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Biomedical subjects

G Edel

Publications and source records attributed to G Edel.

At least 19 recordsLinked to original sources
PubMed1998

[Solitary metastasis of a clear cell renal cell carcinoma after a 20 year latency clinically simulating a vascular tumor].

HISTORY AND CLINICAL FINDINGS: A 72-year-old woman was referred because of progressive skin discoloration with venectasia and swelling in the left lower leg, the possible diagnosis being atypical varicose veins. 20 years before she had a right nephrectomy for "clear-cell" renal adenocarcinoma with subsequent tele-cobalt radiotherapy. On examination a pulsating swelling was palpated over the hyperpigmented area of the skin with venectasia. INVESTIGATIONS: She had hypercholesterolaemia (254 mg/dl) and hyperuricaemia (uric acid 6.2 mg/dl). Duplex sonography, angiography and computed tomography of the lower leg revealed a vascular tumour with infiltration of the right head of the gastrocnemius. DIAGNOSIS, TREATMENT AND COURSE: Because an arteriovenous fistula within a vascular soft-tissue tumour of unknown histology was suspected, a wide resection was performed. Histopathological examination revealed a metastasis of a clear-cell adenocarcinoma. Postoperative diagnostic tests discovered no other findings suspicious of malignancy. It is therefore to be assumed that the resected tumour was a solitary metastasis of the renal adenocarcinoma removed 20 years previously. CONCLUSION: Even rare causes should be considered in the differential diagnosis of vascular tumour, as this case of a solitary metastasis after a latency of 20 years demonstrates.

Adenocarcinoma, Clear Cell↗
PubMed1998

[Coccidioidomycosis as the cause of granulomatous hepatitis].

UNLABELLED: The case of 36-year-old man is reported who fell ill with a febrile infection, shortly after returning from several weeks to Mexico. EXAMINATION: Chest X-ray revealed a pulmonary infiltration. Also, the levels of liver function tests (gamma-GT, alkaline phosphatase, SGOT, SGPT) were clearly increased. As there were no signs of extended bile ducts in ultrasonics, a liver biopsy was indicated. The histology showed a granulomatous hepatitis. DIAGNOSIS: The exposure during the Mexico-trip, the pulmonary infiltration, the histology and the significant raised titers in specific serological tests led to the diagnosis of a general infection by the fungus coccidioides immitis. In addition to pathogenetic aspects of coccidioidomycosis the diagnostic approaches and relevant therapeutic strategies are discussed.

Adult↗
PubMed1997

Primary malignant rhabdoid tumours of the central nervous system: an immunohistochemical and ultrastructural study.

Three cases of primary rhabdoid tumour of the CNS (RT-CNS) are presented. In case 1 a hemispheric tumour developed in a 10.5 months old girl, who survived for 6 months after incomplete resection, radio- and polychemotherapy. Case 2 was a 4 years and 8 months old boy with a large IIIrd ventricle tumour, who died of leptomeningeal tumour dissemination 7 months after diagnosis despite radiotherapy. In case 3 a pineal mass occurring in a 14 month old female was radioresistant and totally exstirpated. The child died due to tumour recurrence two months later. Autopsy examination revealed widespread leptomeningeal dissemination. All three cases fulfilled light and electron microscopic criteria of RT-CNS including abundant eosinophilic cytoplasm, vesicular nuclei with large nucleoli and conspicuous anti-vimentin positive filaments. Extensive immunohistochemical studies showed expression of epithelial (EMA, KL1), macrophage (alpha-1 antichymotrypsin), neuro-ectodermal (GFAP, NSE, beta-tubulin III) and myogenic markers (desmin, actin). Different stress proteins (alpha-B crystallin, HSP70) were also expressed. Tumour cells showed a proliferation (MIB1) index of 28.4% (case 1) and 33.4% (case 2). From our study it can be concluded that RT-CNS reveals significant immuno-morphological heterogeneity thus supporting the view that it is not a specific pathological entity but merely a phenotypic appearance of different neoplasms, some of which are linked to primitive neuro-ectodermal tumours.

Biomarkers, Tumor↗
PubMed1997

Expression of biglycan, decorin and proteoglycan-100/CSF-1 in normal and fibrotic human liver.

The immunohistochemical expression of the three small chondroitin/dermatan sulphate proteoglycans biglycan, decorin and proteoglycan-100 (PG-100), the proteoglycan form of colony-stimulating factor-1 (CSF-1), was studied in normal and fibrotic human liver. In normal liver tissue biglycan and decorin were clearly seen in the space of Disse, which was in contrast to a faint staining of PG-100. Biglycan and decorin were additionally detected around small bile ducts and in vessel walls. In patients with HBs-Ag positive, chronic active hepatitis decorin as well as biglycan showed strong immunoreactivity in fibrotic areas. In contrast to normal liver, PG-100 was visualized in bile duct epithelia. Therefore, PG-100 could serve as an immunohistochemical marker of the involvement of the bile duct system in chronic active hepatitis and progressive liver fibrosis.

Adult↗
PubMed1997

[Angiosarcoma of the hand. Case report].

Angiosarcoma is a very rare malignant bone tumour. The case of a 45-year-old man is presented with a primary epithelioid hemangioendothelioma in the fourth metacarpus. After radical extirpation of the tumour radiation followed. The function of the hand was fully preserved. Five years after operation the patient is free of disease.

Bone Neoplasms↗
PubMed1996

A cell-surface epitope associated with liver-preferential metastasis detected by the new monoclonal antibody 3H4 in the murine tumor model ER 15-P.

In the tumor model ER 15-P, a chemically induced pleomorphic myofibrosarcoma of the C57/Bl6J mouse, cell lines with liver-preferential metastatic tumor spread were selected in vivo. In order to describe cell-surface molecules relevant for hepatic metastasis, monoclonal antibodies were raised against the liver-preferential variants. In a syngeneic immunization with viable tumor cells cyclophosphamide was used for augmentation of the humoral antitumor immunity. The monoclonal antibody mAb 3H4, an IgG2b isotype, reacted with a cell-surface epitope exclusively detected on the liver-preferential metastatic phenotype (Me) of the tumor model ER 15-P; no reactivity with the non-organ-specific metastatic phenotype (P) was observed. Regarding the morphological heterogeneity of different Me and P tumor cell populations, mAb 3H4 antigen expression was consistently associated with liver-preferential metastasis, not with different morphological stages of differentiation. It showed no cross-reaction with other tumor cell lines tested except MethA murine fibrosarcoma. The antibody was unreactive with normal tissue cells in C57/Bl6J mice. mAb 3H4 antigen expression was not dependent on the cell cycle. In an experimental assay of hematogenous metastasis, preincubation with mAb 3H4 significantly reduced the number of liver metastases of the liver-preferential tumor cells. Although no crossreaction of the primary ER 15-P with mAb 3H4 was observed, the antibody also significantly reduced the number of renal metastases of the P tumor cell population. The syngeneic IgG2b monoclonal antibody mAb 3H4 identified a new tumor-associated cell-surface antigen correlating with liver-preferential metastasis. mAb 3H4 antigen expression was a stable property of the liver-preferential tumor cells regardless of morphological diversity or functional cell status. In an in vivo blocking assay mAb 3H4 reduced liver colonization in vivo.

Animals↗
PubMed1996

Intracortical low grade osteosarcoma. A unique case and review of the literature on intracortical osteosarcoma.

The thirteenth case of an intracortical osteosarcoma is presented. According to the authors' knowledge, this case appears to be the first report of an intracortical low grade osteosarcoma of the fibrous dysplasia-like variant in the femur. All other cases (except one small cell variant) reported in the literature were histologically diagnosed as high grade osteoblastic or sclerotic variants. The finding of both a low grade and a small cell variant of osteosarcoma supports the concept that intracortical osteosarcoma rather represents a distinct entity defined by location than an early detected conventional medullary osteosarcoma.

Child↗
PubMed1995

[Tumorous space-occupying lesions of the pelvic skeleton. A radiological analysis of 234 cases].

PURPOSE: From the material of a bone tumour record file, an attempt was made to determine criteria enabling radiographic prediction of malignancy and tumour entity of lesions of the pelvis. METHODS: Patients' age, location and radiographic morphology of 234 space-occupying lesions of the pelvis were analysed retrospectively. RESULTS: 62.8% of all lesions were malignant, and the portion of malignant tumours increased with increasing age. While 68.0% of the lesions were found in the ilium, 18.8% in the pubis and 13.2% in ischium, the proportion of benign and malignant lesions did not vary in the different bones. Lesions showing a growth rate according to Lodwick grade IA and to IB were benign in 100% and in 82.0%, respectively. In contrast, tumours of grade II or III were malignant in 89.1% and 88.0% of cases, respectively. CONCLUSIONS: By the construction of subgroups by combining the patients' age and growth rate, the prediction of the malignant potential of a lesion increased significantly. The younger the patient, the more aggressively a benign lesion may grow, while the older the patient the slower a malignant tumour may grow. Prediction of the tumour entity is rarely possible.

Adolescent↗
PubMed1994

Anaplastic thyroid carcinoma with osteosarcomatous differentiation.

A case of a thyroid tumour with the cytological and histological pattern of anaplastic carcinoma with extensive osteosarcomatous differentiation in a 54-year-old Kaukasian woman is presented. Immunohistochemical examination revealed keratin-vimentin co-expression in anaplastic tumour areas. According to the WHO classification of thyroid tumours the present tumour has to be classified as an anaplastic carcinoma. A retrospective survey revealed only twenty-four comparable cases in the literature. The present tumour most likely represents an example of a neoplastic epithelial-mesenchymal metaplasia. The possible mechanisms of the occurrence of thyroid tumours with mixed epithelial-mesenchymal differentiation are briefly discussed.

Carcinoma↗
PubMed1994

[Determination of the growth rate of tumor-like space-occupying lesions of the bones. A study of 1154 lesions of the long tubular bones].

In 1088 primary and secondary bone tumors and tumorlike lesions and in 66 inflammatory lesions, the growth rate was graded according to the Lodwick classification. Grade IA and grade IB were correlated with benign lesions in 99.8% and 91.3% of cases, respectively. In contrast, grade III and grade II were associated with malignant tumors in 100% and 89.6%, respectively. With increasing age, the proportion of malignant tumors among those graded as IB or II increased significantly. Tumors classed as grade IC were benign in 57.5% and malignant in 42.5% of cases. The growth rates of the individual tumor entities were analyzed.

Adolescent↗
PubMed1993

Spindle cell (leiomyomatous) rhabdomyosarcoma, a rare variant of embryonal rhabdomyosarcoma.

A rare case of the leiomyomatous variant of embryonal rhabdomyosarcoma is reported. A 13-year-old boy presented with a recurrent painless mass on the ventral side of the right forefoot. Microscopically, the tumor consisted of spindle-shaped and round tumor cells in a fascicular or storiform, focally hemangiopericytoma-like growth pattern. The cytoplasm of the spindle-shaped tumor cells was eosinophilic and fibrillary, in some areas resembling smooth muscle cells. Immunohistologically, all tumor cells were vimentin-positive, most of them also stained with antibodies to desmin and muscle specific actin (MSA). In addition, many tumor cells showed a co-expression of alpha-sarcomeric actin and myoglobin. All tumor cells were negative with alpha-smooth muscle actin. Two years after surgical treatment and chemotherapy the patient is well with no evidence of distant metastases. The clinicopathological features and differential diagnostic problems are discussed.

Adolescent↗
PubMed1993

[Aneurysmal bone cyst or giant cell tumor. The value of x-ray diagnosis for differential diagnosis].

Depending on analysis of radiographic morphology, location and patient's age of 72 aneurysmal bone cysts (ABC) and 47 giant cell tumours (GCT), the following criteria suggest an ABC with a high positive predictive value: location in the diaphysis (100%), in the shaft (92%), in the metaphysis or metadiaphysis (86%), patient younger than 17 years (97%) and growth rate grade Lodwick-IA (88%). GCT were selected via the following criteria: epimetaphyseal location (82%) and growth rate grade Lodwick-II (100%). In 14% of the cases, differential diagnosis between both entities is radiologically impossible.

Adolescent↗
PubMed1993

[X-ray morphology of eosinophilic granuloma other than skull and spine].

The radiological findings in 39 patients with a manifestation of eosinophilic granuloma (e.g.) other than skull and spine were evaluated. The localisation was found in the femur (26%), clavicula (20%) and ribs (20%). The lesions were located in 81% in the diaphysis and in 9.5% either in the epi-metaphysis or epi-metadiaphysis. Associated periosteal reactions were observed in 38% of the patients, and were solid in 25%, lamellar in 10%, and in 3% complex. The majority of the tumours were classified as Lodwick IB lesions (41%). Lodwick IC lesions were seen in 13%, Lodwick II lesions in 25.5% and Lodwick III lesions in 20.5% of the patients. In patients below the age of 20 years the eosinophilic granuloma is characterised by a Lodwick IB lesion without or with a solid periosteal reaction, which allows differentiation from Ewing's sarcoma or osteomyelitis. Contrariwise, in patients above 20 years of age the e.g. appears with a higher Lodwick grade. Hence, differentiation, X-ray morphology, between e.g., metastasis, lymphoma, and multiple myeloma does not seem possible.

Adolescent↗
PubMed1993

[Localization dependent patterns of findings in chondroblastoma].

In a retrospective study the radiographs of 48 chondroblastomas from the files of the Bone Tumour Registry of Westphalia were evaluated. The purpose of the study was to investigate whether chondroblastomas display localisation-dependent radiographic patterns. All radiographs were analysed using the Lodwick criteria. All chondroblastomas (mean age: 18 y., m:f = 1.25:1) showed a geographic pattern of bone destruction. 32 lesions affected long bones, 10 short bones, and 6 flat bones. Chondroblastomas localised in flat bones (Lodwick IA: 0%, IB: 33%, IC: 67%) demonstrated more aggressive patterns of bone destruction compared to lesions affecting long bones (Lodwick IA: 56%, IB: 31%, IC: 13%) or short bones (Lodwick IA: 40%, IB: 50%, IC: 10%). There was no difference between the three bone types in other radiographic patterns (periostitis, calcification, trabeculation).

Adolescent↗
PubMed1993

[Tumorous space-occupying lesions of the tibia. A radiological analysis of 459 cases].

The patients' age, location and radiography of 459 bone tumours and tumour-like lesions of the tibia were analysed retrospectively. 79.2% of all lesions were benign, and the portion of malignant tumours increased with increasing age. Predominantly malignant tumours were found in a distal central metadiaphyseal (100%), in proximal central epimetadiaphyseal (90%) and in a proximal central metadiaphyseal (63%) location. Lesions showing a growth rate according to Lodwick IA and those to IB were benign in 99.5% and in 95.4%, respectively. In contrast, tumours showing a grade II or III were malignant in 85.2% and 100% of cases, respectively. Through the construction of subgroups by combination of patients' age, location and growth rate special tumours were selected in that way, that they were predominantly found in that subgroups.

Adolescent↗
PubMed1993

In-vitro high-resolution ultrasonography of benign and malignant lymph nodes. A sonographic-pathologic correlation.

RATIONALE AND OBJECTIVES: The authors assess the value of combining high-resolution ultrasonography (HRUS) findings in a scoring scale for distinguishing malignant from reactive lymphadenopathy and explain the pathologic causes of altered nodal sonographic architecture. MATERIALS AND METHODS: Sixty-one nodes obtained from 32 consecutive patients were prospectively scanned with 7.5-MHz ultrasound probes in a waterbath. Three sonographic features--long-to-short axis ratio (L/S), hilar width, and cortical width--were graded on a 5-level scoring scale (0-4). Nodes scored > or = 3 were considered malignant and < or = 2 benign. Subsequently, all nodes were microsectioned in a plane matching the sonograms, allowing direct sonographic-pathologic correlation. RESULTS: Eighty-two percent of nodes were correctly characterized using the above cut-off point (sensitivity: 87%, specificity: 74%). Eighty-three percent of nodes scored 4 were malignant and 95% scored 0 were benign. Eighty-two percent of nodes with L/S < 2, 81% with no hilus, and 70% with eccentric cortical widening were malignant, whereas 72% with L/S > or = 2, 86% with a wide hilus, and 91% with a narrow cortex were benign. Sonographic-pathologic correlation showed that tumor infiltration results in rounded nodal shape, loss of hilar echogenicity and cortical widening, whereas reactive disease tends to preserve nodal architecture. CONCLUSION: Morphologic changes detectable using HRUS help distinguish benign from malignant lymph nodes.

Diagnosis, Differential↗
PubMed1993

Primary non-Hodgkin lymphomas of the CNS. Classification, tissue reaction and proliferative activity.

Primary cerebral lymphomas (PCL) are rare tumors, which, however, occur at increasing frequency. From 1980 to 1991, 44 PCL were histologically diagnosed from immunocompetent patients in our department. According to the updated Kiel Classification, 13.5% of the tumors were of low malignancy (4 immunocytomas, 2 centroblastic-centrocytic), and 79.5% were highly malignant B-cell lymphomas (26 centroblastic, 2 Burkitt-type, 3 immunoblastic, 4 unclassified). Two T-cell lymphomas and one large-cell anaplastic lymphoma were found as well. A reactive tissue infiltrate consisting of varying amounts of small T-cells and tissue macrophages was present in all B-cell lymphomas. PCNA-indices reflected the histological grade, with mean counts of 19.5% in low grade neoplasms and 59.3% in high grade ones. No correlation was found to exist between PCNA-index and patient survival.

Antigens, CD↗