Biomedical subjects

H H Rummel

Publications and source records attributed to H H Rummel.

At least 37 records · Page 2Linked to original sources

PubMed1987

[Development of cancer (vulvar cancer) in the Netherton syndrome (ichthyosis, hair anomalies, atopic diathesis)].

So far there has been only one incidence of a malignant tumour associated with Netherton's syndrome, a rare skin disease consisting of congenital ichthyosiform erythroderma, atopic dermatitis and trichorrhexis nodosa (bamboo hair). The aetiology and clinical consequences are discussed on the occasion of a carcinoma of the vulva occurring in a case of a patient with Netherton's syndrome, both phenomena being interlinked.

Biopsy↗

PubMed1986

[Potential malignancy of cystosarcoma phyllodes of the breast. A contribution to the histogenesis of fibrosarcoma].

The present case report, which describes the transformation of a cystosarcoma phylloides into a "borderline case" and subsequently a fibrosarcoma, makes it clear that fibrosarcoma of the breast cannot always be regarded as a tumor which has developed primarily from mesenchymal breast tissue. Just as a benign cystosarcoma can turn malignant if therapy is inadequate, it can also turn into a purely sarcomatous tumor. The clinical consequences of this are that a cystosarcoma should not only be shelled out, but excised generously, with a wide border of healthy tissue. The "borderline" type of cystosarcoma phylloides, or respectively the fibrosarcoma, requires far more aggressive therapy, i.e., mastectomy. In fibrosarcoma cases additional selective lymphadenectomy may be considered, although the metastasization pattern is predominantly hematogenic. Overall, however, the prognosis for fibrosarcoma cases is better than for those with breast cancer.

Adipose Tissue↗

PubMed1986

[Mesonephrogenous cervix papilloma in childhood and adolescence].

Five cases of mesonephric cervical papilloma have so far been described in children and adolescents. Basing on the observation of a further tumour of thus type in an eight-year old child, the authors discuss histogenesis, histological diagnosis and therapeutical consequences.

Adolescent↗

PubMed1985

[Carcinoma formation in a neovagina following vaginoplasty].

A carcinoma occurs only very rarely in a neovagina. This extremely rare occurrence is a suitable example of an exogenous carcinogenesis. Only 6 cases have so far been reported in literature. The clinical and morphological features are discussed on the basis of the author's own observations on one of his patients.

Adult↗

PubMed1985

DNA flow cytometry of ovarian tumors with correlation to histopathology.

Tissue samples from 49 women with seven benign and 42 malignant ovarian tumors were examined by means of DNA flow cytometry (FCM). The FCM data (DNA-ploidy and the number of S-phase fractions) were compared with the International Federation of Gynecology and Obstetrics (FIGO) stage, the histologic grade of differentiation and in some cases with the clinical outcome. The benign ovarian tumors were all diploid with a mean of 2.1% (+/- 1.66) S-phase fractions. Adenocarcinomas with the histologic grade 1 were diploid and had a mean of 2.1% (+/- 1.17) S-phase fractions. Grade 2 adenocarcinomas were aneuploid in eight of nine cases and revealed an increased proliferative activity (7.7% +/- 2.67 S-phase fractions). A high number of aneuploid cases (nine of 13) and an increased DNA synthesis were found in grade 3 adenocarcinomas (12.0% +/- 5.72 S-phase fractions). Four of six malignant nonepithelial tumors also had high numbers of S-phase fractions (9.7-14.5%). A significant correlation between the histologic grade and the DNA synthesis, FIGO stage, and DNA-ploidy was found. DNA-FCM may be used as an additional diagnostic tool supplementing routine histopathologic examination of ovarian tumors for better biological characterization, especially for those with uncertain grading, for grade 2 neoplasms, and for malignant nonepithelial tumors.

Adenocarcinoma↗

PubMed1984

[Clinical and patho-anatomic aspects of metastases of breast cancer].

The importance of carcinoma of the breast in female malignancies demands a critical examination of the condition of metastases by means of certain clinical and pathological data. The clinical data and the results of autopsies of 384 patients with breast carcinoma were examined. The frequency and the chronology of occurrence of metastases put out metastases of lymphnodes , skeleton, lung, liver and local recurrences. The importance of the mediastinal lymph node metastases in the distribution of metastases in thoracical organs was established and is discussed. The relation of frequency of the metastases to primary tumour staging (TNM) shows a 63% rate of metastases in patients with No and 86% in patients with N+. A comparison of two decades (I = 1960-1969; II = 1970-1979) shows certain trends 1. In decade II more patients with primary stage T1-T2 NoMo were found in autopsies having less metastases. 2. More local recurrences and metastases of genital organs were diagnosed. 3. In decade II more "late-metastases" (2-10 years after primary diagnosis) were found. These developments are explained by better primary diagnostic methods, more frequent follow-up examinations after primary therapy, and more frequent application of secondary therapies (chemotherapy, radiotherapy).

Adenocarcinoma↗

PubMed1984

[Potentials and limits of conventional differential diagnosis of the endometrium].

The reproducible identification of various histological types of the endometrium is of special interest for many reasons. The controversy in endometrial classification and terminology led us to study the algorithm of conventional endometrial diagnosing. This study is to examine the significance of historical morphologic parameters for differential diagnosis by semiquantitative or binary recording and computer-assisted evaluation. The results are based on cross-tables and cluster-analysis. The statistical test showed that most of the historical parameters were neither adequate for reclassification nor exclusion of historical typing of the endometrium. An objective and reproducible classification of endometrial changes by using binary parameters can only be achieved for specific histological types of normal endometrium and several types of hyperplastic endometrium. The dedifferentiated carcinoma is a diagnosis "per exclusionem ", since nearly all of the binary parameters cannot be analysed. The individual borderline lesions cannot be differentiated from each other by descriptive parameters. They cannot even be distinguished from the highly differentiated endometrial carcinomas. This kind of differential diagnosis is obviously not based on conventional formalistic criteria but on nonquantifiable empirical data. This might be a reason for the above mentioned controversy in endometrial diagnosis and terminology.

Diagnosis, Differential↗

PubMed1983

[Correlation of morphological criteria with the rate of growth in cancer of the breast].

Prognosis of carcinoma of the breast depends on a number of factors. Besides tumour staging, these parameters include the number of axillary lymph nodes with metastatic growths, the status of the hormonal receptors, and the histological type of the tumour, especially the tumour grading and the rate of growth correlated therewith. The first few of these criteria are relatively easy to determine. The tumour duplication time has so far been determined only by means of serial mammographies. Only few studies have been conducted on the correlation of the morphological parameters connected with the dynamics of growth of carcinomas of the breast. In a group of 61 patients with carcinoma of the breast and known tumour duplication time determined by serial mammography, it is shown that broadening of the conventional tumour grading by means of additional histopathological malignancy criteria (frequency of mitosis, incidence of nuclear hyperchromasias, formation of tubules and nuclear irregularities) correlates with the growth dynamics of the tumours. This makes it seem possible to draw prospective conclusions on the growth performance of carcinomas of the breast even without resorting to serial mammographies.

Axilla↗

PubMed1983

[Considerations on computer-assisted pattern recognition in the endometrium].

Histomorphological diagnosing very much depends on subjective empiric data. In histomorphology of the endometrium nomenclature as well as diagnostic classification lack uniformity and are full of controversy in literature. This results in opposing assessments of dignity of endometrial hyperplasias and prognosis of varying grades of carcinoma differentiation. One of the reasons is the lack of objective and reproducible diagnostic categories, not yet found. Morphometry with so-called computer-assisted interactive pattern recognition systems might offer the solution to numerous problems. Since there are no specific parameters for diagnostic identification of endometrial hyperplasias and carcinomas, only a combination of sensitive and reproducible parameters can allow for diagnostic identification. We report on our first computer-assisted pattern recognition studies and results that appear to provide an adequate basis for leaving descriptive diagnosing and turning to objective diagnosing. Such an objective diagnosing might not only be of clinical and therapeutic significance but also provide a new evaluation of the today's significance -- still full of controversy -- and prospective potency of endometrial hyperplasias. In computer-assisted interactive pattern recognition also lies the possibility of a contribution to objective tumour grading that appears to have high prognostic significance.

Diagnosis, Computer-Assisted↗

PubMed1983

[Clinical demands on the morphologist in the area of surgical gynecology].

At present in gynecologic oncology no therapeutic strategy is possible without exact histopathological diagnostic procedures according clinical rationales. Describing morphological records, exact details are therefore necessary on clinical staging, histological grade and type of the tumor. This requires a standardized preparation technique and a clinically adapted microscopic working procedure on surgery material. Above all this is necessary for discrimination of defined early cancerous changes and invasive carcinomas.--Analysis of tumor metric is more and more completed by methods of picture analysis (tissue-texture). The principals of an optimal cooperation between clinicians and morphological workers in gynecologic oncology are presented as an example on common used macroscopic and microscopic preparation methods at the histological laboratory of the Department of Gynecologic Morphology at the University Hospital Heidelberg.

Biopsy↗

PubMed1982

[The primary non-Hodgkin lymphoma of the mammary gland].

Basing on an observation made by the authors, the article describes the diagnostic and therapeutic criteria in primary non-Hodgkin lymphoma of the mamma. Despite high malignancy, especially of the lymphoblastic-centroblastic lymphoma and of the immunoblastic lymphoma (Stein, 1974), permanent healing can be achieved via early surgical treatment and subsequent radiotherapy. In the case under discussion, the same tumour reappeared in the contralateral breast after an interval of five years. Since it was possible to exclude a generalisation, it must be assumed that the patient in question had a primary non-Hodgkin lymphoma of the immunoblastic type in both mammae after a period of five years.

Breast Neoplasms↗

PubMed1982

[Diagnosis and treatment of uterine sarcoma].

A group of 54 patients with uterine sarcomata is reviewed. The diagnosis, the pathological anatomy, the treatment and the prognosis of this rare disease which only comprises between 2-4% of all malignant tumours of the uterus is described. Special attention is directed to the tumours of so-called low grade malignancy, regarding their clinical and prognostic aspects in relationship to their morphology and biological potency. The discussion of the treatment centered around the desirability of additional chemotherapy. The answers to the numerous questions in this group of tumours can only be obtained by prospective collaborative studies of randomized groups of patients.

Adult↗

PubMed1982

[Conditions of metastatic spread of endometrial cancer: analysis of autopsy findings and clinical data].

Among 263 patients who suffered from endometrial carcinoma and died of their disease or unrelated causes autopsies showed metastases or recurrences in 165 cases. The conditions for metastatic spread were analysed from the morphological parameters of the tumour. The incidence and localization of above all the lymph node metastases are closely correlated to the grading and the depth of invasion (I 0 to I 3/3) of the primary tumour. The incidence of pelvic lymph node metastases is 8.7% at an invasion depth I 1/3,33% at an invasion depth of I 3/3 of the myometrium. Tumours with the invasion depth I 1/3 show metastases in the para-aortic lymph nodes in 17.3% and at the invasion depth I 3/3 in 50% of the cases. At an invasion depth of I 3/3 17% had exclusively para-aortic lymph node metastases. Pelvic lymph node metastases were found in tumours of the grading G 1 in 5.7% of the cases, in grading G3 in 26% of the cases. The tumour grading and primary extent of the endometrial carcinoma area are closely correlated. At a grading G1 90% of the cases were in stage I/II and only 10% in stage III/or IV. At a grading G3 23.8% of the cases were stage I/II and 76.2% of the cases stage III/IV. Based on the presented analysis it is recommended to supplement the conventional treatment at an invasion depth I 2/3 of I 3/3 with radiotherapy of the para-aortic lymph nodes since 27.3 to 50% of these cases show para-aortic metastases. In 17% of the endometrial carcinomas with an invasion depth I 3/3 exclusively para-aortic lymph node metastases were found which do not respond to conventional treatment.

Adult↗

PubMed1982

[Morphology and clinical aspects of malignant mixed müllerian tumors of the corpus uteri].

Mixed muellerian tumours of the uterus are more common today than uterine leiomyosarcomata. There is a world wide increase in the incidence in the last few years. In the past 15 years we observed 20 mixed muellerian tumours of the uterine body. The patients are usually 10 years older than women with endometrial carcinoma or leiomyosarcoma of the uterus. Morphologically homologous and heterologous tumours must be differentiated. Characteristic is the marked polypoid growth. There is a close correlation between tumour stage and microscopic tumour grading. Tumours with high malignancy are usually in stage I or II. The prognosis correlates well with the grade and stage of the tumour, therefore the elaboration of a prognostic index is necessary. The survival rates are low. Mixed muellerian tumours are not at all or very little influenced by radiotherapy. The single or combined chemotherapies in use o date have not shown satisfactory success. As complete as possible surgical removal is therefore important. It cannot as yet be predicted whether our present combined treatment in stage III and stage IV by operation and post-operative combined chemotherapy with CYVADIC is liable to increase the survival rates.

Aged↗

PubMed1982

[Morphology and clinic of ovarial teratomas (author's transl)].

This analysis covers 170 patients with teratomas from 1965-1978 in the Department of Obstetrics and Gynaecology of Heidelberg University. Malignant teratomas were found in two patients; in a special case, a "gliomatosis peritonei" was identified. The histological composition, the degree of maturity, grading and clinical staging were compared with regard to the prognosis and for obtaining an optimal therapeutic approach and procedure. Under the condition that an accurate and extensive histological diagnosis is obtained, "conservative surgery" seems to be the optimal therapy in fertile patients. In case of malignant teratoma, radical surgery followed by chemotherapy is imperative.

Adolescent↗

PubMed1981

Cytological findings in cases of marsupialized odontogenic cysts. A contribution to early diagnosis of malignant changes.

The early diagnosis of a malignant or premalignant change in cyst epithelium in the follow-up control of fenestrated odontogenic cysts can easily be made using exfoliative cytology. This investigation reveals the findings in 408 cyto-smears of 89 patients. Only in one case was the cyst epithelium free of pathological signs. 405 cyto-smears showed very variable inflammatory changes. The smears of one patient were typical for an ameloblastoma, microscopically smears of three patients showed keratinised epithelium. If the radical removal of an odontogenic cyst is not possible, cyto-smears should be applied and randomly repeated. Thus the possible change of cyst epithelium via inflammation or dysplasia to malignancy can be detected and treated earlier.

Adolescent↗

PubMed1981

[Morphological and clinical aspects of the so-called sinus tumours of the ovary (author's transl)].

Data from literature as well as our own studies are used in the discussion of differential diagnosis of the so-called endodermal sinus tumours. Clinical and paraclinical aspects of this once lethal tumour species are reported. New therapeutic strategies are presented consisting of the introduction of new, effective combinations with adjuvant chemotherapy. Thus at early stages a conservative surgical approach seems to allow the preservation of fertility in these generally young women. But even in more advanced cases the administration of a modern adjuvant polychemotherapy is likely to result in higher survival rates.

Adolescent↗

PubMed1981

[Preliminary results using the histocan needle biopsy for the microscopic evaluation of gynaecologic tumours (author's transl)].

In a preliminary study the new "Histocan"-needle was tested in respect of its diagnostic value in patients with palpatory findings suspicious for recurrent cancer in the pelvis and in patients with breast tumours. Initially there were some difficulties in handling the biopsy needle. Furthermore we saw some haematomas after breast biopsy, which could be avoided, however, by compression of the biopsy wound. From the morphological point of view the fine structures of tissue specimen were without the gross needle-conditioned artifacts and in some respect could be interpreted better than in Silverman-biopsies. Statistical data can only be given after finishing our cooperative studies.

Biopsy, Needle↗