Aspiration of foreign bodies occurs mainly in children and elderly people. When the foreign body is a tablet, this event can be more severe due to the local release of active molecules. We observed spontaneously regressing bronchial necrosis and granuloma due to the aspiration of a tablet of ferrous sulphate. We stress the need to consider the possibility of aspiration of a tablet in elderly patients with acute respiratory symptoms, and the importance of an early removal of the tablet.

The authors present 52 cases of neurological complications of bronchial cancer including 35 cases of non-tumoral manifestations. They stress the frequency and the severity of these complications which are dominated by cerebral vascular accidents and describe the pathogenic features of this particular complication. They define the complications accessible to treatment: iatrogenic pathology, deficiency disorders and certain paraneoplasic syndromes.

Cancer bronchique microcellulaire traite par radiotherapie avec une dose totale de 6500 rads avec survenue progressive d'une paraplegie complete. Pathogenie vasculaire: l'atteinte des arteres spinales est responsable de l'ischemie medullaire progressive et irreversible

Forty-three patients with small-cell bronchial carcinoma were treated with sequential combination chemotherapy of the CMC-VAP type alternating every 6 weeks. Toxicity affected mostly blood cells and occurred during induction. The response rate was 60% in circumscribed forms with a median survival of 15 months, and 30% in diffuse forms with a median survival of 6 months. The value of alternating protocols and the place of radiotherapy are discussed in the light of these results.

Emergency bronchial fibroscopy is often asked for by intensive care units. It is usually easy to make examination. The authors tried to evaluate its diagnostic and therapeutical efficiency. They gathered 48 observations of endoscopies performed in the intensive care unit. The diagnostic efficiency is valued at 70% and the therapeutical one at 85%. The main indication is the pulmonary obstruction besides tracheal stenoses, tracheal ruptures, hemoptysis and searching for opportunistic germs.

From 200 observations, the authors study the results of laboratory examinations and paraclinical testings of the pleura. Neoplastic etiologies represent a 1/3 of all pleurisies. In 20% of cases a definite etiological diagnosis could not be obtained in spite of exploring thoracotomies. The limit of 30 g/l of proteins for the differentiation of mechanical transsudates and inflammatory exsudates was inaccurate. Cytodiagnosis was efficient in 75% of mesotheliomas but the percentage fell to 53 in secondary cancers. For needle biopsy results were respectively of 66% and 57%. Thoracotomy (24 cases) enabled a diagnosis in half the cases where it was performed. Thorascopy seems to bring similar results.

Alveolar cancer is the only true cancer of the lung as opposed to the common bronchial cancer. The authors defend this thesis by contesting the excessive usage of the expression bronchiolo-alveolar cancer and by supporting it with 12 original observations together with the literature review. The anatomo-pathological data are reported and discussed in order to analyze the reliability of the observations; diagnosis can vary according to the methods used in comparing the bronchial cytology and the examination of the operation tissue samples; the evolutive back search of observations revealed that out of 9 operated cases with localized involvement, 5 patients were still alive 2 years later. Complementary examinations by scintigraphy with labelled bleomycin were disappointing; this test performed 4 times was only once positive. Data from electron-microscopy and tissue culture seem to point towards a histogenesis from type II pneumocyte.

Fifty-one patients suffering from non-microcellular bronchial cancer with metastasis were divided at random into two groups: 33 patients received BACFON polychemotherapy, 18 patients did not receive chemotherapy. There was no global significant difference between the two groups (total mean survival time : 22 weeks with good therapy and 18 without), but a significant difference could be observed if there was an early response (M.S.T. : 38 weeks) compared to no response (M.S.T. : 15 weeks). Similar results were obtained when radiotherapy was associated (M.S.T. : 34 weeks) compared to chemotherapy without radiotherapy (M.S.T. : 22 weeks).

Bronchial necrosis and granuloma induced by the aspiration of a tablet of ferrous sul- phate. R. Lamaze, P. Tréchot, Y. Martinet. ERS Journals Ltd 1994. ABSTRACT: Aspiration of foreign bodies occurs mainly in children and elderly people. When the foreign body is a tablet, this event can be more severe due to the local release of active molecules. We observed spontaneously regressing bronchial necrosis and granuloma due to the aspiration of a tablet of ferrous sulphate. We stress the need to consider the possibility of aspiration of a tablet in elderly patients with acute respiratory symp- toms, and the importance of an early removal of the tablet.