Biomedical subjects
H F Otto
Publications and source records attributed to H F Otto.
[Multiple pulmonary leiomyomatosis hamartoma (author's transl)].
The multiple pulmonary leiomyomatosis hamartoma (MPLH) is rare. Typical is the difference between the marked pulmonary alterations on chest X-ray film and the poor symptomatology. The (MPLH) is observed nearly only in women. The diagnosis is linked to pathological-histological findings.
[Malignant lymphomas of the intestinal tract. Histological and immunohistological findings in 22 intestinal lymphomas].
The histology and immunohistology of 22 malignant lymphomas of the intestinal tract have been studied using the so-called "Kiel classification". We have found 12 lymphomas with low grade malignancy (lymphocytic, lympho-plasmocytoid, centrocytic, centroblastic-centrocytic) and 10 with high grade (centroblastic, lymphoblastic, immunoblastic). In all cases of lympho-plasmocytoid and immunoblastic lymphoma a monoclonal pattern of intracellular immunoglobulin was identified by the immunoperoxidae method. This technique offers considerable help in distinguishing between (monoclonal) malignant lymphomas and (polyclonal) lympho- or immunoproliferative processes.
[Histological classification of primary thymic tumors].
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[Tuberculous stenosis of the transverse colon].
A 14 year old Turkish girl presented with unspecific abdominal symptoms and barium enema showed an almost complete obstruction in the region of the splenic flexure. The picture was that of a neoplasm and a left hemicolectomy was performed. Histological examination revealed ulcerating hypertrophic tuberculosis of the colon. The incidence, pathology and symptomatology of colonic tuberculosis are discussed.
[Crohn's disease and intestinal cancer. A report of 5 cases and review of the literature (author's transl)].
Until 1979 there were explored 192 surgical specimens from patients with Crohn's disease at the Institute of Pathology of the University of Hamburg. For the present study there was a follow-up examination of 161 specimens. Among these Crohn's specimens we found five (3.1%) simultaneously existing ("Crohn-associated") carcinomas with following localisation: 3 carcinomas of the distal small bowel by terminal ileitis resp. ileo-colitis, one carcinoma of the rectum by ileocolitis, and one carcinoma of the esophagus by terminal ileitis. Proceeding from these observations the relevant world literature was summarized and the relationship between the two diseases was discussed. Statistical calculations and local peculiarities may indicate that Crohn's disease of the small and large bowel has to be classified cancer risk disease. Carcinomas are not only developing from inflammatory bowel segments, they are also accumulated in pancreas, stomach and esophagus. It is not possible to make an exact statement about the real cancer quote because most of the published Crohn's carcinomas are not derived from epidemiological studies.
["Malabsorptive" dermatitis herpetiformis. A study with particular regard to biopsy findings of the small intestine (author's transl)].
21 patients (6 females and 15 males) with Dermatitis herpetiformis have been studied with special considerations of the small intestinal biopsy-findings. During this investigation the patient's mean age was 45 years (20-68) and the mean age at onset was 38 years (17-64). In 5 patients (23.8%) total villous atrophy (group I) and in 4 patients (19.0%) a severe partial or subtotal villous trophy (group II) was found on small intestinal biopsy. The sprue-like changes were patchy lesions. Histocompatibility-antigens of type HLA-AL were found in 38.1% and of type HLA-B8 in 47.6%. After 20 years of the disease one patient died of a malignant lymphoma of the intestine (immunoblastic sarcoma). In all patients the number of interepithelial lymphocytes in the small bowel mucose was significantly increased, as it was in those patients with a normal villous pattern (group III). In a quantitative analysis of specifically labeled (peroxidase-anti-perosidase complex) IgG-, IgA- and IgM-cells in the intestinal mucosa it was found that the number of all three plasma cell classes are increased significantly (P less than 0.01).
[Ultrastructural observations on transitional cloacogenic carcinomas of the ano-rectal region (author's transl)].
The clinical and pathological features of four transitional cloacogenic carcinomas (TCC) are presented with particular reference to electron microscopy. The incidence of this tumour is 1.4% of all ano-rectal neoplasms. Three cases showed a gross appearance similar to the common rectal neoplasms. One tumour presented without an intraluminal lesion, but infiltrated the bowel wall and the anal glands. TCC show a distinct histological pattern. The degree of differentiation of the basic transitional cell component determines the "grading" of the lesion. We distinguish between grade I, II and III. Grade I lesions show uniform polygonal cells with only occasional mitotic figures. There is distinct palisading of the nuclei of the peripheral tumour cell layers. Grade II lesions are characterized by partial or total loss of the peripheral palisading. Grade III lesions are extremely anaplastic ("oat cell" carcinoma). This histological classification correlates well with the prognosis. Electron microscopic investigation of TCC revealed the ultrastructural features of basal cells. The uniform tumour cells with large nuclei contain tonofibrils, desmosomes and hemi-desmosomes, free ribosomes, and relatively few other organelles. We did not find keratinocytes or keratohyalin granules in these four cases of TCC. It is emphasized that TCC of the ano-rectal region differ fundamentally from the basalcell carcinomas of the skin in their biological behaviour.
Interepithelial cells of the oral mucosa in mice. An ultrastructural classification with reflections on the origin of the Langerhans cell.
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The local immune response in ulcerative colitis.
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[Colitis carcinoma. Possibilities of early diagnosis].
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[Endoscopic findings in Whipple's disease (author's transl)].
In a patient with massive ascites, bouts of fever of unknown aetiology and cachexia, duodenoscopy and laparoscopy revealed white-yellow, partly confluent, nodules and plaques on the duodenal mucosa, and the surface of the liver and the peritoneum of the upper right abdominal quadrant, leading to the diagnosis of Whipple's disease. Histological examinations of these deposits revealed an accumulation of PAS-positive macrophages (SPC cells = sickle-form particle containing cells) and lysosomal bacterial inclusions under the electron-microscope. This raises the possibility of a simple endoscopic method for diagnosing Whipple's disease.
[Investigations on the ultrastructure of lympho-epithelial thymomas with special reference to "emperipolesis" (author's transl)].
The ultrastructure of eleven thymomas with lymphocytic predominance, one "epitheloid" cell thymoma and two normal human thymuses is described with special reference to "Emperipolesis". All patients have had myasthenia gravis. The normal human thymus consists of three parts: outer cortex, inner cortex, and medulla. The outer cortex contains mainly lymphoblasts and Metcalf's macrophages within the so-called "Clark-packet's". The inner cortex consists mainly lymphocytes and interdigitating reticulum cells, and the medulla of epithelial cells, lymphocytes and Hassall's corpuscles. In all cases of lympho-epithelial thymoma and in normal human thymuses there are enormous interdigitations between epithelial (tumor) cells, lymphocytes and macrophages. The "epitheloid" cell thymomas also show findings which suggest an epithelial cell interaction. We have not found intact lymphocytes inside the cytoplasm of normal and/or tumor epithelial cells, macrophages or interdigitating reticulum cells. The intracellular existence of intact lymphocytes has been termed "Emperipolesis" by Humble, Jayne, and Pulvertaft, meaning "internal wandering". These investigations indicate that "Emperipolesis" is not an adequate term for cellular interaction in normal human thymuses and thymomas. A false impression of intraepithelial location of thymic lymphocytes is created by two-dimensional sections of complex thymic structure. These ultrastructural studies revealed damage to lymphocytes only in macrophages with lymphocytolysis within these cells and accumulation of numerous heterophagic vacuoles containing fragments of lymphocytic debris within them.
[Colorectal adenomas].
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[Precancerous epithelial dysplasia in ulcerative colitis. Histological possibility for the early diagnosis of colitis carcinoma (author's transl)].
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[A comparative clinical and pathological study on the classification and prognostic features of 57 thymomas. I. Microscopy and ultrastructural pathology (author's transl)].
Fifty-seven thymomas, defined as neoplasms of the epithelial-reticular framework cells of the thymus, were assessed in respect to histologic type, inclusive of there ultrastructural aspects. The median age of the 57 patients was 40.4 years, with a range of 2 1/2--72 years. All neoplasms were located in the anterior mediastinum. The tumours in 40 cases were encapsulated and without invasion of adjacent tissue or implants (equal to non-invasive thymomas). The tumors in 17 cases were invasive of adjacent tissue, particularly mediastinal pleura, pericard and trachea. Six of 57 patients (equal to 10.5%) with thymomas have had a thoracic and supraclavicular lymph node metastasis, and osteolytic metastases in the vertebrae and sternum. Thirty-seven (equal to 64.9%) were so-called lympho-epithelial, 7 (equal to 12.3%) pure epithelial, 4 (equal to 7.0%) atypical (or anaplastic) with granulomatous focuses, 3 (equal to 5.3%) carcinoid and one (equal to 1.8%) seminomatous tumors. One patient have had a thymic cyst as a tumor-like conditions of the thymus, and four patients (equal to 7.0%) have had a thymo-lipoma. The histologic type of thymoma had no proof value in predicting prognosis with the exception of the so-called atypical or anaplastic thymoma. The fine structural aspects of thymomas and the fine structural differential diagnosis of anterior mediastinal tumors are discussed.
[A comparative clinical and pathological study on the classification and prognostic features of 57 thymomas. II. prognostic features (author's transl)].
The most important prognostic determinants of the thymomas are the gross findings at operation (equal to the presence or absence of gross invasion of adjacent tissue) and the presence or absence of the thymoma-associated systemic disease, particulary myasthenia gravis. The histologic type of thymoma had no proof value in predicting prognosis with the exception of the so-called atypical thymomas. Thirty-four of 57 patients with thymomas were females and 23 males. The tumors in 40 cases were non-invasive thymomas, and in 17 cases the tumour were invasive of adjacent tissue. 35.1 percent of patients were asymptomatic, the tumours being discovered on roentgenograms done on a routine basis or for an unrelated porpose. 40.3 percent of patients have had a thymoma-associated systemic disease. The most common presenting symptoms were related to myasthenia gravis (26.3%). The 5-year survival rate was 90 percent for non-invasive thymomas without myastenia gravis and 50 percent for invasive thymomas. The 5-year survival rate for patients with myasthenia gravis and encapsulated (non-invasive) thymomas was approximately 60 percent, whereas that for invasive thymomas with myasthenia gravis was 40 percent. The primary form of therapy for all thymomas is the surgical excision. In cases with invasive and/or metastasizing thymomas, postoperative radiation and adjuvanted chemotherapy is indicated, but in most series, the longterm results of this form of therapy are discouraging.
[Retroperitoneal, non-chromaffin paraganglioma of the right kidney (author's transl].
A case of retroperitoneal, nonchromaffin paraganglioma simulating a hypernephroma of the right kidney is described. Prognosis and therapy of this rare tumor is discussed and the literature is reviewed.