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Multifocal fibrosclerosis is a rare entity of unknown cause, characterized by systemic fibrosis. We report the observation of a 40 year old patient, without any particular pathological history, who presents a combination of mediastinal and retroperitoneal fibrosis of idiopathic origin.

Bronchogenic cysts are very rare congenital lesions. Pleural localization is even more rarely documented in the literature. Only histological analysis can confirm the diagnosis, as no clinical or scannographic features are pathognomonic. Surgical removal of the lesion is justified by the risk of complications.

Alveolar microlithiasis (AML) is a rare condition characterized by the accumulation of calcium concretions in the pulmonary alveolar lumen. We report two cases of AML, suspected on chest radiography and confirmed by chest CT scan with pathognomonic appearance and transbronchial lung biopsy. ALM is often asymptomatic in contrast to the importance of the characteristic radiological lesions. The etiology of this pathology is unknown, but a genetic origin with the autosomal recessive transmission is suspected with mutation of the SLC34A2 gene.

Granulomatosis with polyangiitis, formerly known as Wegener's disease, is a severe systemic necrotizing vasculitis, associating an inflammation of the vascular wall with a peri and extravascular granulomatosis. It is a rare disease that affects small vessels.it is classically translated by an otorhinolaryngological, respiratory and renal involvement. Other systemic manifestations of vasculitis may also be present.of slow evolution, the disease is often misleading and difficult to diagnose.The aim of our work is the analysis of the clinico-radiological thoracic and extra-thoracic manifestations, as well as the therapeutic and evolutionary profile in a retrospective study of a series of 22 cases.

Pulmonary aspergilloma is a serious deep mycosis, especially in countries with high tuberculosis endemicity, because of its bleeding complications, which are sometimes massive, and can be life threatening. Our work is a retrospective, descriptive and analytical study of 167 cases of pulmonary aspergilloma, collected from January 2003 to May 2021 in the department of respiratory diseases of the CHU IBN ROCHD of Casablanca, whose aim was to provide a better characterization of this pathology in our context in order to improve the management of these patients. We counted 111 (66.26%) men and 56 (33.53%) women, aged between 21 and 80 years, with an average age of 48.5 years. A history of tuberculosis was present in 150(89.8%) cases, as well as COPD in 25(15%) cases. Respiratory symptoms were dominated by hemoptysis in 151 (90.4%) cases, dyspnea in 83 (49.7%) cases and chest pain in 55 (33%) cases. 64 (38.32%) cases had a normal pleuropulmonary examination, while 79 (47.3%) cases had snoring. The diagnosis was made mainly on radio-clinical data. Aspergillus serology was positive in 98(59%) cases. On thoracic CT, the typical grelot image was present in 70 (42%) cases. The lesions were predominantly in the right upper lobe in 115(69%) cases. The CT scan also classified the lesions as simple aspergilloma (SCA) in 35(21%) cases and as chronic cavitary pulmonary aspergillosis (CCPA) in 132(79%) cases. The treatment was surgical in 108 (64,67%) cases. The postoperative course was simple in the majority of patients. However, we had 3 (2.77%) postoperative deaths. The average duration of follow-up of these patients was 3.5 years, during which an empyema was noted in 6 (6.81%) cases, a death in 5 (6%) cases and a recurrence in 2 (2.22%) cases. Medical treatment of PA with Itraconazole was indicated in 59 (35%) cases, for an average duration of 12 months with quarterly clinical, biological and radiological follow-up. The evolution was marked by clinical improvement in 15(25%) ....

Fernand Widal syndrome is a condition with an often severe triad of asthma, intolerance to acetylsalicylic acid and nasosinus polyposis. Aim of the work: to determine the clinical peculiarities of the patients carrying this syndrome in our context.Patients and methods: we carried out a retrospective study carried out over a period of five years at the service of respiratory diseases of the University Hospital of Casablanca, collecting 16 cases of patients carrying this triad. Result: The average age was 44.2 years, with a female predominance (75% of cases). All patients had atopy, mainly rhinitis and conjunctivitis. In 62.5% of the cases, asthma was moderate to severe with moderate to severe obstructive airways in 60% of cases. Five patients had a history of hospitalization for severe exacerbation of asthma in one medical facility and four others in intensive care unit with intubation in three patients. All patients were on inhaled corticosteroids and long-acting bronchodilators using antileukotrienes. Despite optimal medical treatment and polyp surgery in patients with locally resistant rhinitis, 38% of rhinitis cases and 56.6% of severe asthma cases were poorly controlled. In conclusion, patients with SFW have difficult-to-control asthma and rhinitis under optimal medical treatment, sometimes requiring desensitization with aspirin and the emergence of new therapies.

The present study highlights the Multiple pulmonary hydatidosis with cardiovascular localization. Cardiovascular localization remains exceptional with an estimated frequency between 0.5 and 2% of all hydatid localizations. Multislice CT with cardiac synchronization, as illustrated by our observation, allows an accurate morphological and extension assessment thanks to its very good spatial resolution and the possibilities of multiplanar reconstructions. Medical antiparasitic treatment is the treatment of choice for inoperable patients due to too many hydatid cysts, or debilitated terrain, or as a complementary treatment to surgery when there is a risk of dissemination.

The COVID-19 pandemic is an unprecedented global health crisis, Thoracic imaging has demonstrated its valuable role in the development of this pneumopathy. But has also allowed the evidence of asymptomatic attacks. We report the observation of a patient whose thoracic scan performed during his covid infection, revealed a thymic cyst, which is a very rare congenital tumor in adults.

Inflammatory pseudotumours of the lung are usually unifocal lesions of unknown pathogenesis and benign prognosis. We report the observation of a 68-year-old patient, hospitalised for etiological evaluation of a retracted opaque haemithorax revealed by exertional dyspnoea and chest pain. A radioclinical presentation suggested the diagnosis of a malignant bronchopulmonary tumour, but was refuted immediately after examination.

Primitive tuberculosis of the nasopharynx is rare. Clinical symptoms and paraclinical examinations are often confusing. Pseudotumour forms are frequent, which poses a problem of differential diagnosis with cavum cancer. We reported two cases of nasopharyngeal tuberculosis, followed up in the ear, nose and throat department of the Arrazi Hospital of the Mohammed VI University Hospital in Marrakesh. The first case concerned a 22-year-old female patient admitted to hospital for an etiological assessment of a right spinal adenopathy evolving in a context of altered general condition with weight loss, anorexia, and night sweats. The second case was a 14-year-old patient with a fistulised right spinal adenopathy with nasal obstruction and homolateral deafness. Nasofibroscopy in both patients showed a burgeoning tumour on the right posterolateral wall. A biopsy of the cavum was indicated. The histological study of the biopsies revealed an epithelial-giganto-cellular granuloma with caseous necrosis. This allowed to make the diagnosis of nasopharyngeal tuberculosis, and an antibacillary treatment was instituted. The evolution was favorable.

Resume Introduction L’asthme chez les personnes âgees est un probleme de sante qui est de plus en plus preoccupant. Sa prevalence va augmenter dans les 20 prochaines annees en raison de la tendance a la longevite de la population mondiale. Le but de notre travail est de tracer les caracteristiques epidemiologiques et cliniques ainsi que les difficultes therapeutiques de l’asthme chez ce groupe de patients. Patients et methodes Etude retrospective d’une cohorte de 112 patients âges de plus de 65 ans et souffrants d’un asthme bronchique, suivis a la consultation d’allergologie du CHU Ibn Rochd de Casablanca sur une periode de 13 ans. Resultats La moyenne d’âge etait de 67,5 ans avec une predominance feminine. L’atopie familiale etait presente dans 41 % des cas et personnelle dans 67 % des cas. Cinquante-deux pour cent des patients avaient des comorbidites, dominees par le diabete, l’hypertension arterielle et le reflux gastro-œsophagien. L’asthme evoluait en moyenne depuis 16 ans. Les prick-tests, realises dans 34,8 % des cas, etaient positifs dans 51,2 %. La spirometrie, realisee chez tous les patients, avait retrouve un trouble ventilatoire obstructif dans 56,2 % des cas. La prise en charge etait basee sur l’education therapeutique et le controle de l’environnement dans tous les cas. Le traitement de fond etait prescrit en fonction des stades et du niveau de controle de la maladie. L’asthme etait classe non controle dans 48,2 % des cas. Conclusion L’asthme du sujet âge est severe, souvent non controle et associe a des facteurs de comorbidites posant ainsi des difficultes a la fois diagnostiques et therapeutiques. Sa prise en charge necessite une education avec une comprehension du schema du traitement.