aaThoracic radiotherapy is one of the major treatment modalities in lung cancer. Radiation pneumonitis and fibrosis are well-known side-effects. ''Radiation bronchitis" in the form of inflammatory reaction of the airways mucosa following therapeutic external-beam radiation and highdose endobronchial radiation (brachytherapy) has also been reported. Otherwise, there is very little mention in the literature regarding the effects of the radiation on the airways.In this article, we report a case of sclerosing mediastinitis with bronchial stenosis discovered 1 yr after external thoracic radiotherapy. Case reportA right upper lobectomy for a peripheral adenocarcinoma of the ventral segment of the right upper lobe was performed on a 59 yr old woman in November 1992. This patient had a relevant medical history of a 40 pack-year history of smoking, a left sylvian stroke in 1988, and an inferior myocardial infarction in 1990. The postoperative staging (tumour, node, metastasis (TNM) classification), using a systematic mediastinal sampling, was T3N0M0 in view of an extension to the parietal pleura and the absence of metastases.External radiation therapy was, therefore, performed using an 18 MeV photon linear accelerator. Doses of 2 Gray (Gy) each were delivered in 27 fractions by a combination of anteroposterior parallel opposed fields (16 fractions), anterior direct fields (seven fractions), and anteroposterior opposed oblique angle wedge fields (four fractions). The total dose applied to the tumour bed and the right hilum was around 57 Gy. The total dose applied to the paratracheal left chain was approximately 45 Gy, and the spinal cord received about 42 Gy.In November 1993, the patient complained of persistent cough and a gradual onset of dyspnoea. On physical examination, a decrease in the breath sounds over the right lung was noted, the left lung being clear; no other findings of note were detected. Blood results were normal except for a slight elevation of hepatic enzymes. The carcinoembryonic antigen (CEA) was 10 ng·mL -1 (normal values <7 ng·mL -1 ), the level before the operation being 15 ng·mL -1 . The Mantoux test was negative.Chest radiography disclosed a right hilar enlargement and a right apical thickening. Thoracic computed tomography (CT) showed the presence of a right paratracheal mass with extension around the right main-stem bronchus, the lumen of which was severely narrowed ( fig. 1). The subcarinal area was also involved. A slight heterogeneous enhancement was observed after administration of contrast material. An area of soft tissue density containing dilated bronchi, with a straight edge corresponding to radiation fibrosis localized in the middle lobe with adjacent pleural thickening was present conforming to the radiation port. Magnetic resonance imaging (MRI) revealed that this mass had a low intensity signal both in T1 and T2 weighted images. This short T2 relaxation time was said to be suggestive of a benign fibrous process.Fibreoptic examination revealed an 80% extrinsic stenosis of the right ma...

A case of pulmonary Langerhans cell histiocytosis, proved by both lung high-resolution computed tomography and lung biopsy, is described. Following smoking cessation, lung nodules and cysts gradually disappeared on serial computed tomography scans, with complete clearance of the lesions after 12 months. The role of tobacco smoking is discussed, in detail, against the background of the literature.

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The authors report a case of a black African patient who suffers from a chronic eosinophilic pneumonia. In view of the lack of precise reporting in the literature of such a case in black Africans, the initial difficulty of strictly excluding a parasitologic etiology is discussed. From the comparison of paraclinical and clinical data with those of the literature, the authors emphasize the close relationship between asthma and chronic eosinophilic pneumonia and the role of alveolar eosinophils in the physiopathology of that illness.

The authors report an observation of Wegener's granulomatosis with pulmonary, bronchial, renal, cutaneous and sinusal involvement. Five years ago, the patient was referred to us because of bilateral diffuse pulmonary infiltrates of unknown origin. A corticotherapy was introduced at that time and a complete clearance of the pulmonary infiltrates was noted. Nineteen months after the treatment's withdrawal, the disease recurs with the reappearance of pulmonary infiltrates. Beyond these unusual clinical aspects, histological examination of the bronchial biopsies were of diagnostic value.