 were in stage III A, 1 in stage III B and 6 in stage IV. Eight patients underwent curative surgery (7 lobectomies, 1 pneumonectomy). Survival was known with precision in 14 patients: 8 died after a mean follow-up of 15 months (range: 3 and 31 months); 3 were alive with an active cancer and 4 are still alive in complete remission after curative surgery. Six published studies totalling 387 cases are concordant in demonstrating that primary lung cancer is severe in adults below 40 years of age and that surgery is useful in such cases, even with N2 lymph node involvement.

Adenocarcinoma↗

[Eosinophilic lung disease caused by filariasis. Apropos of a case].

A 23-year-old male Pondichery native consulted for vesperal dispnoea. The main abnormalities detected were blood and alveolar eosinophilia and bilateral micronodular lesions at radiography. The parasitic origin of these symptoms was suspected, then confirmed by serological tests for filaria. The outcome was favourable after antiparasitic therapy. The histopathological, clinical and evolutionary features of pulmonary eosinophilic filiariasis are described, with emphasis on the treatment and on follow-up laboratory tests.

Adult↗

[Multifocal tuberculosis of bone. Apropos of an exceptional case].

Multifocal tuberculosis of bones (MTB) is exceptional in Europe. To the few cases found in the literature the authors add another case well documented by computerized tomography and nuclear magnetic resonance and remarkable for the number of bone lesions and their coexistence with extra-skeletal lesions. The patient was a 28-year old man native of the Ivory Coast in whom the imaging techniques demonstrated no less than 19 different bone lesions plus an abscess of the iliopsoas muscle and a prevertebral pus collection. The diagnosis of MTB was confirmed by the finding of alcohol- and acid-fast bacilli at needle aspiration of the bone lesions and by the presence of folliculo-caseous Ziehl-stained granuloma on bronchial biopsies. Fourteen months after treatment with specific 4-drug therapy, the outcome is favourable. This case is exceptional by the diffusion of bone lesions and by their association with bronchial lesions due to lymph node fistulization. Modern imaging techniques (CT, NMR), clearly demonstrated the bone lesions and their extent.

Adult↗

[Severe forms of effort-induced asthma].

Severe reactions in exercise-induced asthma (EIA) seem to be underestimated in the published literature. We report two cases of near-miss death from EIA that occurred after a short run. We review 364 exercise tests that were performed between September 1987 and October 1988 by a standardised protocol on a treadmill, on patients with possible EIA. A positive test, defined by a fall of FEV1 of at least 20% was found in 173 patients. From 21 patients with a fall of greater than 50%, 4 presented severe signs of: Cyanosis. Intense dyspnea with impediment of speech. General malaise with hypertension. These 4 patients were not greatly different from patients of the 50% fall group when compared for FEV1 before the test and for heart-rate during the test. They differed in the duration of the asthma attack, which was more protracted, despite the use of beta-2 agonists. The onset of severe reactions is 2.3% of positive tests and seems to be unpredictable.

Adult↗

[Pleurisy and sarcoidosis].

Two cases of sarcoidosis associated with pleurisy are presented. The pleural effusion had the same characteristics in both cases. Histology showed non-caseating epithelioid and giant cell granulomas in the parietal pleura. The first case was consistent with sarcoid pleurisy, but in the second case culture of a pleural biopsy specimen fragment demonstrated tuberculous pleurisy. Pleurisy may complicate sarcoidosis in about 2.5% of patients, notably in extensive pulmonary sarcoidosis with extrathoracic lesions. The clinical presentation and the appearance of the pleural fluid are varied. In most cases, a predominantly lymphocytic sero-fibrinous exudate is present. Thorough bacteriological studies, best performed on pleural tissue cultures, must follow the discovery of non-caseating tuberculoid granulomas which are also found in tuberculous pleurisy. Among the various pathogenetic theories considered, the immune reaction theory deserves special mention.

Adult↗

[Simultaneous or successive primary multifocal bronchial cancer. Apropos of 12 cases].

Twelve cases of bifocal and bilateral bronchial carcinoma are presented. The two tumours developed successively in 6 cases and simultaneously in 6 cases. Patients' mean age (60 years) was the same as in other lung cancers. Four out of 12 patients produced a history of old ENT or skin cancer. In 11 out of 12 cases the second tumour, undetectable by radiology, was discovered at bronchoscopy. In 2 patients the two tumours had a different histology: adenocarcinoma and squamous cell tumour. In all other cases, both tumours were of the squamous cell type. Treatment of the second contralateral tumour was difficult to determine, especially when the first tumour had been widely excised. However, radiotherapy focused on small endobronchial tumours seemed to give interesting results.

Adenocarcinoma↗