Zentralblatt fur allgemeine Pathologie u. pathologische Anatomie最新文献

According to present knowledge, mutations of mitochondrial DNA (mtDNA), implicated in the mitochondrial theory of carcinogenesis that had been inaugurated 50 years ago by Graffi, appear to be involved in malignant transformation of cells, although no definite evidence has been provided, as yet. However, as very recently elucidated, a clear-cut association exists between different classes of mutations of mtDNA (among them point mutations, deletions and duplications) and some human mitochondriopathies, particularly neuromuscular diseases. These include Leber's hereditary optic neuropathy, the Kearns-Sayre syndrome and two encephalomyopathies known by the acronyms MERRF and MELAS syndrome. The different alterations of mtDNA, though variable, can be assigned to defined positions on the genetic map of mtDNA. Point mutations of mtDNA seem to occur preferentially in conjunction with maternally inherited disorders. Although the results obtained so far are of interest mainly in terms of cognitive theory they provide new stimuli for the development of molecular diagnosis, genetic counselling and possibly for more effective treatment of the above diseases.

Described in this paper are two cases of non-Hodgkin lymphoma (NHL) of the thyroid gland in women with Hashimoto's thyroiditis. NHL may be misinterpreted for its histological similarity to anaplastic thyroid carcinoma. The immunoperoxidase technique can be used with good success to confirm the lymphocytic origin of tumor cells.

Hereditary motor and sensory neuropathies (HMSN) comprise a heterogeneous group of disorders. Since phenotypic manifestations are similar in most families, classification is based on differences in the mode of inheritance, onset and progression of the disease, nerve conduction velocity and nerve biopsy findings. Autosomal dominant, autosomal recessive, X-dominant and X-recessive forms, substantial intrafamilial differences, intermediate forms and the combination of neuropathies with spinocerebellar degeneration within one and the same sibship have been described. On the basis of selected own cases it is demonstrated that there is a broad spectrum of functional and structural abnormalities depending on the progression of the disease and on the site of nerve studied (proximal or distal part). Both the neuronal and hypertrophic variants begin with axonal degeneration of the dying back type followed by segmental demyelination and variable degrees of hypertrophic Schwann cell proliferation. Constantly, posterior columns of the spinal cord reveal fiber loss. Since the molecular basis of the different forms remains to be clarified it seems to be of greater interest to underline common features than to separate seemingly different nosological entities. It is suggested that the latter are partly the result of a selection of cases with a variable severity. Evidently, the syndrome of myatrophic ataxia comprises apart from "pure" HMSN with unsignificant degenerations of posterior columns and "pure" Friedreich's ataxia with mild peripheral nerve fiber loss intermediate forms.

A fibrolamellar variant of hepatocellular carcinoma with metastases in 2 regional lymph nodes was surgically removed from a girl, 17 years of age. This type of tumor has a typical histological pattern. Prognosis is found to be better than that of the common hepatocellular carcinoma.

Series of semi-thin sections were prepared of mature human placentas after immersion and perfusion fixation. Evidence was produced to the existence of syncytial bridges between neighbouring chorionic villi. Besides, syncytial knots and sprouts were present, as well as structures apparently similar to bridges which had resulted from peculiar cutting through a syncytial knot. The latter have been referred to as artefacts by other authors and are obtainable only under two conditions: 1. pre-existence of nuclear agglomeration at cutting level; 2. accidentally appropriate cutting. Such coincidence has been recordable from two thirds of all cases, but it is by no means responsible for all cases of bridge formation. Structures of that kind are never artefacts by any account of lexical meaning. The following criteria are suggested for differentiation between bridges, on the one hand, and structures resembling bridges due to tangential sections: 1. Number of nuclei relative to bridge surface; 2. Limitation of surface; 3. Appearance and arrangement of nuclei.

The first part of this review of pathological aspects relating to the placenta is made up of introductory comments on the material that is subject of histological investigation as well as on clinical questions and a thorough description of macroscopic findings. Hints are also given on collection of placental samples and histological investigation. The coverage is completed by a few comments on the normal anatomy of the placenta.

Reference is made in numerous recent immunological studies to immunological mechanisms which were found to play a role in acceptance of pregnancy or habitual abortions. The most important theories likely to offer explanations for these phenomena are reviewed in some detail, including hormonal immunosuppression, immunologic-anatomic barrier at the placenta as well as blocking factors and anti-sperm antibodies. Molar pregnancy is associated with a particular immunological situation. None of the theories mentioned can be preferred, for the time being, to explain acceptance of normal pregnancy or the causes of recurrent spontaneous abortions.

70 cases of acute dihydralazine-associated hepatitis with centrolobular or confluent necroses, registered in the files of the Berlin-Friedrichshain Institute of Pathology, between 1981 and 1985, were classified into 3 types of diagnostic probability for differential diagnosis versus virus hepatitis. Classification was conducted according to recommendations given by a working group of pathologists, specialised in liver pathology. 42 cases out of this material had come from Prenzlauer-Berg Hospital, Department of Infectious Diseases, and were re-examined under clinical aspects. 6 of them were discarded from evaluation. Type I proved to be of high diagnostic reliability, as was seen from 61% of all cases. Only 3 cases had to be discarded from that group and were associated with other drugs, such as halothane, methyldopa, and propranolol. The following clinical parameters proved to be of particular value for definite assessment of drug-induced hepatitis: time of exposure (for analysis of co-medication), time of recovery, and re-exposure test. Only circumstantial evidence so far can be provided for all histological types to causative relationship between drug ingestion and hepatitis. Compliance with mandatory notification should be ensured in all cases, since suspicious cases are explicitly included. Higher sex-related disposition of women to drug-induced hepatitis was confirmed in our material, with the female-to-male ratio being 3:1.