Case Report: Mepolizumab in the treatment of idiopathic chronic eosinophilic pneumonia [version 3; peer review: 2 approved]

Idiopathic chronic eosinophilic pneumonia (ICEP) is a rare interstitial lung disease of unknown cause. It usually responds well to systemic corticosteroid therapy, but relapses are frequent. We describe two cases of 21- and 27-year-old patients, presenting with dyspnea. The diagnosis of steroid-relapsing and steroid-dependent ICEP was made respectively. Mepolizumab was prescribed to both patients. This treatment resulted in successful long-term disease management with much fewer side effects than a traditional corticosteroid therapy

Case Report: Tracheal infiltration with wheezing revealing Hodgkin's disease [version 2; peer review: 2 approved]

Hodgkin's disease with an initial tracheobronchial involvement is not common. The symptoms might be misleading, resulting in a diagnosis delay. We report the case of a 38-year-old woman with a one-month history of wheezing associated with a dry cough. The physical examination revealed a good general state of health, bilateral wheezing and supra-clavicular lymphadenopathy. The adenopathy biopsy's histopathology revealed Hodgkin lymphoma. The whole body FDG-PET scan was an important tool to assess the diagnosis as well as for the staging. The patient was treated with chemotherapy. Another unusual aspect is the tracheobronchial metastasis confirmed by a bronchial biopsy. Thus, our patient was put on a second-line chemotherapy. She died one year after the initial diagnosis. To conclude, it is an atypical clinical presentation of an Hodgkin lymphoma with a tracheobronchial relapse. It should be considered in the differential diagnosis of asthma or a tracheal tumor

Spontaneous Resolution of a Pulmonary Cystic Amyloidosis Mass

Introduction: Amyloidosis is a rare illness characterized by the deposition in organs of amyloid, which can be detected by histological staining. Amyloidosis restricted to the lower respiratory tract is unusual. Results: We reported the case of a 68-year-old woman with no history of chronic disease who presented with dyspnoea on exertion, cough and fatigue. The physical examination was unremarkable. A CT scan showed a cystic mass with a thickened wall in the apical segment of the left lower lobe. A biopsy of the mass was performed, and histological and immunohistochemical study confirmed the diagnosis of AL amyloidosis. The patient’s clinical and radiological symptoms spontaneously improved without treatment after 3 years. Conclusion: Amyloid-related cystic lung disease is a rare presentation of amyloidosis in the thorax. More case reports are required to determine if such masses can resolve without treatment and whether amyloid-associated cystic lung disease actually exists

Case Report: A very rare case of a Pleural Effusion revealing Multiple Myeloma [version 3; peer review: 1 approved, 2 approved with reservations]

Multiple myeloma is a common malignant bone-based disease. Pleural effusions reported in these patients remain rare. It is commonly due to congestive heart disease, pulmonary embolism, nephrotic syndrome or a second neoplasia. The true myelomatous pleural effusion resulting from a direct tumoral invasion of the pleural are extremely rare. We report here the case of a massive pleural effusion revealing multiple myeloma in a 71-year-old patient. The chest ultrasound showed a massive pleural effusion in the left side with a multinodular thickening of the pleura. The medical thoracoscopy showed a grape-cluster appearance. The diagnosis was made by pleural guided biopsy revealing abnormal plasma cells with an intense positive CD 138 (plasma cell marker) and MUM1 (multiple myeloma oncogene1) staining with a light kappa chain in the protein electrophoresis associated with a myeloma. Unfortunately, our patient died one month after the initial diagnosis. We present also a review of the recent literature in order to highlight the clinical presentations of the myelomatous pleural effusion, the diagnostic tools, the therapeutic strategies as well as the outcomes

Seasonal dynamics of plankton communities coupled with environmental factors in a semi arid area: Sidi Saâd reservoir (Center of Tunisia)

International audienceIn this study, we studied the influence of the physical-chemical and biological factors (bacterioplankton and phytoplankton abundances) for zooplankton dynamics in a Sidi Saâd reservoir in Centre of Tunisia. The samplings were carried out in spring, summer, autumn and winter (2005 to 2006) in the deepest station (surface, 5, 10 and 15 m). In this reservoir, the highest density of zooplankton abundance was recorded in summer (92.2 ind L-1; 0.43 × 103 μg L-1) and autumn (86.9 ind L-1; 0.23 × 103 μg L-1) at a depth of 10 m. The copepods (56% of total zooplankton abundance) and cladocera (42% of total zooplankton abundance) were the most abundant groups. The physico-chemical factors, especially the water temperature (r = 0.53, p = 0.027, n = 16) and dissolved oxygen (r = -0.59, p = 0.03, n = 16), influence directly the zooplankton community. It was suggested that in Sidi Saâd reservoir, both the top-down and bottom-up regulations account for the regulation of zooplankton. The phytoplankton was the factor responsible for the structure and seasonal dynamics of the zooplankton community, which are well related to changes in algae diversity and abundance, noting that cyanobacteria have major impacts. The “top-down” effect of planktivorous fish on the zooplankton is a significant factor affecting the plankton community’s dynamics in this reservoir

Intercostal lung herniation secondary to thoracotomy: a case report

Intercostal lung herniation is defined as a protrusion of the lung parenchyma through a defect in the intercostal muscles between adjacent ribs. The authors report a case of intercostal pulmonary hernia in a 45-year-old male patient, with smoking habit (30 packs-year), presented to the emergency department with dyspnea. He had the history of pulmonary emphysema complicated with a total right pneumothorax in 2015 treated by mini-thoracotomy with bullectomy and pleural abrasion. In 2019, he was admitted to hospital for left chest pain. The computed tomography (CT) scan of the chest revealed a bilateral emphysema with intercostal lung hernia through the fourth intercostal space the patient underwent, a left thoracotomy with repair of the intercostal muscle defect. He was discharged from hospital free of complications