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Abstract The syndrome of Leser‐Trélat (LT) is a rare paraneoplastic syndrome. However, patients presenting with the sign of Leser‐Trélat should be considered to harbor an occult malignancy or a progressive tumor disease until “proven” otherwise. Herein, we present two cases of non‐small‐cell lung carcinoma associated with LT syndrome.

Abstract It is well established that exposure to respirable crystalline silica is associated with higher mortality. Such exposures are associated with an increased risk of silico‐tuberculosis, silicosis, and other respiratory morbidities. We report two cases of accelerated silicosis, complicated with pulmonary tuberculosis and pulmonary infection.

Abstract Primary pulmonary synovial sarcoma (SS) is a rare neoplasm. Its clinicoradiologic attributes are not yet well defined. We report the observation of a patient followed for primary pulmonary synovial sarcoma. We report the radio‐clinical features of this rare tumor.

Objectives: Several new cancer therapies targeting signaling pathways involved in the growth and progression of cancer cells were developed as personalized medicine. Our study aimed to identify epidermal growth factor receptor (EGFR) mutations for TKI treatment in non-small-cell lung cancer (NSCLC) Tunisian patients. Methods: Analysis of the TKI sensitivity mutations in exons 18 to 21 of the EGFR gene and exon 15 of the B-raf gene was performed in 79 formalin fixed-paraffin embedded (FFPE) NSCLC samples using pyrosequencing. Results: EGFR mutations were detected in 34 cases among 79 (43%), with the predominance of the L861Q in exon 21 found in 35.3% of the cases (12 out of 34). Deletions in exon 19 were found in 8 cases (23.5%), and only one young male patient had the T790M mutation. Three patients harbored composite EGFR mutations (p.E746_A750del/p.L861R, p.E746_S752>V/p.S768I, and p.G719A/p.L861Q). Furthermore, the EGFR mutated status was significantly more frequent in female patients (p = 0.019), in non-smoker patients (p = 0.008), and in patients with metastasis (p = 0.044). Moreover, the B-raf V600E was identified in 5 EGFR negative patients among 39 analyzed samples (13.15%). Conclusion: The p.L861Q localized in exon 21 of the EGFR gene was the most common mutation identified in our patients (35.3%), whereas the “classic” EGFR mutations such as Del19 and p.L858R were found in 23.5% and 11.7% of the cases, respectively. Interestingly, most of p.L861X mutation-carrying patients showed good response to TKI treatment. Altogether, our findings suggest a particular distribution of the EGFR-TKIs sensitivity mutations in Tunisian NSCLC patients.

Les pneumopathies infiltrantes diffuses (PID) constituent une manifestation fréquente des connectivites. Elles peuvent être révélatrices de la maladie ou survenir au cours du suivi. Le syndrome des anti-synthétases (SAS) est une connectivite auto-immune complexe et hétérogène. Des anticorps de type «anti synthétases», en particulier l´anticorps anti-Jo-1 caractérise ce syndrome. Le pronostic du SAS étant conditionné par la survenue d´une PID et de sa sévérité dictant ainsi la prise en charge thérapeutique du SAS. Nous rapportons l´observation d´une patiente âgée de 57 ans se présentant avec un tableau d´une PID aigue fébrile révélant le diagnostic d´un SAS. L´évolution a été favorable sous boli de corticoïdes associés au cyclophosphamide.

Primary lymphoma presenting a solitary lesion of the chest wall is extremely rare, as the majority of chest-wall tumors arise from metastasis. We report a case of a 64-year-old man with no history of HIV infection or pyothorax who presented with dry cough, right pleuritic pain and dyspnea. A computed tomography scan revealed an irregular pleural mass invading his right chest wall with pleural effusion. CT-guided needle biopsy revealed extranodal marginal zone B-cell lymphoma. The patient was treated with chemotherapy and radiotherapy. The patient has 9 years of follow up with 2 relapse's episodes. Keywords: Pleura, Computed tomography, Needle biopsy, Marginal zone B-Cell lymphoma, Primary effusion lymphoma

INTRODUCTION : il existe une controverse concernant la relation entre le taux d'éosinophiles sanguins (Eos) et la sévérité des exacerbations de BPCO. L'objectif de notre travail est de déterminer la relation entre le taux d'Eos et les différents paramètres de sévérité d'une exacerbation aiguë (EA) sévère de BPCO.Méthodes: étude rétrospective monocentrique portant sur les patients porteurs de BPCO suivis entre 2005 et 2015 ayant nécessité l'hospitalisation. Nous avons comparé 2 groupes de patients: G1(Eos+): Eos =200 cell/µl (103 cas, 20,4%), G2(Eos-): Eos =200 cell/µl (403 patients: 79,6%).Résultats: cinq cent six patients BPCO ont été inclus dans l'étude. Il n'y avait pas de différence significative entre les 2 groupes concernant l'âge, le genre, le VEMS, et le nombre d'EA/an (Eos+:2.6, Eos-:2.5 EA/an; p = 0,48). L'analyse des paramètres de sévérité des EA sévères montre l'absence de différence entre les 2 groupes concernant la PaO2 mesurée à l'admission (60,5, 59,2 mmHg; p = 0,26), la capnie (p = 0,57), le pH (p = 0,74), le taux de CRP (mg/l) (82,7, 81; p = 0,89), la leucocytose (p = 0,36), le recours à la ventilation non invasive (5.8%, 6.5%; p = 0,81), la ventilation mécanique invasive (p = 0,5), la durée d'hospitalisation (9.7, 9 jours; p = 0,21), ainsi que le délai de la prochaine EABPCO (p = 0,32). La survie à 1 an était comparable entre les 2 groupes (94% vs 96%; Log Rank: 0,708).Conclusion: l'augmentation du taux d'Eos chez les patients BPCO ne semble pas avoir une influence péjorative au cours des EA sévères. Malgré la prise en considération du taux d'Eos dans les décisions thérapeutiques dans les récentes recommandations, l'importance et l'intérêt pronostique de l'Eos au cours de la BPCO pourrait être population dépendant.