Segmental bronchial atresia--a case report and a literature review

Bronchial atresia is a short and juxtahilar bronchus interruption. This uncommon malformation leads to an obstructive and systematized emphysema, often associated with mucoid impaction. The authors report the case of a 5-year-old boy and review the literature in order to recall the radiologic features of this affection, which are characterized by an obstructive segmental or lobar emphysema often located in the upper lobe. The modern imaging means are not necessary for diagnosis. Bronchography confirms the atresia. Neonatal bronchial atresia appears as an opaque segment or lobe with retention of the alveolar liquid.

[Abdominal injuries in children. The value of emergency abdominal ultrasonography]

Abdominal injuries are frequent in children. Their early assessment is the best guarantee for an accurate management.

PATIENTS AND METHODS

Seventy children with abdominal trauma were evaluated by early ultrasonography.

RESULTS

This investigation found abnormalities in 52 patients, with hematic peritoneal effusion in 26 cases, renal lesion in 20 cases, hepatic lesion in ten cases, splenic lesion in seven cases and a lesion involving liver, spleen and pancreas in one case. Based on these results, surgery was performed in six cases. The remaining cases were simply supervised with a good prognosis.

CONCLUSION

Ultrasonography represents the main investigation in children's abdominal trauma, allowing an early, efficient and non-costly morphological diagnosis. Computerized tomography (CT) scan has some particular indications.

[Hypertrophic osteoarthropathy associated with malignant thymoma in a child]

We report a case of pulmonary hypertrophic osteoarthropathy in a child with malignancy thymoma. This entity is infrequent in pediatric patients.

[Contribution of ultrasonography in thyroid diseases. Apropos of 100 cases]

Thyroid disease is a very common disease, essentially affecting women, and raises diagnostic and therapeutic problems. The objective of this study was to specify the value of ultrasonography in the diagnosis and aetiological orientation of these lesions, based on a retrospective study of 100 patients. The results of ultrasonography were compared to the histological results. The aetiologies detected were dominated by benign lesions, particularly adenomas (56 cases), dystrophic goitres (32 cases) and cancers (7 cases). Ultrasonography allowed the detection of clinically impalpable nodules with no isotope scan signs in 11% of cases. The ultrasonographic appearance of benign nodules was variable. Solitary nodules were detected in 63 cases. They were hyperechoic in 15 cases, isoechoic in 8 cases, cystic in 9 cases, and mixed in 31 cases. A peripheral clear halo was revealed in 25 cases and macrocalcifications were present in 17 cases. Malignant lesions were visualized in 7 cases and were solitary in 5 cases. Solitary lesions had a hypoechoic echostructure in 1 case, an isoechoic echostructure in 2 cases and a mixed echostructure in 2 cases. The margins were poorly demarcated in 3 cases, and circumscribed without peripheral halo in 2 cases. Cervical lymphadenopathy was detected in 2 cases. Graves' disease, diagnosed in 2 patients, showed a diffuse hypoechoic appearance of the entire thyroid gland. Ultrasonography is a sensitive morphological method for the diagnosis of thyroid lesions. A detailed and precise analysis of the ultrasound signs of the lesion can suggest that benign or malignant nature of the lesion, which can be completed by Doppler-ultrasound and especially ultrasound-guided needle biopsies.

[Radiological aspects of histiocytosis X]

The histiocytosis X is a tumoral affection related to the proliferation of a highly differentiated cell which reaches the reticulohistiocytary system. The radiology represents on top of the clinic and the histology, the central pillar of this diagnostic tripod. This retrospective study is about 14 files of patients collected in different departments of UHC Ibn Rochd between 1976 and 1988. In the 14 observations, the diagnosis has been confirmed by an anatomopathologic examination. The disease supervenes with predominance at the young age (9 cases 11 years). The reach of the bone is very frequent (9/14 cases) and often multiple (7/9 cases), the preferential localizations are at the craniofacial level (50%), at the level of flat bones, the girdles (25%), the femur and the tibia (25%). The radiologic aspect is an osteolysis in the shape of lacunae with rounded and outlines suited with "take-piece", sometimes polycyclic in the card of geography. This osteolysis has sometimes a quite characterized aspect of the disease especially at the level of the cranium, the maxillomandibular massive, the supracotyloid region and the rachis. The reach of the lun during the histiocytosis X is relatively frequent (4/14 cases). It is often about an interstitial pneumopathy that is sometimes complicated of pneumothorax. The standard radiologic examinations of the osseous Skeleton help in making the diagnosis, permitting the complete physical examination of the extension and the supervision of the disease. The scintigraphy is less reliable and the scanner is not specific. However, the scanner explores better the base of the Skull and certain viscers which the reach can make revise the prognosis.

Rhabdomyosarcome para vertebral : cause rare de compression medullaire

Le rhabdomyosarcome est la tumeur maligne mésenchymateuse la plus fréquente chez l’enfant. Il se voit essentiellement au niveau des extrémités et la sphère ORL. La localisation paravertébrale avec compression médullaire est beaucoup plus rare. Les auteurs rapportent un cas de rhabdomyosarcome paravertébral avec extension endocanalaire et compression médullaire. Il s’agit d’une fille âgée de 6 ans admise pour un tableau de compression médullaire. L’examen clinique retrouve une patiente paraplégique avec niveau sensitif T8, des réflexes ostéo-tendineux abolis et une contracture des muscles paravertébraux. L’IRM médullaire montre un processus tissulaire à point de départ musculaire paravertébral droit, de signal hétérogène avec extension intra-canalaire et compression médullaire. La patiente a eu une laminectomie avec biopsie chirurgicale. L’étude histologique a posé le diagnostic d’un rhabdomyosarcome alvéolaire. La patiente a été traitée par chimiothérapie suivie d’une radiothérapie. L’IRM de contrôle a montré une régression totale du processus tumoral. Après un recul d’une année, la patiente a présenté une récidive locale avec métastases pulmonaires. Malgré cette localisation rare, le rhabdomyosarcome doit être évoqué devant un processus paravertébral avec extension épidurale et compression médullaire chez l’enfant.Mots clés : Rhabdomyosarcome, IRM, compression médullaire.