Zentralblatt fur allgemeine Pathologie u. pathologische Anatomie最新文献

Correlations which exist between morphometric parameters of remaining testicular tissue, on the one hand, and serum hormones on the other (testosterone = T, follicle-stimulating hormone = FSH, luteinising hormone = LH), depending on therapeutic action taken on patients for malignant testicular tumours, seem to suggest that decline in epithelial thickness together with increase in wall thickness leads to rise in FSH. No unambiguous relations, on the other hand, were found to exist between testosterone or luteotrophic hormone and morphometric findings. Hence, FSH seems to characterise the severity of damage to germ epithelium and thus the degree of impairment to spermatogenesis. FSH may be accepted as a criterion for fertility disorders in sexually active men.

Normal maturation of the placenta (signs of maturation) and disorders in maturation are covered in the third part of this account of placental pathology. Impairment of maturation should be related to pregnancy age and intrauterine fetal development. A historic account is given of various classifications so far applied to impaired placental maturation, and a new setup is recommended for introduction to routine diagnosis.

This article deals with metastatic involvement of the heart and is based on autopsy material of the Institute of Pathology, Medical Faculty of the University of Zagreb, from the beginning of 1983 through June 1988. The incidence of heart metastases of carcinomas originating from various sites as well as positions of the tumor within the heart were considered. Heart metastases were recorded from 39 of 477 malignant neoplasms of epithelial origin, which made an incidence of 8.2%. Pericardium and myocardium were equally involved. Pericardial involvement occurred mostly as diffuse carcinosis, whereas the myocardium was involved most frequently on the left side. Metastases from primary lung carcinoma affected the heart in 7.4% of all cases and from carcinoma of the female genital tract in 7%. Great attention is deserved by primary carcinomas of the tongue and sublingual region which involved the heart in 23.7% of all cases. No similar data were found in the available reference.

Malformations of both the umbilical cord and placenta are covered in the second part of this account of placental pathology. Disorders in placental development are subdivided on the basis of the classification published by Vogel (1984). Particular importance is attributed, in this context, to purely morphological differentiation between hydatid and partial mole. Also discussed is the problem of early placental angiomatosis (chorioangiosis, chorioangiomatosis). However, its association with malformations of the placenta seems to be questionable.

An attempt was made by means of microbiological and histomorphological methods for diagnostic elucidation of reactive lymphadenopathies in 52 patients. The serological findings differed from those recorded from clinically intact individuals, in that they included not only increased prevalence of antibodies but also increased antibody titres to cytomegalovirus, influenza virus, and toxoplasma gondii. The dynamic of antibody titres against antigens specific of herpesvirus, influenza virus, and toxoplasma gondii were followed up and enabled positive detection in 11 of 18 patients of active infections with the above pathogens involved. Histologically, the lymph nodes affected were characterised by alterations reminiscent to Piringer lymphadenitis. While, in the course of bacteriological investigations, various bacterial species were isolated from lymph node tissue of 35 patients, direct morphological identification from lymph node sections failed to work. Immature sinus histiocytosis and an increase in phagocytosis activity were among the typical tissue findings.

A 25 year old woman developed 2 subcutaneous myxomas one month after removal of an atrial myxoma. The pathogenesis of this event is discussed. Special attention was given to distinction between true myxomas and myxoid sarcomas as well as to myxomatous diathesis, caused by a widespread, genetically determined specific abnormality of certain mesenchymal cells (Swiss-syndrome). With all aspects considered, this appears to be the best interpretation of the case under review.

In diagnostic pathomorphology of lymphoproliferative diseases, immunohistochemical methods are of great importance. These methods help to elucidate the following issues: reactive or malignant nature of a lesion, origin of atypical cells (lymphoreticular or other), type of malignant lymphoma (Hodgkin's disease or malignant non-Hodgkin lymphoma, NHL), grade of malignancy, T- or B-cell origin and subtype of NHLs. All results of immunohistochemistry should be carefully scrutinized in the light of routine pathomorphological findings. The possibilities of immunohistochemistry are demonstrated by two examples: 1. Origin and stage of differentiation of B-cell chronic lymphocytic leukaemia cells with special emphasis on the presence of follicular dendritic reticulum cells in the lymph nodes of a few, otherwise typical cases of CLL. 2. Description of two cases of a new type of NHL that contains intrasinusoidal B-cells. Monoclonal plasma cells with immunoglobulins of the same isotypes as those of intrasinusoidal B-cells were observed in both cases. These findings suggest that the intrasinusoidal B-cells may be plasma cell precursors.

An account is given of the concept of glial dystrophies (SEITELBERGER 1970), with reference being made to the astroglial syndromes involved, that is to the complex of astroglial dystrophy (AD). Basic research more recently conducted on the physiology of astroglia seem to support the assumption that astroglia represents a particular pattern of cytochemical processes and regulations which, in response to disturbance, is likely to cause characteristic and quite often selective morphological alterations. A distinction is made between 3 sub-groups of AD, that is AD proper in a more limited sense, gliovasal dystrophy (GVD), and glioneuronal dystrophy (GND). In this context, the most common forms of astroglial alterations are discussed in keeping with the above definition. The Rosenthal fibre is defined as a disorder of the astroglial cytoskeleton which may grow manifest as reactive or systemic alterations, depending on expression. The various forms of abnormal astrocytes in hepatogenic AD were found to differ from each other in both morphology and immunocytochemical reactivity, according to their particular pathogenetic patterns. Presenile glial dystrophy is a senile disease that is characterised by massive numerical increase in astrocytes, primarily at the corticomedullary interface and is accompanied by diffuse cerebral atrophy but only minor nerve cell alterations. It is thus an entity in its own right, apart from Pick's and Alzheimer's diseases. A selective astroglial oedema may be experimentally induced in regions of epileptic hyperactivity of nerve cells by systemic administration of kainic acid. It is in conformity with the functional linkage of astrocytes with cerebral vessels and neurons that AD is quite often associated with alterations of these structures, as well: GVD and GND.(ABSTRACT TRUNCATED AT 250 WORDS)

Histogenetic classification was applied to 416 cases of human exocrine pancreas carcinoma. Fundamental importance was attributed, in that context, to duct-associated histogenesis. A distinction was, therefore, made between ductal and ductular pancreas carcinomas. Invasive ductal carcinomas were subdivided by three categories: highly stromatous classical adenocarcinoma with poor prognosis, invasive ductal carcinoma with further differentiation (myxoma, squamous carcinoma, pleomorphous macrocellular and parvicellular types), and variations with specific differentiation (serous, mucinous tumours) with good prognosis. Invasive ductular carcinomas were subdivided by terminal non-papillary adenocarcinoma with protracted illness, ciliary adenocarcinoma, microglandular adenocarcinoma, ductulo-acinous tumour with excellent prognosis, and oncocytic carcinoma. These should be distinguished from intermediary cells with cellular transformation and neoplastic differentiation, such as adenocarcinoma with hepatocellular differentiation and mixed tumours (exocrine and endocrine) with alternatingly predominant cell spectra. Determination of prognostically differentiated tumours types is considered to be an indispensable prerequisite for adequately adjusted effective therapy. This appears to be the only approach which promises progress for the future.

The opening of the Prosector's Department at the Charité of Berlin and appointment of its first Prosector are reported in this paper. The scientific need for getting clinical postmortem investigations performed by full-fledged anatomists or for having them at least anatomically supervised and pressures resulting from Europe's first cholera outbreak, approaching Berlin about 1830, had been the principal motivations behind the initiative. On May 8, 1831, Dr. Philipp Phoebus was appointed the first Prosector of the Charité of Berlin. The position had been offered as a part-time job. Most aspects relating to the post had not been clearly defined by that date, for example, the rights and duties of a Prosector, his integration with the general pattern of Charité services, and his subordination to the local hospital committee. Phoebus made an unsuccessful attempt to define and thus secure the Prosector's position by means of a self-drafted policy paper. Misunderstandings on end and strained relations with the clinicians on the spot prompted him to quit service after 16 months. An account is given of his short but successful time at Charité, with reference being also made of the specific reason for his resignation. An outline is subsequently presented of Phoebus' further life and work, including scientific careers in Berlin, Stolberg/Harz, and at Giessen University where he held a professorship in pharmacology.