A case of leiomyosarcoma of the inferior vena cava in a 74 year old woman is reported. The clinical and pathological features are described and the outcome and response to treatment analysed. This is a very rare form of malignant disease (less than 100 published cases) which mainly affects elderly women. The diagnosis is often made at a late stage because the symptomatology is not specific and because the tumour is so rare. Treatment is mainly surgical and is only possible in the infrarenal part of the inferior vena cava. It is very difficult or impossible to operate on the upper part of the vessel. The prognostic is poor. There are no reports of survival after 5 years.
Three cases of mushroom growers lung, responding to the criteria for an extrinsic allergic alveolitis, have been observed in the Hôpital Bichat, Paris. In the first case, a "semi-delayed" hypersensitivity phenomenon of type III was evoked, an "immediate" type I phenomenon in case 2, and an association of the two in the third case. Clinical manifestations may develop very rapidly in subjects working in areas where they are exposed to a high inoculum of fungal products. Multiple antigens are involved: Psalliota, actinomycetes of different varieties, manure substrate, fungal spores, bacteria, cereal dust, etc. A recognized occupational disease, it leads to a change in activity and the right to compensation.
The authors report 2 observations of auriculoventricular blockage developed during a mediastino-pulmonary sarcoidosis, requiring a heart pacer in the first case and corticosteroid treatment in the second. The frequency of the disorders of intracardiac conduction was evaluated by a retrospective study of 412 cases of mediastino-pulmonary sarcoidosis. Seventy two ECG were considered abnormal, a frequency of 17.2%. The disorders of auriculo-ventricular and intra-ventricular conduction represented a third of cases. What is known on the risk of lethal evolution of cardiac sarcoidosis in which those abnormalities are significant, justifies an electrophysiological investigation. The indications for a definitive cardiac stimulation and corticosteroid treatment are debated. On this final point, it seemed necessary to plan a prospective study to confirm the merits of the treatment and to define its modalities.
