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  • 1
    Electronic Resource
    Electronic Resource
    Megakaryocytes in chronic myeloproliferative disorders: Numerical density correlated between different entities (1991)
    Springer
    Virchows Archiv 418 (1991), S. 493-497 
    Details
    ISSN: 1432-2307
    Keywords: Megakaryocytes ; Chronic myeloproliferative disorders ; Morphometry ; Histology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A morphometric evaluation of number and grouping of megakaryocytes (MK) in five different groups of chronic myeloproliferative disorders (CMPD) was performed by counting 60 high power fields equaling approximately 14.28 mm2 of haematopoiesis in each case. Twenty-one up to 29 cases were evaluated for each of five categories of CMPD and one control group; a total of 132 cases of CMPD and 33 control cases were used. The mean number of MK per square millimetre was 15.54±1.53 in chronic myeloid leukaemia of common or granulocytic type (CML.CT), 69.91±5.85 in CML with megakaryocytic increase (CML.MI), 59.59 ±3.27 in polycythaemia vera (P. vera), 59.85±4.59 in primary thrombocythaemia (PTH), 67.58±4.11 in chronic megakaryocytic granulocytic myelosis (CMGM), and 19.7±3.07 in controls. The distinction between free or isolated MK, and between clustered or grouped MK corresponds to the total cell counts of MK in the various groups of CMPD. Clustering of MK was significantly higher in CMGM and PTH compared to other groups, but the difference between them was not statistically significant. Significant differences in the mean number of MK were obtained between controls and CML.CT on the one hand and all other groups of CMPD on the other. The results further support the histological sub-classification of CMPD according to the primary disorders of the Hannover classification (not advanced by sclerosis, fibrosis or excess of blasts, respectively).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01606498
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  • 2
    Electronic Resource
    Electronic Resource
    Hairy cell leukemia (1976)
    Springer
    Virchows Archiv 370 (1976), S. 273-289 
    Details
    ISSN: 1432-2307
    Keywords: Bone marrow biopsy ; Hairy cell leukemia ; Differential diagnosis ; Myelofibrosis ; Electron microscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 24 patients with hairy cell leukemia, histological and fine structural findings from biopsies of the bone marrow are reported and their validity is compared with other diagnostic procedures available. Diagnosis by light microscopy of anterior iliac crest biopsies obtained by the method of myelotomy is possible with a high degree of accuracy. The differentiation of hairy cell leukemia from other myelo- or lymphoproliferative disorders based on cytomorphology as well as patterns of growth is emphasized. Morphological differences between fibrosis in this entity and other lesions such as malignant lymphomas, Hodgkin's disease, osteomyelofibrosis and -sclerosis are emphasized. Electron microscopy of the bone marrow shows single fibroblastic cells with numerous slender cytoplasmic processes randomly dispersed among the hairy cells. These fibroblasts are probably responsible for the synthesis of the reticulin and collagen fibres in their surroundings. Moreover fine structure of the hairy cells demonstrates pinocytic activity but no apparent phagocytosis in contrast to the phagocytic reticulum cells (histiocytes, macrophages). In the bone marrow the precursor cells and the many immature forms of hairy cells exhibit an overall lymphocytoid appearance during their maturation, suggesting a lymphocytic origin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00445773
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  • 3
    Electronic Resource
    Electronic Resource
    The impact of megakaryocyte proliferation for the evolution of myelofibrosis (1992)
    Springer
    Virchows Archiv 420 (1992), S. 473-478 
    Details
    ISSN: 1432-2307
    Keywords: Histopathology ; Bone marrow ; Megakaryocytes ; Myeloid leukaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A histological study on sequential bone marrow biopsies in patients with chronic myeloid leukaemia (CML) was performed. We wished to answer the question as to whether a different content of megakaryopoiesis in the bone marrow of CML patients has a prognostic significance for the development of myelofibrosis during the course of disease. In addition, the significance of possible changes in the quantity of megakaryopoiesis in this process was assessed. In 186 patients who had no fibre increase at first diagnosis, the rate of subsequent myelofibrosis varied from 19% for the common or granulocytic subtype (CML.CT) to 40% for patients with features of megakaryocytic increase (CML.MI). No significant differences were found either in the rapidity of progression to fibrosis or in the final rate of osteomyelosclerosis. Whereas in CML.MI most patients (75%) showed an increase of fibres only, this was accompanied by an additional increase of megakaryocytes in CML.CT, changing the histological pattern from CML.CT to MI or MP, respectively. The data therefore revealed a correlation between fibre increase and subtyping of CML as suggested by the Hannover classification of chronic myeloproliferative diseases. Subtypes of CML with megakaryocytic increase could be shown to present a “pre-myelofibrotic” stage of disease and may therefore be conceived as a particular pathway of acceleration.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01600251
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  • 4
    Electronic Resource
    Electronic Resource
    Histologic findings in bone marrow biopsies of patients with thrombocythemic cell counts (1992)
    Springer
    Annals of hematology 64 (1992), S. 286-291 
    Details
    ISSN: 1432-0584
    Keywords: Myeloproliferative disorders ; Megakaryopoiesis ; Histopathology ; Bone marrow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Histologic diagnoses from bone marrow biopsies were analyzed in a total of 1165 patients presenting with thrombocythemic platelet counts at initial examination. Two cut-off points suggested by the Polycythemia Vera Study Group to define thrombocythemia by platelet counts were compared: the former limiting value of 1000×109/l platelets versus the recently proposed value of 600×109/l. The percentage of all nonproliferative disorders was 41% under the lower, dropping to 11% under the high cut-off point. The respective figures for myeloproliferative disorders increased from 49% under the lower to 74% under the high limiting value. Primary thrombocythemia was included in 72% by the lower, and in only 40% by the high limiting value when classified by its histologic pattern in bone marrow biopsy. A striking decrease of platelet counts occurs, related to fiber increase, among each of three main groups of myeloproliferative disorders: in CML with megakaryocytic predominance from 40% down to 25%, in megakaryocytic-granulocytic myelosis (primary, i.e., agnogenic myelofibrosis) from 36.6% to 10%, and in primary thrombocythemia from 72.6% to 28.6% in cases with reticulin sclerosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01695473
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  • 5
    Electronic Resource
    Electronic Resource
    Zytogenetik als Ergänzung zur Histopathologie am Beispiel des myelodysplastischen Syndroms (1994)
    Springer
    Der Pathologe 15 (1994), S. 286-291 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Myelodysplastisches Syndrom ; Knochenmark ; Zytogenetik ; Histopathologie ; Prognose ; Key words Myelodysplastic syndrome ; Bone marrow ; Cytogenetics ; Histopathology ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The value of cytogenetics performed simultaneously with histopathology was evaluated in patients with myelodysplastic syndrome (MDS). Clonal karyotype changes of the bone marrow cells supporting the histological diagnosis were found in 38/69 cases (55 %). The chromosome aberrations, especially complex changes, were significantly correlated to distinct histopathological findings such as atypias of the haematopoietic cell lines and myelosclerosis. Complex karyotype changes were further associated with short survival of the MDS patients. Our results demonstrate that cytogenetic analyses are helpful in supplementing the histopathological diagnoses. Recent developments in molecular cytogenetics even allow the detection of chromosomal aberrations in non-dividing cells from cytological preparations or tissue sections which may become available for routine diagnosis.
    Notes: Zusammenfassung Die Bedeutung simultaner zytogenetischer und histologischer Untersuchungen wurde bei Patienten mit myelodysplastischem Syndrom (MDS) überprüft. Die Ergebnisse zeigen, daß klonale Karyotypveränderungen der Knochenmarkzellen bei 38 der 69 (55 %) analysierten Patienten auftraten und damit häufig eine Absicherung der histologischen Diagnose erlaubten. Die Chromosomenanomalien, insbesondere komplexe Karyotypveränderungen, korrelierten signifikant mit einer Reihe histopathologischer Befunde, darunter Atypien der einzelnen hämatologischen Zellreihen und Myelosklerose. Durch den Nachweis komplexer Karyotypveränderungen war eine unabhängige prognostische Aussage möglich. Damit zeigen unsere Ergebnisse am Beispiel des MDS, daß zytogenetische Analysen eine sinnvolle Ergänzung der histologischen Untersuchung sein können. Darüber hinaus ist durch den Einsatz der molekularen Zytogenetik die Bestimmung von Chromosomenanomalien in zytologischen Ausstrichpräparaten oder Gewebeschnitten möglich, wodurch sich solche Befunde auch für die tägliche Diagnostik verwenden lassen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050056
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  • 6
    Electronic Resource
    Electronic Resource
    Das histologische Bild der Anämien in Knochenmarksbiopsien (1995)
    Springer
    Der Pathologe 16 (1995), S. 46-52 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Anämie ; Histologie ; Erythropoese ; Aplastische Anämie ; Hämolyse ; Key words Anemia ; Histology ; Hemolysis ; Aplastic anemia ; Erythropoiesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A total of 41,553 bone marrow biopsies were collected for the Bone Marrow Registry from January 1989 to June 1994 included 6,366 taken from 5,011 patients referred because of unexplained anemia. An increasing percentage of biopsies submitted for examination are designated anemic: this rose from 7.2 % in 1989 to 18.9 % within the first 6 months of 1994, reflecting an increased need to find the reasons for anemic conditions. Histologically, seven main groups have been found: (1) myelodysplastic syndrome (MDS) accounting for 32 % of all anemia patients seen, (2) infectious anemia (23.5 %), (3) iron deficiency anemia (22.7 %), (4) hemolytic anemias (7.2 %), (5) aplastic anemia (6.8 %), (6) megaloblastic/pernicious anemia (5.0 %), and (7) anemia due to bleeding (3.0 %). These seven groups of anemia can be diagnosed in core biopsies on the basis of their particular histopathology, so that films of bone marrow smears are not always needed.
    Notes: Zusammenfassung Die Auswertung von 6 366 Untersuchungen, die wegen unklarer Anämie im Knochenmarksregister in den Jahren 1989 bis Juni 1994 untersucht worden sind, zeigt eine eindeutige Zunahme des Anteils der Anämien an den Einsendungen: 1989 waren es nur 7,2 %, im ersten Halbjahr 1994 aber 18,9 %, der Durchschnittswert beträgt rund 15 % in den insgesamt 41 553 in dieser Zeit untersuchten Biopsien. Die Zunahme ist v. a. auf die Zahl von Untersuchungen bei den über 50 jährigen zurückzuführen, die 73 % der 5 011 untersuchten Patienten ausmachen. Dies hängt besonders mit dem auf das Alter konzentrierten myelodysplastischen Syndrom zusammen, das mit fast 32 % Anteil die weitaus häufigste Ursache einer Anämie im Register ist. Neben dem myelodysplastischen Syndrom sind die Anämien infolge einer Entzündung oder infolge eines Mangels an Speichereisen im Knochenmarksregister mit 23,5 bzw. 22,7 % Anteil besonders häufig. Weitere, jedoch mit einem Anteil zwischen 3 und 7,2 % weit weniger bedeutende Ursachen einer Anämie sind in absteigender Häufigkeit die vielschichtige Gruppe der hämolytischen Anämien, die aplastische Anämie sowie die Gruppe der megaloblastären bzw. echten periziösen Anämie und die Anämie bei Blutung. Die einzelnen Anämieformen können durch typische histologische Veränderungen in der Biopsie des Knochenmarks unterschieden werden. Die Histopathologie der 6 wesentlichen Hauptgruppen wird beschrieben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050075
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  • 7
    Electronic Resource
    Electronic Resource
    Histopathologie der chronischen myeloischen Leukämie in diagnostischen Biopsien vom Knochenmark (1995)
    Springer
    Der Pathologe 16 (1995), S. 70-74 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter CML ; Histopathologie ; Knochenmark ; Megakaryozyten ; Histiozyten ; Key words CML ; Histopathology ; Bone marrow ; Megakaryocytes ; Histiocytes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Histopathology of the bone marrow of diagnostic biopsies prior to any therapy is described in a total of 412 Ph1-positive patients. Special attention is paid to the distribution of megakaryocytes, increase of fibres and blasts, and occurrence of storing histiocytes of pseudo-Gaucher type. Megakaryocytes were significantly increased in 31.6 % of diagnostic biopsies, myelofibrosis was found in 15.8 %, significant increase of blasts in 2.4 %. Pseudo-Gaucher cells were detected in 57.8 % of a total of 412 biopsies. These histiological features are considered as an indication of the progress of the disease. A semiquantitative specification of CML by this criteria is described which can be performed rather reliably and defines the stage of CML at diagnosis prior to substantial treatment.
    Notes: Zusammenfassung Die Histopathologie der chronischen myeloischen Leukämie (CML) wird aus den diagnostischen Biopsien des Knochenmarks von 412 Philadelphia-positiven Patienten beschrieben. Besonders berücksichtigt wird die Verteilung der Megakaryozyten, die Vermehrung von Fasern, von Blasten und von speichernden Histiozyten, nämlich der Pseudo-Gaucher-Zellen. Die Megakaryozyten waren eindeutig vermehrt bei 31,6 % der Patienten am Tag der Diagnose. Eine erkennbare Myelofibrose wiesen 15,8 % auf, eine deutliche Blastenvermehrung 2,4 % der Patienten. Speichernde Histiozyten vom Typ der Pseudo-Gaucher-Zellen zeigten 57,8 % im Knochenmark. Die Veränderungen werden als morphologische Kriterien der fortschreitenden Erkrankung interpretiert. Es bietet sich an, die CML semiquantitativ einzuteilen, was einfach und sicher durchgeführt werden kann. Damit wird die Erkrankung aus der Knochenmarkbiopsie heraus besser verständlich und für Verlaufsuntersuchungen definiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050078
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  • 8
    Electronic Resource
    Electronic Resource
    Solitärer Fibröser Tumor des Epikards (1996)
    Springer
    Der Pathologe 17 (1996), S. 139-144 
    Details
    ISSN: 1432-1963
    Keywords: Schlüsselwörter Solitärer Fibröser Tumor ; CD 34 ; Herztransplantation ; Histopathologie ; Herztumoren ; Key words Solitary Fibrous Tumor ; Heart-neoplasms ; Differential diagnosis ; Mesothelioma ; CD 34
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A giant Solitary Fibrous Tumor (SFT) arising in the pericardium is described. A 53 year old women was suspected to have a lung tumor and thoracotomy was performed. Intraoperatively the child-head sized mass was found to be localized in the pericardial sac. The histopathological interpretation of a small wedge-biopsy was ’endothelioma of uncertain malignancy' and heart-transplantation was performed two months later. The patient died of postoperative infection. Post mortem examination could exclude tumor rest or metastasis. The explanted heart revealed a large bulk of 2800 gramms arising from the epicardium of the left chamber and enveloping the heart without invading the underlying myocardium. The histopathological pattern varied between cell-rich and -poor fibromatous areas and well capillarized endothelioma-like zones. Immunohistochemistry revealed positive reactions with monoclonal antibodies against Vimentin and CD 34 and no reactions against Cytokeratins and Faktor VIII. This pattern was confirmed in 7 SFT's of the pleura from our archives. A second control group of 7 mesotheliomas was positive for cytokeratins and vimentin but not for CD 34 and Faktor VIII. Diagnosis of SFT might be difficult because of its variability in histopathology, sometimes mimicking a hemangiopericytoma or endothelioma. Recent reports of tumor localizations devoiding serosal surfaces illustrate the diagnostic and histogenetic dilemma of this tumor. The differentiation of SFT from mesothelioma and endothelioma can be achieved by immunophenotyping including CD 34.
    Notes: Zusammenfassung Das sehr seltene Vorkommen eines Solitären Fibrösen Tumors (SFT) am Perikard wird anhand einer eigenen Beobachtung vorgestellt. Der Fall zeigt die diagnostischen Schwierigkeiten, die bei diesen Tumoren durch ungewöhnliche Lokalisationen und die Variabilität des histologischen Bildes entstehen können, besonders wenn primär nur kleine Biopsien zur Beurteilung zur Verfügung stehen. Der riesige, 2800 g wiegende Tumor schien in der Lunge zu liegen. Erst durch die Operation wurde ein Herztumor erkannt, von dem bioptisch nur eine kleine Gewebeprobe genommen werden konnte. Histopathologisch wurde daran die Diagnose eines semimalignen Hämangioendothelioms gestellt und deshalb bei der 53jährigen Frau eine Herztransplantation durchgeführt, deren postoperativen Komplikationen sie erlag. Die Untersuchung des Tumors am explantierten Herzen zeigte zelldichte und zellarme fibromatöse neben hämangioperizytom- oder endotheliomartigen Arealen. Ein infiltratives Wachstum oder eine Metastasierung ließ sich auch durch die Obduktion nicht nachweisen. Die immunhistochemische Untersuchung ergab eine positive Reaktion mit Antikörpern gegen CD 34 und Vimentin und negative Reaktionen gegen Keratine und andere, v. a. vaskuläre, Marker. Die Kenntnis dieses charakteristischen Muster sollte die Diagnose eines SFT auch an kleinen Biopsien erleichtern. Auch trägt sie wesentlich zur inzwischen klaren histogenetischen Abgrenzung des meist gutartigen Tumors vom Mesotheliom bei. Die zu diesem Thema lange Zeit währende Diskussion, die von der historischen bis zur neuesten Literatur reicht, wird kurz referiert. Dabei wird auf die zunehmende Beschreibung dieser Tumoren auch ohne Bezug zu serösen Häuten verwiesen. Um Unklarheiten bezüglich der Entität und Dignität zu vermeiden, sollten überholte Synonyme für den SFT, die eine Verwandtschaft mit dem Mesotheliom vermuten ließen, besser nicht mehr verwandt werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002920050147
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  • 9
    Electronic Resource
    Electronic Resource
    Angioimmunoblastic lymphadenopathy (1980)
    Springer
    Virchows Archiv 389 (1980), S. 369-380 
    Details
    ISSN: 1432-2307
    Keywords: Angioimmunoblastic lymphadenopathy ; Bone marrow involvement ; Histopathology ; Differential diagnosis ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 23 cases of angioimmunoblastic lymphadenopathy (AILAP) diagnosed by lymph node biopsy were investigated with regard to bone marrow involvement, using plastic embedding technique. 14 patients (61%) out of 23 displayed a granuloma-like focal or extended infiltrate, predominantly in the center of the bone marrow spaces. This lesion contained lymphocytes, plasma cells, histiocytic reticulum cells and sometimes immunoblasts with whorls of arborizing vessels and increased reticulin fibers. The different types of cellular infiltration in lymph nodes in AILAP are not encountered in bone marrow. Further, there is only a relatively slight increase of vessels which are not always as thick-walled in the bone marrow as in the lymph nodes of AILAP patients. 7 out of 14 (50%) cases with marrow involvement died with recurring lymphomas and infiltration of liver and spleen after 4 to 54 months after the first biopsy. This demonstrates the unfavorable clinical outcome of AILAP with bone marrow infiltration, since only 2 of 9 patients (22%) without marrow involvement at the time of biopsy have died to date: one had toxic heart failure following chemotherapy and another developed septicaemia. Early marrow lesions of Hodgkin's disease and granulomas in hyperergic myelitis of rheumatic origin have a very similar appearance and may therefore be confused with AILAP infiltrates. Histopathology of lymph nodes is therefore an essential requirement in differentiating between these disorders. The outstanding value of bone marrow biopsy in AILAP-patients is firstly, in staging the disease and secondly, in early recognition of systemic spread connected with an unfavorable prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00430660
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