Rev Pneumol Clin
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Lambert-Eaton syndrome is a myasthenia-like syndrome of paraneoplastic origin which is often associated with anaplastic small-cell lung cancer. It seems to be an autoimmune disease responsible for a deficit of acetylcholine ejection in the motor end plate. On the occasion of two recent cases, we review the clinical, physiopathological and diagnostic aspects of this paraneoplastic syndrome.
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In a series of 50 patients with lung lesions touching the thoracic wall, percutaneous ultrasonically guided needle aspiration yielded a pathological diagnosis in 44 cases (sensitivity: 88%). The histological diagnosis of malignant lesion could be confirmed in 41 of these 44 patients. In this group of patients with neoplasia the diagnosis obtained by extemporaneous cytotology was compared with that obtained by lung biopsy: the diagnostic sensitivity of cytology proved to be higher than that of biopsy (86.36% and 65.90% respectively). ⋯ No bleeding was observed, and there was only one complication: a partial pneumothorax not requiring drainage which was detected by ultrasonography and confirmed by radiography. Thus, ultrasonically guided needle aspiration of lesions adjacent to the thoracic wall appears to be an efficient and reliable diagnostic method. Lack of irradiation, real-time guidance, low cost, high sensitivity and easily available equipment are as many reasons to prefer this method to other interventional radiology methods in patients with peripheral lung masses detectable by ultrasounds.
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The authors present the main characteristics of respiratory pasteurellosis on the basis of 32 personal cases. The predominant background is chronic obstructive lung disease consecutive, in most cases, to chronic bronchitis. In patients without chronic lung disease the infection occurs when the terrain is deficient. ⋯ Diagnosis rests on isolation of the micro-organism and can be completed by serodiagnosis and intradermal reaction to pasteurelline. The severity of respiratory pasteurellosis depends on the clinical form and the background. The curative treatment is simple and effective as a rule, but prevention is possible and recommended since pasteurellosis is a potentially severe infection.