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Biomedical subjects

M Altmannsberger

Publications and source records attributed to M Altmannsberger.

88 records · Page 5Linked to original sources

[Pseudo-tumour after injections of procaine-polyvinylpyrrolidone (author's transl)].

In a 67-year-old woman a tumour-like swelling developed at the site of repeated bilateral injections of procaine solution with polyvinylpyrrolidone as an additive. The histological picture of the removed tumour showed striking similarities to a malignant histiocytic tumour. The diagnosis was histiocytic inflammation due to polyvinylpyrrolidone storage. Retention of polyvinylpyrrolidone increases with increasing molecular weight and is dependent of the form of application. Treatment consists of removal of the storage focus, because polyvinylpyrrolidone maintains foreign-body reaction and absorption and storage in internal organs may cause further complications. Injectable drugs should not be used with polyvinylpyrrolidone as depot-carrier.

Aged↗

An unusual case of adamantinoma of long bones.

Adamantinoma of the tibia is a rare bone lesion, in which it is impossible to predict the biological behaviour. A case of extremely late local recurrence and lung metastasis is presented. Additionally, the patient developed pneumothorax on the right side months before intrapulmonary metastasis could be detected by X ray. Finally 1 week before her death the young woman suffered from paraneoplastic severe hypercalcemia leading to hypercalcemic coma and pancreatitis.

Adolescent↗

Diagnosis of human childhood rhabdomyosarcoma of antibodies to desmin, the structural protein of muscle specific intermediate filaments.

Four embryonal rhabdomyosarcomas, one tumor diagnosed as an undifferentiated sarcoma, probably a rhabdomyosarcoma, and six different non-muscular sarcomas were investigated with antibodies specific for different intermediate filament types. The tumor cells in the rhabdomyosarcomas and the undifferentiated tumor were stained clearly by antibodies to desmin, the intermediate filament type characteristic of muscle. The staining of tumor cell by antibodies to vimentin, the intermediate filament type characteristic of certain cell types of mesenchymal origin including myoblasts, was different in these 5 cases. In one case of embryonal rhabdomyosarcoma nearly all tumor cells were stained, but in the remaining cases few or no tumor cells were positive with the vimentin antibody. In these rhabdomyosarcomas not only the large rhabdomyoblasts, but also the small undifferentiated cells were labeled by antibodies to desmin. In the latter cell type the desmin filaments were arranged typically in coils. In contrast, tumor cells in the non-muscular mesenchymal sarcomas were stained only by antibodies to vimentin but not by antibodies to desmin or prekeratin. The retention of the desmin marker characteristic of normal muscle in cases of rhabdomyosarcoma not only allowed the undifferentiated desmin-positive sarcoma to be classified as rhabdomyosarcoma but also suggests that the use of antibodies to desmin could be very helpful in the future for the diagnosis of undifferentiated rhabdomyosarcomas.

Adult↗

Various sympathetic derived human tumors differ in neurofilament expression. Use in diagnosis of neuroblastoma, ganglioneuroblastoma and pheochromocytoma.

We have extended our analysis of human tumors using antibodies specific for each of the five types of intermediate filaments to neuroblastoma, ganglioneuroblastoma, pheochromocytoma, ependymoblastoma, and alveolar soft part sarcoma. Tumor cells in the three cases of neuroblastoma, as well as in the single case of alveolar soft part sarcoma, did not react positively with sera directed against any of the five intermediate filament types. We suppose, therefore, that neuroblastoma at least may be derived from a cell type - possibly present in peripheral neurones - which in vivo has very few or no intermediate filaments. In ganglioneuroblastoma and in pheochromocytoma the tumor cells were positive when tested with antibodies directed against neurofilaments and negative with those directed against other intermediate filament types. The ependymoblastoma was positive when tested with antibodies directed against glial fibrillary acidic protein (GFA) and negative when tested with antibodies against other intermediate filament types. Use of antibodies to the different intermediate filament types appears to be a valid way in which to classify tumors, and so far the data presented here and elsewhere support the hypothesis that tumor cells retain the intermediate filament type typical of their cell of origin. Wider use of these sera would seem particularly useful in cases such as neuroblastoma, rhabdomyosarcoma or lymphoma where diagnosis is currently difficult using conventional histological stains.

Adolescent↗

Expression of intermediate filaments in different human epithelial and mesenchymal tumors.

Fifty primary gastrointestinal and breast carcinomas, four embryonal rhabdomyosarcomas, six nonmuscular mesenchymal malignant tumors and one mesothelioma have been studied to determine what type of intermediate filaments they express, using affinity purified antibodies to prekeratin, vimentin and desmin and FITC or peroxidase labeled second antibodies. The tissues were alcohol fixed and paraffin embedded before use. In all carcinoma cases the tumor cells are stained by antibodies to prekeratin, while the vimentin antibody only decorates the stroma. Prekeratin positive tumor cells are not only seen in well differentiated tumors, but also in signet ring cell carcinomas. In the case of rhabdomyosarcoma the tumor cells clearly were decorated by antibodies to desmin, while the vimentin antibody only stained very few tumor cells. In cases of nonmuscular mesenchymal tumors, the tumor cells could only be labeled by antibodies to vimentin and not by antibodies to prekeratin or desmin. In biphasic tumors like mesothelioma, different parts of the tumor were separated by antibodies to prekeratin and vimentin.

Adenocarcinoma, Mucinous↗

Antibodies to intermediate filaments as diagnostic tools: human gastrointestinal carcinomas express prekeratin.

Twenty-five primary gastrointestinal carcinomas have been studied using immunofluorescence microscopy with affinity-purified antibodies to prekeratin and to vimentin. The tissues were alcohol fixed and paraffin embedded before use. In all cases (i.e., one case of esophagal carcinoma, seven stomach carcinomas, and 17 large bowel carcinomas) the tumor cells are stained by antibodies to prekeratin. In cases in which only very few tumor cells are present, such as signet ring carcinoma, immunofluorescence with prekeratin antibody provides an easy way to visualize single tumor cells. When the same specimens were tested with antibodies to vimentin, the tumor cells were unstained, and only the fibroblasts and vessels of the stroma were decorated. Four of the tumors were also negative when tested with antibodies specific for either desmin, or glial fibrillary acidic protein or neurofilaments. Three metastases to the abdominal region from tumors originating in the ovary, stomach, and large bowel were like the primary tumors in that the tumor cells were positive when stained with antibodies to prekeratin and negative when tested with the antibodies to vimentin.

Adenocarcinoma↗

The distribution of keratin type intermediate filaments in human breast cancer. An immunohistological study.

Antibodies to different intermediate filament proteins can be used to distinguish cells of epithelial, mesenchymal, muscle, glial and neuronal origin. Antibodies to prekeratin which characterize cells of epithelial origin, and antibodies to vimentin which recognize cells of mesenchymal origin have been used to study twenty cases of breast carcinoma (sixteen infiltrating ductal carcinomas and four infiltrating intraductal carcinomas), two cases of cystic breast disease, two fibroadenomas and one case of benign cystosarcoma phylloides. The prekeratin and vimentin were detected using specific antibodies to these proteins by immunofluorescence microscopy using alcohol fixed paraffin-embedded tissues. In eighteen out of the twenty carcinomas the tumor cells were strongly and specifically stained by antibodies to prekeratin. DIfferent tumors gave different patterns of prekeratin staining. In contrast, when the same specimens were tested with the vimentin antibody, the tumor cells were unstained, and instead only the usual strong staining to fibroblasts and blood vessels in the stroma was observed. In cystic breast disease, fibroadenomas, and benign cystosarcoma phylloides, cells of epithelial origin were strongly stained by the prekeratin but not by the vimentin antibody.

Adenofibroma↗

[Significance of immunohistologic methods in the differential diagnosis of solid tumors in childhood].

We have investigated 56 histologic and 13 cytologic specimens of malignant round cell tumors of childhood. The immunohistological detection of intermediate filament polypeptides, neuron specific enolase (NSE) as well as leukocyte common antigen (LCA) allows the histological classification of such tumors. Neuroblastomas demonstrate a positive reaction with antibodies to neurofilaments and NSE independent of differentiation. Rhabdomyosarcomas could be labeled by the desmin antibody, while Ewing sarcomas, malignant lymphomas as well as nonmuscular sarcomas only express vimentin. In nephroblastomas the intermediate filament specific antibodies reveal expression of keratin and vimentin in blastema cells, while tubules are only labeled by the keratin antibody. In undifferentiated nephroblastomas, which lack formation of tubules blastema cells are keratin negative and vimentin positive. Thus antibodies to intermediate filaments, LCA and NSE seem to be useful tools to distinguish the so called "round cell tumors" of childhood.

Adolescent↗

[Use of low-molecular fluorescent dyes for localizing tumor cells].

A novel fluorescence microscopic technique, based on the application of low-molecular fluorescent dyes, was used to study the expression of the enzyme guanidinobenzoatase in malignant tumors of the head and neck area. Frozen sections have shown that moderately and highly differentiated squamous cell carcinomas express this enzyme, particularly in the area of tumor invasion. The protease is capable of breaking down fibronectin, an important component of the extracellular matrix. In less differentiated squamous cell carcinomas as well as malignant melanomas almost all tumor cells exhibited guanidinobenzoatase activity. The fluorescence microscopic technique presented here provides a fast and easy method for the localization of tumor cells. At the same time it provides a better understanding of the biological control of a tumor-associated protease, thus furnishing important new information on the invasion behavior of malignant tumors.

Carcinoma, Squamous Cell↗

Some histopathologic aspects regarding onset of antirejection therapy after heart transplantation.

The histopathologic indication for starting antirejection therapy has so far been given by the diagnosis of moderate rejection in endomyocardial biopsies, that is, rejection with necroses of myocytes and predominantly lymphocytic infiltrates (corresponding to the descriptive diagnosis of moderate rejection in the Stanford classification, grade 4 and more in the Texas classification, and A-3 moderate rejection in the Hannover classification). Our present results, however, have shown that the critical limit for the onset of antirejection therapy may be fixed somewhat higher on the scale of severity of acute rejection and that it may be reasonable to define an affection of more than 20% of the total biopsy material by morphologic changes corresponding to the traditional definition of moderate acute rejection as the decisive histopathologic finding that should induce antirejection therapy. This means that the diagnosis of moderate rejection has to be divided into two groups: (1) A-3a moderate acute rejection not yet requiring therapy that, however, does necessitate bioptic control within 7 to 10 days; (2) A-3b moderate acute rejection requiring antirejection therapy. The introduction of this differentiation of histopathologic diagnoses is not just another sophisticated scientific theorem; its practical significance may be seen in a definitive restriction of the application of antirejection therapy, which means a reduction of the risks and side effects imposed on heart-transplanted patients by chemotherapy and particularly by steroid therapy.

Biopsy↗

Ultrasound-guided percutaneous fine needle aspiration biopsy of abdominal and retroperitoneal masses. Accuracy of cytology in the diagnosis of malignancy, cytologic tumor typing and use of antibodies to intermediate filaments in selected cases.

The reliability of ultrasound-guided fine needle aspiration biopsy (FNAB) in the detection of intraperitoneal and retroperitoneal malignancies was evaluated in 308 consecutive cases seen between 1979 and 1983. The prevalence of malignant neoplasms was 68.5%. The overall accuracy of FNAB diagnosis was 88.9%, with a sensitivity of 84.4% and a specificity of 98%. The predictive value of positive and negative results were 98.9% and 74.6%, respectively. Additionally, the cytologic results were statistically evaluated with respect to the different sites of the biopsied lesions (including pancreas, liver, kidneys and miscellaneous sites). The overall accuracy was highest for malignant lesions in the liver (96.4%) and in miscellaneous sites (89.5%). Reasons for false-negative results included incorrect areas sampled, limited material due to fibrosis or necrosis and cytologic misinterpretations. The accuracy of cytologic tumor typing with respect to histogenetic origin was 96.8%. Cytologic subclassification was performed with lower accuracy (82.5%), and exact determination of the site of the primary tumor from cytologic criteria alone was possible for 35.7% of carcinomas. In selected cases, routine cytologic examination was supplemented by intermediate filament typing using well-characterized antibodies against cytokeratin, vimentin, desmin and neurofilaments. Examples are shown in which use of this method clearly increased the accuracy of the diagnosis. Only two serious complications (bleeding) of fine-needle aspiration biopsy were encountered in this series.

Antibodies↗