[Fibromatosis of the female breast].
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Biomedical subjects
Publications and source records attributed to H Cremer.
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The rare case of disseminated peritoneal leiomyomatosis is reported. A 41 year old non-gravid patient had a laparotomy for uterine fibroids and numerous subperitoneal nodules were found in the abdominal cavity. The light and electron microscopic examinations showed disseminated peritoneal leiomyomatosis. The nodular proliferation of the sub-peritoneal stroma is characteristic for this disease. The patient is free of problems three years following the initial diagnosis of disseminated peritoneal leiomyomatosis.
The morphological and clinical findings of a papillomatous cystic para-ovarian blastoma are reported. A 48-year old patient had a hysterectomy and partial right salpingectomy in 1974. In 1980 at now age 54 the remaining appendages right and left were removed. The histologic examination of the remaining right appendages showed in the mesorovarium a 17 x 15 x 12 mm diameter papillomatous cystic para-ovarian blastoma with abundant formation of psammoma bodies and numerous lymph follicles in the stroma. The left ovary showed a papillomatous, fibromatous, serous cystadenoma. The aetiology of the papillomatous cystic para-ovarian blastoma is unknown. A relationship to the prior right salpingectomy is unlikely. The concommitant findings of a papillomatous fibromatous serous cystadenoma of the left ovary is suggestive of a tumour diathesis of the mesonephric system in this case.
A collective of 38 patients with a thymoma, confirmed by microscopic investigation, was analysed retrospectively. 63% of them were female. In 27% of the cases the final diagnosis could be made by autopsy only. 56% of the operated patients lived half of their age-dependant expectation of life. The 5- and 10-year-survival rates amount 84% and 68%, respectively. Of the non-operated patients no one was alive 2.5 years after diagnosis. There was no consistent relationship between the different histologic structure of thymomas (degree of lymphocytic infiltration) and the clinical behaviour and the survival rate. All patients with "parathymic syndromes" were women. One case with pure red cell anemia (erythrophthisis) was associated with spindle-shaped epithelial thymoma. The incidence of myasthenia gravis did not depend on the histologic pattern of thymomas.
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Radiologic and pathoanatomic findings in two patients with the very rate primary osteoliposarcoma of bone are reported. In one case, there was a manifestation on the left femoral shaft which led to pathologic fracture. Amputation of the femur was followed by a 2.5-year tumor-free interval. In the second case, there was a manifestation in the region of the right upper part of the ilium. After radiation and cytostatic therapy, pronounced intratumoral ossifications occurred and the patient's condition was good up to exitus lethalis 3 years after diagnosis. Osteoliposarcoma thus shows a markedly more favorable prognosis than the osteosarcoma and rather corresponds to that of a liposarcoma. Typical clinical and radiologic symptoms are lacking.
The authors describe radiologic and pathoanatomic findings in the very rare Mafucci-Kast syndrome. In a 39-year-old Libyan patient multiple enchondromas of the fifth ray of the left hand were found with signs of malignant transformation. Furthermore, there were angiomas of the skin, of the soft meninges, and the bone. In addition, there was a low-grade malignant astrocytoma of the frontal lobe of the brain. Chromosome analysis revealed a normal male chromosome set. The tendency to develop malignant tumors which is repeatedly emphasized in the literature was also shown in the present case. The reason for this, especially for the high spontaneous rate of malignant transformation of multiple enchondromas, is unknown. The occurrence of angiomas and multiple enchondromas in cartilaginous performed bone suggests the presence of mesodermodysplasia.
Carcinoembryonic antigen (CEA) had been demonstrated immunocytochemically in normal colorectal mucosa (resection margins of colonic carcinomas), in transitional mucosa (mucosa adjacent to carcinomas), in non-specific proctitis and colitis, and in ulcerative colitis. In the resection margins and in non-specific proctitis and colitis, specific CEA staining is generally observed at the surface epithelium. In transitional mucosa, CEA staining is most intense in branching crypts and at the base of the crypts. In ulcerative colitis, areas with regenerative activity as well as precancerous or cancerous specimens exhibit an intense CEA positive membrane straining. In conclusion, colonic tissue with a high proliferative activity, such as transitional mucosa and ulcerative colitis, show a more intense CEA staining than normal colonic tissue. Moreover, the staining pattern is different in proliferating tissues as compared to normal tissue. A pronounced membrane staining in ulcerative colitis indicates rather a higher proliferative activity than cancer or precancer.
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The article reports on a case of an aneurysmatic bone cyst which deteriorated into a malignant cyst four years after the first exposure to roentgen radiation, developing massive metastases in the lung after two further years. Almost all malignant courses of an aneurysmatic bone cyst which have been described in literature (a total of 12 cases so far) developed subsequent to x-ray treatment. The case reported here is unusual in so far as the malignant transformation took place after a short while only, whereas the total radiation dose was relatively low. The authors sound an urgent warning against x-ray treatment of aneurysmatic bone cysts.
This report deals with two cases of a spontaneous perirenal hematoma. In the first case the spontaneous perirenal hematoma resulted from hemorrhages from the vessels of the stratum fibrovasculare of the renal capsule. This bleedings led to the development of a granulation tissue which in turn is rich in small blood vessels. Due to the lytic activities of this granulation tissue the hematomas became resorbed and finally are transformed into a big pseudocyst which surrounds the lower half of the kidney. On the other hand the new-built vessels of the granulation tissue are the source of further bleedings thereby perpetuating the process. In the second case the perirenal hematoma resulted from two aneurysms of the renal artery. In both cases clinical and radiological investigations had been unable to demonstrate the lesion.
23 cases of liver cell carcinoma were reclassified according to the WHO classification schema. Appropriate cases could be classified without any difficulty into the trabecular, compact and acinar type groups; there was more difficulty to classify the scirrhous type of carcinoma. Carcinoma composed by clear cells, and inacrocellular eosinophilic carcinoma with lamellar fibrosis have a lower incidence of mitoses than the other carcinoma types. AFP could be demonstrated in tumor tissue by immune histochemistry in one case only; HBs-Ag could never been shown by the aldehyd-thionin method. The ratio mitoses/apoptoses was approx. 2:1.
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