Revue des maladies respiratoires最新文献

{"title":"[When salvage surgery for apparent \"recurrence\" of small-cell lung cancer leads to prolonged survival while correcting the initial diagnosis].","authors":"M Glenisson, C Al Zreibi, L Gibault, T Toubiana, F Le Pimpec-Barthes","doi":"10.1016/j.rmr.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.rmr.2025.09.001","url":null,"abstract":"<p><strong>Introduction: </strong>The distinction between small cell lung carcinoma (SCLC) and carcinoid tumors may be challenging in small biopsy specimens, particularly when cellular artefacts (crush artifact…) are present. Nevertheless, an accurate diagnosis of these two neuroendocrine neoplasms - whose prognoses are radically different - is crucial to ensure appropriate therapeutic management.</p><p><strong>Case report: </strong>We report the case of a 40-year-old female patient referred for salvage surgery for recurrent small cell lung carcinoma (SCLC). Confirmed histologically, the recurrence had been treated 44 months earlier with concurrent chemoradiotherapy and prophylactic cranial irradiation. For this apparent 'relapse', left pneumonectomy with extended radical lymphadenectomy including dissection around the recurrent laryngeal nerve was performed, achieving R0 resection. Final histopathological analysis revealed an atypical carcinoid tumor with lymph node involvement in stations 10 and 4L. Review of the initial pathology slides - on which the Ki-67 proliferation index had not been determined - revealed that the same tumor had been present from the outset. Ten and a half years after this procedure, the patient remains alive, with a bone recurrence diagnosed one year ago.</p><p><strong>Conclusion: </strong>Salvage surgery can correct an initial misdiagnosis and ultimately provide the patient with the appropriate treatment. Any clinico-radiological and pathological discordance should prompt either a repeat biopsy or an external expert review. Systematic use of the Ki-67 proliferation index for all diagnoses of pulmonary neuroendocrine tumours, particularly in small biopsy specimens, may help to avoid such diagnostic pitfalls.</p>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical emphysema reduction: A viable alternative in the era of endobronchial valves].","authors":"J Milesi, R Naud, S Delliaux, F Bregeon, A Boussuges, H Dutau, P A Thomas, B Coiffard","doi":"10.1016/j.rmr.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.rmr.2025.09.002","url":null,"abstract":"<p><strong>Introduction: </strong>Management of patients with chronic obstructive pulmonary disease (COPD) and severe emphysema is complex. While endobronchial valve placement has become a widespread option, lung volume reduction surgery (LVRS) remains an important but sometimes underused alternative. Selecting the most appropriate intervention requires a multidisciplinary approach, especially for lung transplantation candidates.</p><p><strong>Case report: </strong>We report the case of a 57-year-old male former smoker referred for lung transplantation due to advanced COPD with severe upper-lobe predominant emphysema and pronounced pulmonary hyperinflation. The patient had disabling dyspnea (mMRC 3), a BODE index of 6, and major pulmonary function impairment (forced expiratory volume at 1st second [FEV₁] 31% predicted; residual volume 329% predicted). After multidisciplinary discussion and StratX® analysis, the patient underwent right upper lobectomy. Six months postoperatively, he had experienced significant symptomatic and functional improvement: FEV₁ had increased to 56% predicted, residual volume had decreased to 191%, and V˙O₂ max had improved. Ventilation efficiency and gas exchange likewise improved. Diaphragmatic ultrasound demonstrated enhanced mobility and thickening.</p><p><strong>Conclusion: </strong>This case highlights the interest of LVRS in carefully selected patients with severe emphysema, which remains viable in the era of bronchoscopic interventions. LVRS can provide clinical and functional benefits, improve quality of life, and in some cases delay lung transplantation. It remains an essential part of the therapeutic arsenal for end-stage emphysema and should be considered in multidisciplinary evaluations.</p>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faut-il faire maigrir les patients ayant une insuffisance respiratoire chronique et une obésité ?","authors":"A.-L. Borel ,&nbsp;P. Suzeau ,&nbsp;J.-C. Borel","doi":"10.1016/j.rmr.2025.06.004","DOIUrl":"10.1016/j.rmr.2025.06.004","url":null,"abstract":"<div><div>Les patients qui souffrent d’une insuffisance respiratoire chronique peuvent être en situation d’obésité. L’obésité peut être à l’origine de l’insuffisance respiratoire chronique, notamment dans le cadre du syndrome d’obésité hypoventilation (SOH) ou de certaines formes d’asthme. Elle peut également majorer certains symptômes comme la dyspnée. Dans ce contexte, il est souvent demandé au patient de s’engager dans une modification des habitudes de vie, voire dans un projet de chirurgie bariatrique, pour permettre une perte de poids. Cette perte de poids est-elle toujours souhaitable ? Nous discuterons dans cet article les possibilités actuelles pour obtenir une perte de poids significative et durable, les arguments en faveur d’une stratégie de perte de poids chez les patients ayant une insuffisance respiratoire chronique et ceux qui incitent à la prudence.</div></div><div><div>Patients suffering from chronic respiratory failure may present with obesity, which can cause respiratory failure, particularly in cases of Obesity Hypoventilation Syndrome (OHS) or certain forms of asthma. It can also aggravate symptoms such as dyspnea. In this context, patients are often asked to change their lifestyle, or even to undergo bariatric surgery, the common objective being to help them lose weight. That said, a question may be raised: is weight loss always desirable? In the present review of relevant articles, we report on: (a) the current possibilities for achieving significant and lasting weight loss, (b) the arguments in favor of a weight loss strategy for patients with respiratory failure, and (c) the arguments suggesting a need for caution.</div></div>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 8","pages":"Pages 394-404"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venues aux urgences pour asthme et devenir à l’issue : enquête PASS du réseau CRISALIS","authors":"A. Didier ,&nbsp;C. Camus ,&nbsp;A. Lemeur ,&nbsp;L. Bieler ,&nbsp;C. Rudzky ,&nbsp;C. Barnig ,&nbsp;A. Dussaucy ,&nbsp;A. Beurnier ,&nbsp;J.-M. Nguyen Quang ,&nbsp;F.-X. Blanc ,&nbsp;A. Kenzi ,&nbsp;P. Bonniaud ,&nbsp;N. Baptiste ,&nbsp;A. Bourdin ,&nbsp;M. Sebbane ,&nbsp;P. Chanez ,&nbsp;L. Pahus ,&nbsp;G. Devouassoux ,&nbsp;V. Labeye ,&nbsp;N. Khayath ,&nbsp;L. Guilleminault","doi":"10.1016/j.rmr.2025.06.006","DOIUrl":"10.1016/j.rmr.2025.06.006","url":null,"abstract":"<div><h3>Introduction</h3><div>L’admission aux urgences pour asthme est un signal d’alerte dans le parcours de soins. Les objectifs du projet Parcours Asthme Sévère Sécurisé (PASS) étaient d’établir un état des lieux des séjours aux urgences pour asthme et d’identifier points forts et axes d’améliorations du parcours de soins.</div></div><div><h3>Méthodes</h3><div>Les passages aux urgences pour asthme ont été recueillis sur l’année 2018 via les départements d’information médicale de 21 établissements en distinguant les hospitalisations et les passages externes. Une étude qualitative a été réalisée par entretiens avec les acteurs de terrain sur les établissements.</div></div><div><h3>Résultats</h3><div>Au total, 2883 patients hospitalisés aux urgences ont été dénombrés. Parmi eux, 1350 (47 %) ont été ensuite hospitalisés dans un service, dont 530 (39 %) en pneumologie, 170 (13 %) en soins intensifs ou en réanimation et 650 (48 %) dans d’autres services. Six critères de qualité du parcours patient ont été identifiés par l’ensemble des centres et sont soit existants soit, envisagés ou en cours de mise en place.</div></div><div><h3>Conclusion et perspectives</h3><div>L’asthme reste significativement responsable d’hospitalisations aux urgences. Des critères de qualité du parcours de soins à partir des urgences sont identifiés. Toutefois, seuls une minorité d’entre eux sont effectifs dans les centres. Des études complémentaires devraient permettre d’identifier les actions nécessaires à la mise en place de ces critères à l’échelle nationale.</div></div><div><h3>Introduction</h3><div>An emergency room visit for asthma is a warning sign of a breakdown in care. The objectives of the PASS project (Safe Severe Asthma Pathway) were to establish an inventory of asthma emergency room stays and to identify the existing strengths and areas for improvement in the patient care pathway.</div></div><div><h3>Methods</h3><div>One-year emergency room visits for asthma were collected from the medical information departments of 21 healthcare establishments. Hospitalizations were distinguished from outpatient visits. A qualitative study was carried out by interviewing the involved parties.</div></div><div><h3>Results</h3><div>Close to 3000 (2883) patients were admitted to emergency departments in 2018. Among them, 1350 (47%) were hospitalized in a ward, including 530 (39%) in pulmonology, 170 (13%) in intensive care or resuscitation, and 650 (48%) in other departments. Recognized as important by all 21 centers, six patient pathway quality criteria and are either already in place, planned or in the process of being set up.</div></div><div><h3>Conclusion and perspectives</h3><div>Asthma remains responsible for numerous hospitalizations in emergency units. However, only a small number of the identified quality criteria are actually applied in the centers. Further studies should help to pinpoint the actions needed to apply these criteria on a nationwide scale.</div></div>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 8","pages":"Pages 387-393"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maladies auto-immunes et inhibiteurs des points de contrôle immunitaires","authors":"A. Mogenet ,&nbsp;M. Duruisseaux ,&nbsp;B. Grigoriu ,&nbsp;L. Greillier","doi":"10.1016/j.rmr.2025.07.001","DOIUrl":"10.1016/j.rmr.2025.07.001","url":null,"abstract":"<div><div>Les inhibiteurs des points de contrôle immunitaires sont désormais incontournables pour la prise en charge des patients atteints de cancer bronchique primitif, quel que soit le sous-type histologique et désormais le stade. Néanmoins, les toxicités immuno-induites par ces anticorps monoclonaux sont parfois très invalidantes. Concernant les patients porteurs d’une maladie auto-immune, plusieurs questions se posent concernant le bénéfice et les risques de l’immunothérapie, mais également les conséquences de la corticothérapie systémique et autres traitements spécifiques. L’objectif de cet article est de synthétiser les données de la littérature concernant l’utilisation des inhibiteurs des points de contrôle immunitaires chez les patients souffrant à la fois de cancer bronchique et de maladie auto-immune.</div></div><div><div>Immune checkpoint inhibitors are now an essential therapy for lung cancer. These monoclonal antibodies are nevertheless responsible for immune-related adverse events. With particular regards for patients with previous autoimmune disease, less is known about the efficacy and safety of immune checkpoint inhibitors, but also about the consequences of steroids or other specific therapies. The aim of this article is to synthesize available data in the literature on immune checkpoint inhibitors experience in patients with both lung cancer and autoimmune disease.</div></div>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 8","pages":"Pages 405-413"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144744610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sommaire","authors":"","doi":"10.1016/S0761-8425(25)00231-1","DOIUrl":"10.1016/S0761-8425(25)00231-1","url":null,"abstract":"","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 8","pages":"Page iii"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommandations de la SP2A (Société Pédiatrique de pneumologie et d’allergologie) pour la prise en charge de l’asthme de l’enfant de 6 à 12 ans (en dehors de la crise d’asthme) – Texte court","authors":"S. Lejeune ,&nbsp;S. Wanin ,&nbsp;F. Amat ,&nbsp;G. Lezmi ,&nbsp;A. Deschildre ,&nbsp;R. Abou Taam ,&nbsp;G. Labouret ,&nbsp;D. Drummond ,&nbsp;J. Mazenq ,&nbsp;P. Cros ,&nbsp;H. Corvol ,&nbsp;A. Hadchouel Duverge ,&nbsp;C. Schweitzer ,&nbsp;L. Giovannini-Chami","doi":"10.1016/j.rmr.2025.08.001","DOIUrl":"10.1016/j.rmr.2025.08.001","url":null,"abstract":"","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 8","pages":"Pages 418-433"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruxolitinib, tuberculose disséminée et myélofibrose primitive : un cas d’école","authors":"A. Gérard ,&nbsp;V. Cauhape ,&nbsp;J. Courjon ,&nbsp;D. Viard ,&nbsp;L. Inchiappa ,&nbsp;A. Gaudart ,&nbsp;F. Vandenbos","doi":"10.1016/j.rmr.2025.06.005","DOIUrl":"10.1016/j.rmr.2025.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Le ruxolitinib est un inhibiteur de Janus kinase 2 (JAK2i) indiqué notamment en cas de myélofibrose primitive. Ce traitement favorise la survenue d’infections bactériennes et virales et peut réactiver certaines infections, dont la tuberculose.</div></div><div><h3>Observation</h3><div>Nous rapportons le cas d’un patient de 80 ans hospitalisé pour une tuberculose disséminée. Il était traité depuis 28 mois par ruxolitinib pour une myélofibrose primitive associée à la mutation JAK2^V617F. Le dépistage pré-thérapeutique d’une infection tuberculeuse latente n’avait pas été réalisé. Seize mois après le début du ruxolitinib, des lésions osseuses, péritonéales et ganglionnaires sont apparues. Finalement, le diagnostic de tuberculose disséminée a été posé 12 mois après la constatation des premières lésions secondaires. La tuberculose était alors à l’origine d’une atteinte péritonéale diffuse, ganglionnaire étagée, pleuropulmonaire, musculaire et surtout osseuse multiple avec destruction de la 6^e vertèbre thoracique. Un traitement par quadrithérapie antituberculeuse et la suspension du ruxolitinib ont permis une lente amélioration.</div></div><div><h3>Conclusion</h3><div>Avant de débuter un traitement par ruxolitinib, un test immunologique de dépistage de l’infection tuberculeuse latente doit être systématiquement réalisé, même dans un pays de faible incidence tuberculeuse.</div></div><div><h3>Introduction</h3><div>Ruxolitinib is a Janus kinase 2 inhibitor (JAK2i) used in patients with primary myelofibrosis. This treatment is a risk factor for bacterial and viral infections, and can reactivate latent infections, such as tuberculosis.</div></div><div><h3>Observation</h3><div>We report the case of a 80-year-old patient hospitalized for disseminated tuberculosis. He had been treated for 28 months with ruxolitinib for JAK2^V617F-muted primary myelofibrosis. Pre-therapeutic screening for latent tuberculosis infection had not been performed. Sixteen months after starting ruxolitinib, bone, peritoneal, and lymph node lesions appeared. Finally, the diagnosis of disseminated tuberculosis was made 12 months after the first secondary lesions were observed. By then, tuberculosis had caused diffuse peritoneal involvement, staged lymph node involvement, pleuropulmonary, muscular, and especially multiple bone lesions with destruction of the 6th thoracic vertebra. A treatment with quadruple antituberculosis therapy led to slow improvement. Ruxolitinib was discontinued.</div></div><div><h3>Conclusion</h3><div>Before initiating treatment with ruxolitinib, an immunological test for latent tuberculosis infection should be systematically performed, even in a country with a low tuberculosis incidence.</div></div>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 8","pages":"Pages 414-417"},"PeriodicalIF":0.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Imaging tests for the diagnosis of dyspnea during pregnancy].","authors":"I Kambutse, M Ranty, P-Y Le Roux, F Couturaud, C Tromeur","doi":"10.1016/j.rmr.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.rmr.2025.08.002","url":null,"abstract":"<p><p>Dyspnea during pregnancy may be due to cardiopulmonary disease (pleural effusion, pneumonia, pulmonary embolism, acute pulmonary oedema, asthma). Investigation requires thoracic imaging which is available in current practice. Given the risk of fetal malformation when radiation level exceeds 100mGy, clinical practices are heterogeneous. The choice of thoracic imaging for pregnant women also needs to take into account the level of ionizing radiation absorbed by the mother and the risk of radiation-induced cancer. In order to limit the number of potentially irradiating tests, it is essential to use non-irradiating thoracic imaging, to implement well-defined diagnostic strategies as first-line approaches and, more particularly, to apply imaging protocols adapted to the physiology of the pregnant patient. While thoracic imaging with ionizing radiation during pregnancy is not contraindicated, it must be clearly justified, and given the risks of fetal malformations and maternal cancer induced by radiations, it behooves clinicians to take into full account the benefit-risk balance and, as a rule, to apply the precautionary principle.</p>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sommaire","authors":"","doi":"10.1016/S0761-8425(25)00215-3","DOIUrl":"10.1016/S0761-8425(25)00215-3","url":null,"abstract":"","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 7","pages":"Page iii"},"PeriodicalIF":0.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}