Gingival Metastasis Revealing Lung Adenocarcinoma

Introduction:?The lung adenocarcinoma is an invasive malignant tumor. Its visceral metastases are multiple. The gingival location is uncommon if not exceptional. Observation: We report the case of 66-year-old patient with a right cervical radiculopathology. Clinical examination objectified a superior vena cava syndrome with gingival tumor budding whose excisional biopsy found a location of a poorly differentiated and infiltrating carcinoma. The bronchoscopy revealed a tumor nodule obstructing the right mainstem bronchus with the histological study concluded as a moderately differentiated adenocarcinoma infiltrating. Conclusion: Gingival metastasis revealing lung adenocarcinoma is uncommon even exceptional. It may delay the diagnosis and management of already poor prognosis.

Lung Cancer in Women

At the same smoking level, women have a higher risk of lung cancer. The aim of the study was to evaluate epidemiological, clinical and histological profile of women＇s lung cancer. A retrospective study including women patients with a confirmed lung cancer followed at the Pneumology Department of University Hospital Center Mohammed VI of Marrakesh in Morocco between January 2010 and December 2014. 14 cases were included in the study. The average age of patients was 54.2 years. Active smoking was noted in 2 patients （14.4%）. The chest X-ray showed an atelectasis in 6 cases （42.8%）, hilar opacity in 6 cases （42.8%） and alveolar opacity in 2 cases （14.4%）, pleural effusion was present in 3 cases （21.4%）. Histological confirmation was obtained in 10 cases （71.4%） by bronchial biopsy, 2 cases with pleural biopsy （14.4%）, one case （7.1%） by lymph node biopsy and one case trans-parietal biopsy （7.1%）. An adenocarcinoma was found in 9 cases （64.3%）, squamous cell carcinoma in 4 cases （28.6%） and small cell carcinoma in one case （7.14%）. The study shows that the lung cancer in women in our context occurs more often in non-smoker patients and it＇s usually an adenocarcinoma type.

Ataxia Telangiectasia Syndrome Revealed by Severe Pneumonia

Ataxia Telangiectasia (AT) is a rare autosomal recessive multisystem disease. The diagnosis is often made on a clinical triad that combines neurological signs dominated by a progressive cerebellar ataxia, oculocutaneous signs (telangiectasia, coffee stain milk), immunodeficiency (humoral and cellular) with sinopulmonary infections and elevated alphaphetoprotein. The diagnosis of AT is usually early, however, some forms may be revealed late. We reported a case of a 19-year-old patient, admitted for severe pneumonia with Klebsiella Pneumonia. In its history, it was found a notion of recurrent respiratory infections and bronchiectasis. In its clinical examination, it had been discovered cerebellar ataxia and occulocutaneous telangiectasia. The determination of plasmatic alphafoetoprotein was elevated, and the search of immunodeficiency showed a mixed deficit (humoral and cellular) suggesting the diagnosis of AT.

Purulent Hydroaeric Pleural Effusion Due to Infection with <i>Gemella morbillorum</i>: A Case Report

Gemella morbillorum (G. morbillorum) is an opportunistic bacterium, which can sometimes cause severe infections especially in immunocompromised subjects. Respiratory infections due to this germ are rare, but are described. We reported a new observation of 34-year-old female patient, admitted for unusual location and clinical presentation of respiratory infection with G. morbillorum;she was presented a left pleuritic pain, a productive cough associated with purulent and foul sputum and dyspnea with onset one month earlier. The clinical examination was objectified a polypnea at 32 cycles/minutes, intercostal indrawing and mixed pleural effusion syndrome. She had also many dental caries and bad oral health status. Chest radiography showed an air-fluid image in the left chest and the thoracocentesis had revealed purulent fluid. The culture of this fluid had isolated a G. morbillorum. The diagnosis of mixed pleural effusion due to G. morbillorum in an immunosuppressed diabetic patient was made. The patient was put on antibiotics, thoracic drainage and Chest physiotherapy with good improvement.

<i>Pneumocystis jiroveci</i>Pneumonia in an Immunocompetent Female Patient

Introduction: The pneumocystosis is an infection caused by a saprophytic germ Pneumocystis jiroveci. It is exceptional in immunocompetent patients. Case report: This is a 30-year-old patient, admitted to the service for an acute respiratory failure. She was treated for pulmonary tuberculosis 6 months ago. The review has objectified clinique cyanosis of the lips and extremities with a blood pressure 120/70 mmHg, a heart rate of 70 bats/min, a temperature of 38°C and SaO2 to 82% in the open air. The chest radiograph objectified reticulonodular opacities on the right. The patient was put under bi-broad-spectrum antibiotics. Due to the non improvement of the patient’s state, the search for Pneumocystis jiroveci in induced sputum was made and it was positive. The search for a field of immunosuppression was negative.

Hiatal Hernia by Rolling Revealed by Respiratory Symptoms: A Rare Condition and Atypical Presentation

Hiatal hernia by rolling is a rare pathology estimated at 5% of all diaphragmatic hernias. It is usually asymptomatic. Sometimes, it can be accompanied by different symptoms, such as post prandial bloating, dysphagia, regurgitation, retro sternal pain, even respiratory symptoms. The aim of this article is to show that a hiatus hernia by rolling can cause a misleading clinical picture that may be taken wrongly for a heart or respiratory disease. We report the case of an 80-year-old patient whose presentation was suggestive of an acute heart condition, but the scan confirmed a rolling diaphragmatic hernia. Because of the rarity and the atypical presentation of this case, we have found it desirable to bring this new observation.