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Among non-chromaffin paragangliomas, the so-called aorticopulmonary or branchiomeric mediastinal chemodectomas are very rare tumors. A case is reported, and 57 similar cases described in the literature are reviewed. As recommended by Olson, a separate group was instituted of 21 cases of the so-called posterior mediastinal or aorticosympathetic group of the costovertebral groove. In principle, aorticopulmonary chemodectomas are non-functional, and in 9 out of 10 cases follow a slow and benign course extending over many, or even tens of years. In contrast to carotid and jugular paragangliomas they are rarely multifocal: when this is the case it is difficult to confirm the presence of metastases, this being however the most reliable criterion of their malignancy. The fortuitous discovery on a radiography of a tumor of the anterior and middle compartments of the upper mediastinum should invoke the presence of an aorticopulmonary chemodectoma, and lead to arteriography of the aortic arch region. Diagnosis is made essentially by pathological examination. Treatment is exclusively by surgical excision, and this was complete in nearly half of the cases treated. Prognosis is not hopeless after partial removal, however, and a relatively comfortable survival can be obtained extending over many years.

Five new cases of solitary fibrous mesothelioma of the visceral pleura support this review of the literature. Well encapsulated, mostly pedunculated, the implantation on the visceral pleura remains asymptomatic for a very long time and is more likely to be an incidental finding on a chest radiograph. Two extrathoracic signs are associated with certain huge tumors : hypoglycemia and osteoarthropathy. Histologic examination discloses whorls of collagen with scattered spindle-shaped cells. Electron microscope reveals characteristic features of both fibroblasts and mesothelial cells. Complete surgical removal is the best treatment for localized fibrous mesotheliomas of the visceral pleura. Recurrences after resection are rare and late recurrence, as long as 16 years after initial excision, usually behaves in a benign fashion.

Acquired ichtyosis appears to be a rather rare paraneoplasic syndrome, mainly observed during the course of Hodgkin's disease, but also accompanying visceral cancers. Two cases of generalised ichtyosis in patients with bronchial carcinoma are reported, emphasis being placed on the need for systematic investigations to determine this possible aetiology. Diagnostic problems are discussed, as well as hypotheses concerning the pathogenicity of these affections, which is still obscure, emphasis being placed on the secretory potential of these tumours and the role of immunological phenomena.

The authors report their experience of the evolution and treatment of spontaneous pneumothorax in the adult, in a series of 124 cases, starting from January 1965 to May 1975. Recurrences occur in 27% of cases whatever therapeutics are used. They discuss frequency and modality in relation to the etiology and the proposed treatment of pneumothorax.

In a 59-year old sand-blaster, histologically proven silicosis was complicated by systemic lupus erythematosus (SLE) and focal glomerulonephritis with IgG, IgA and ClQ deposits. Nothing likely to facilitate SLE was detected by investigating the familial background, the HLA phenotype and the complement system. This type of SLE differs from drug-induced lupus-like syndromes by a high level of anti-double helix DNA antibodies and by the renal lesions observed. The connection between silicosis and SLE lies in changes in humoral immunity, i.e. polyclonal activation and production of antinuclear antibodies. A decrease in the number of suppressor T-cells may also be held responsible.