Biomedical subjects
Publications and source records attributed to P Meister.
This is the report of a case with recurring giant cell tumor of the femur, which showed roentgenological evidence of pulmonary metastases. Only at the third biopsy sarcomatous changes as morphological signs of malignancy were found. Contrary to some elsewhere published giant cell tumors with sarcomatous components, there was no preceding irradiation in our case.
Clinicopathologic study of five cases of soft tissue tumors revealed distinct differences from skeletal Ewing's sarcoma in preferential localisation and mean age. The cases examined here are similar to cases described earlier as "extraskeletal Ewing's sarcomas". They show light- and electronmicroscopical features analogous to skeletal Ewing's sarcoma. The term extraskeletal Ewing's sarcoma appears to be appropriate for this type of soft tissue tumor.
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This study was performed to comparatively assess the diagnostic accuracy of computerized tomography (CT) and nuclear liver-scanning in detecting and defining circumscript and diffuse liver diseases in 83 patients. Presence or absence of liver diseases was assessed based on the results of invasive diagnostic procedures such as biopsy, laparoscopy, laparotomy, and/or autopsy. The percentage of true negative diagnoses was 94% for CT and 91% for static gamma-imaging (n = 33). With a rate of 94% true positive diagnoses, CT proved to be superior to gamma imaging with radiocolloids (81% true positives) in diagnosing circumscript liver diseases (n = 31). In addition. CT was superior to nuclear imaging regarding discrimination of number and size of space-occupying lesions within the liver. In contrast to nuclear screening, CT scans were pathognomonic to some circumscript liver diseases such as cysts, metastases, and perhaps echinococciasis. This was also true for obstructive jaundice. Nuclear imaging, because it reflects a sort of liver function, was superior with cirrhosis, whereas CT showed only alterations in the size and shape of the liver and spleen.
Classification (119 patients) of age, sex and side distributions and the frequency of additional fibromatoses or other diseases in palmar fibromatosis (Morbus Dupuytren) showed extensive agreement with other investigations. Contractures were also found in mutiple foci with high cell density and without intensive collagen fiber formation corresponding to the proliferative or involution phase. Cells with contractile elements ("myofibroblasts") could also be demonstrated with both electron and immunofluorescence microscopes. These elements may be of importance for the formation of the contracture in palmar fibromatosis and may disappear again as the collagen becomes more mature.
According to observations in six patients and published reports, malignant histiocytosis is characterized by premature multifocal proliferation of atypical histiocytes, especially in lymph-nodes, spleen, liver, bone marrow, and lung. The diagnosis can be confirmed by electron-microscopy, and enzyme as well as immunocytochemical tests. Fever, anaemia, leukopenia (with absolute reduction in T-lymphocytes), and jaundice are frequent. Immunoglobulins are normal or polyclonally increased. Malignant histiocytosis is more like monocyte leukaemia and histiocytosis X than neoplasms of the lymphatic system.
The clinical, morphologic, and cytochemical findings of 7 patients with malignant histiocytosis are presented in this study. The diagnoses were confirmed by the use of electron microscopy and cytochemistry (acid phosphatase and naphthol-AS-acetate-esterase). Two different types of malignant histiocytes were identified by the differentiation and development of cell organells. The relation of malignant histiocytosis to monocytic leukemia and to normal histiocytes (and their precursors) is discussed. And finally, there are statements on the origin and peculiarities of malignant histiocytes.
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Various salient histological features were rated from + to +++ in a semiquantitative evaluation of a series of 155 cases of fibrous histiocytoma. Relations between individual histological features, as well as between histological findings, localisation and size of lesions, and age or sex of the patient were tested statistically. Most impressive was an inverse proportional relationship between cellular and fibrillar densities: highly cellular fibrous histiocytomas chiefly showed little fiber formation. Accordingly, cases with marked fiber formation were distinguished by low cellularity. Based on this statistically significant relation, 3 subtypes could be classified on a scale of increasing fiber formation and decreasing cellular density. The majority of cases showed medium cellularity and fibrillar density, with distinct storiform (spokewheel or "whirlygig") pattern which is compatible with typical storiform histocytoma, including clincally progressive, recurrant FH and/or "dermatofibrosarcoma protuberans". The typical patient was more frequently female than male, 40 years of age with a 0.5 to 1.0 cm size tumor node in the lower extremities located in the corium, often with beginning infiltration of the subcutaneous fat tissue.
To evaluate the accuracy of CT in diagnosing circumscript liver disease, CT findings in 105 patients were compared to the results of invasive diagnostic procedures (laparoscopy, laparotomy, and autopsy). In all patients at least one of these procedures was performed in addition to CT. CT proved to be a valuable noninvasive method in detecting and differentiating circumscript liver lesions such us metastases, primary liver tumors, solitary cysts and polycystic disease, abscesses, and echinococciasis. The 10% rate of false positive and false negative diagnoses indicates the limitations of the method.
Fibrous histiocytomas of the nose and paranasal sinuses are very unusual. Two cases of these tumors are reported. Prognostic histological features and biological behaviour are discussed.
During one year 3 patients with static (latent) bone cavities were observed in the Clinic and Policlinic for maxil-lofacial surgery of the University of Münich. The findings are compared with reports from the literature and possible causes are discussed.
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A unique case of a metastasising choriocarcinoma, inadvertently transplanted to a man from a female cadaver kidney is reported. When the kidney was removed six days after transplantation, arterial blood vessel infiltration by chorio-carcinoma cells and high levels of human chorionic gonadotropin (HCG) in the serum of the recipient indicated an haematogenous dissemination of viable neoplastic cells. The immunosuppressive therapy was discontinued after removal of the graft and the HCG levels in the recipient gradually decreased over a periode of eight weeks, indicating a slow immunologic rejection of the tumor cells. The recipient committed suicide seven months after the transplantation had failed. No metastases were found at a legal autopsy. It seems advisable, whenever there is evidence that neoplastic cells might have been transfered by a homograft, to remove the graft and discontinue the immunosuppressive therapy. Neoplastic cells already disseminated can still be eliminated when the immunologic system is intact and not suppressed.
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