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  • 1
    Electronic Resource
    Electronic Resource
    Expression of cortical and medullary thymic epithelial antigens in thymomas. An immunohistological study of 14 cases including a characterization of the lymphocytic compartment (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Histopathology 14 (1989), S. 0 
    Details
    ISSN: 1365-2559
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Four monoclonal antibodies against antigens expressed differentially by the normal thymus epithelium, which define the cortical, medullary and subcapsular compartments, were used for immunohistological characterization of the epithelial cells in 14 thymomas. Furthermore, thymoma-associated lymphocytes were studied with monoclonal antibodies directed against T-lymphocyte differentiation antigens (CD1a, CD3, T-cell antigen receptor). Only four of the 14 thymomas could be classified into either medullary or cortical type thymoma based on the immunophenotype of epithelial cells. Ten cases escaped immunophenotypical classification due to co-expression of medullary and cortical antigens by the tumour cells. This aberration from the normal phenotype might indicate the failure of differentiation of such tumours. The immunophenotype of the associated lymphocytes, on the other hand, made it possible to classify the tumours as cortical (5 cases), mixed (2) and medullary (3) thymomas. Four thymomas escaped this classification scheme due to the absence of lymphocytes (2) or to a hybrid immunophenotype (2). Nevertheless, thymocytes of cortical type clearly predominated and were seen in all thymomas with associated lymphocytes. This feature may constitute a good diagnostic tool in differential diagnosis since, in 28 mediastinal or extramediastinal metastasis of tumours not derived from thymic epithelium and associated with various numbers of lymphocytes, none of them were found to contain CD1a positive lymphocytes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2559.1989.tb02181.x
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  • 2
    Electronic Resource
    Electronic Resource
    Zur Ultrastruktur des Dünndarmepithels beim Morbus Whipple (1970)
    Springer
    Virchows Archiv 351 (1970), S. 142-154 
    Details
    ISSN: 1432-2307
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Beim Morbus Whipple treten unter therapeutischer Einwirkung (Antibiotica, ACTH, Azosulfapyridin) neben den typischen Stromaveränderungen auch Alterationen des Deckepithels auf. Hierzu gehören Strukturveränderungen an den Zellorganellen der Enterocyten (Invaginationen und Segmentierung der Zellkerne, Schwellung der Mitochondrien und vermehrtes Auftreten mitochondrialer Granula, Hyperplasie der Golgi-Felder, Vesiculationen des endoplasmatischen Reticulum), der Panethschen Zellen (Hyperplasie des Golgi-Apparates, sekretähnliche Cytoplasmaeinschlüsse), der undifferenzierten und Hellen Zellen (Hyperplasie der Golgi-Felder, Kernaktivierung) und eine Proliferation der enterochromaffinen Zellen mit verstärkter Sekretausschleusung. Die Epithelveränderungen sowohl beim unbehandelten als auch beim behandelten Morbus Whipple werden als Folge der Stromaalterationen angesehen. Unter dem Einfluß der Therapie kommt es zu einer Bakteriostase und Bakteriolyse, damit zur Normalisierung des Lymphabflusses und der Mikrozirkulation der Zottenstrombahn. Dadurch wird ein vollwertiger Epithelbesatz geschaffen. Die beschriebenen Veränderungen sind mithin nicht Ausdruck einer Epitheldegeneration, sondern einer metabolischen Aktivierung.
    Notes: Summary In Whipple's disease in addition to the stromal alternations the surface epithelium also undergoes change during treatment with antibiotics, ACTH, and sulfapyridine. The morphological changes seen in the epithelial cells are: invagination and segmentation of the nuclei, swelling of the mitochondria, increased mitochondrial granules, hyperplasia of the Golgi fields, vesiculation of the endoplasmic reticulum. The changes seen in the Paneth cells are: hyperplasia of the Golgi apparatus and secretory-like cytoplasmic inclusions. The undifferentiated and “clear” cells reveal hyperplasia of their Golgi fields and increased nuclear activity. The enterochromaffin cells proliferate and show increased secretion. The epithelial changes in the treated and untreated patients with Whipple's disease are held to be the result of alterations of the stroma. With therapy a bacteriostasis and bacteriolysis develop and the lymphatic drainage and capillary bloodflow of the villi return to normal, resulting in a reestablishment of a normal epithelium. The changes described are not degenerative but represent instead those of increased metabolic activity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00542939
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  • 3
    Electronic Resource
    Electronic Resource
    Zur cytologischen Ultrastruktur des Schleimhautstroma bei Enteropathien, insbesondere bei der idiopathischen Steatorrhoe (1971)
    Springer
    Virchows Archiv 353 (1971), S. 191-206 
    Details
    ISSN: 1432-2307
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird an Hand von Dünndarmbiopsien über mesenchymale Zellreaktionen bei Enteropathien, insbesondere bei der idiopathischen Steatorrhoe berichtet. Das Biopsiematerial eines unausgewählten Krankengutes wurde lupen- und lichtmikroskopisch sowie elektronenoptisch untersucht. Lediglich in der Gruppe der idiopathischen Steatorrhoe („coeliac sprue“) fanden sich konstante Veränderungen. Die übrigen primären oder sekundären enteropathischen Affektionen sind histomorphologisch uncharakteristisch und inkonstant. Eine diagnostische Abgrenzung der einzelnen Krankheitsbilder ist von morphologischer Seite nicht möglich. Für die idiopathische Steatorrhoe sind eine subtotale Zottenatrophie („flat mucosa“), eine signifikante Erhöhung interepithelial gelegener Lymphocyten (15,7% auf 1000 Epithelzellen bei Normwerten zwischen 7,0 und 7,5%) und eine massierte, vorweiegend plasmacelluläre und lymphocytäre Stromainfiltration kennzeichnend. Die Plasmazellen zeigen die morphologischen Kriterien der Stimulation, ein Teil der Lymphocyten die einer initialen Transformation. Auf Grund dieser Befunde wird eine mögliche immunologische Komponente im Ablauf der idiopathischen Steatorrhoe diskutiert. Auch die engen lymphoepithelialen Beziehungen könnten auf Immunphänomene hinweisen. Es muß offen bleiben, ob es sich bei den interepithelialen Lymphocyten um immunkompetente, immunologisch aktive oder um sog. Memory-Zellen handelt.
    Notes: Summary This investigation was designed to study the reactions of mesenchymal cells in enteropathy by means of jejunal biopsies. The biopsy material was intentionally obtained from unselected patients and was studied with magnifying lens, light and electron microscopy. Uniform lesions were found only in coeliac disease. Other primary or secondary enteropathic diseases were associated with non-characteristic and variable histomorphological changes not allowing a definite classification. In idiopathic steatorrhoe the typical findings are: flat mucosa, a significant increase of lymphocytes in interepithelial spaces (15.7% in 1000 epithelial cells as compared to 7.0 to 7.5% normally), and an intense infiltration of the stroma by plasma cells and lymphocytes. Flat mucosa can be considered as a quantitatively specific sign in idiopathic steatorrhoe compared with findings in enteropathic disease of other etiology. Morphologically the plasma cells appear to be activated. Some of the lymphocytes seem to be in a state of initial transformation. Because of these findings the close contact of lymphocytes and epithelial cells suggest immunological factors determining the course of idiopathic steatorrhoe. Morphologically it can not be decided, however, if the interepithelially arranged lymphocytes are immunologically competent or active or if they have to be considered as a memorycell-type.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00545729
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  • 4
    Electronic Resource
    Electronic Resource
    Über die „malabsorptive“ Dermatitis herpetiformis Duhring (1979)
    Springer
    Virchows Archiv 383 (1979), S. 195-206 
    Details
    ISSN: 1432-2307
    Keywords: Dermatitis herpetiformis Duhring ; Malabsorption syndromes ; Intestinal lymphoma ; Small bowel biopsy ; Local immune response
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 21 patients (6 females and 15 males) with Dermatitis herpetiformis have been studied with special considerations of the small intestinal biopsyfindings. During this investigation the patient's mean age was 45 years (20–68) and the mean age at onset was 38 years (17–64). In 5 patients (23.8%) total villous atrophy (group I) and in 4 patients (19.0%) a severe partial or subtotal villous trophy (group II) was found on small intestinal biopsy. The sprue-like changes were patchy lesions. Histocompatibility-antigens of type HLA-A1 were found in 38.1% and of type HLA-B8 in 47.6%. After 20 years of the disease one patient died of a malignant lymphoma of the intestine (immunoblastic sarcoma). In all patients the number of interepithelial lymphocytes in the small bowel mucose was significantly increased, as it was in those patients with a normal villous pattern (group III). In a quantitative analysis of specifically labeled (peroxidase-anti-peroxidase complex) IgG-, IgA- and IgM-cells in the intestinal mucosa it was found that the number of all three plasma cell classes are increased significantly (P〈0.01).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01200899
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  • 5
    Electronic Resource
    Electronic Resource
    Observations on the ultrastructure and function of the so-called “microfold” or “membraneous” cells (M cells) by means of peroxidase as a tracer (1981)
    Springer
    Virchows Archiv 390 (1981), S. 289-312 
    Details
    ISSN: 1432-2307
    Keywords: Microfold (membraneous) cells ; Tuft cells ; Electron microscopy ; Horseradish peroxidase ; Sequential uptake
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 79 NMRI mice and Wistar rats were used for ultrastructural investigations of the sequential uptake of horseradish peroxidase (HRP) by M cells. In addition the ultrastructure of the so-called tuft-cells was reported. HRP, a foreign protein antigen, was applied either by injection (Owen 1977), or by stomach tube. After variable exposure times (5 min to 3 h) segments of the distal small intestine, containing Peyer's patches, mesenteric lymph nodes and liver tissue were removed. After fixation, they were reacted with H2O2-3,3′-diaminobenzidine tetrachloride and were examined by light and electron microscopy for HRP reaction products. The uptake of HRP mainly occurs through the M cells in the dome epithelium of Peyer's patches with a continual transport of the antigenic material into lymphoid cells, macrophages, and dendritic reticulum cells. In the 3 h specimens a few single HRP-positive lymphoid cells can be observed within the efferent lymphatics of Peyer's patches. In addition, a continual uptake of HRP by necrobiotic enterocytes was observed. It has also been shown that after 3 h HRP is located inside the Kupffer cells of the liver. These findings also support the presumption that antigenic material can be transmitted via the portal circulation. However, definite, quantitatively and permanently recorded uptake of HRP by brush border cells was not be observed. To exclude a toxic effect of the applied HRP on the enterocytic epithelium additional resorptive-physiological investigations were performed using the in vivo-perfusion-recirculation method and in vitro-accumulation of L-phenylalanine.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00496560
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  • 6
    Electronic Resource
    Electronic Resource
    Thymus-Carcinoid (1976)
    Springer
    Journal of cancer research and clinical oncology 88 (1976), S. 55-67 
    Details
    ISSN: 1432-1335
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über ein seltenes Carcinoid des Thymus bei einem 32 Jahre alten Mann berichtet. Gleichzeitig werden 25 bislang publizierte Fälle der Literatur referiert. Thymus-Carcinoide finden sich vornehmlich bei Erwachsenen, sehr viel häufiger bei Männern als bei Frauen. Sie liegen zumeist im Mediastinum anterius. Die einzig effektive Therapie ist die möglichst radikale operative Entfernung. Auf Grund hoher lokaler Tumorrezidivraten in Verbindung mit einer lymphogenen und hämatogenen (Spät-) Metastasierung erscheint uns eine (postoperative) Nachbestrahlung (Telecobalt) generell indiziert. Thymus-Carcinoide gleichen in ihrer histologischen Struktur den Dünndarm-carcinoiden bzw. den Bronchusadenomen mit ultrastrukturell nachweisbaren „neurosekretorischen„ Granula. Histogenetisch entstammen sie dem APUD-System. Es bleibt indessen offen, ob Thymus-Carcinoide eine autochthone Geschwulst oder einseitig ausdifferenzierte Teratome im Sinne eines “simplified teratoma” darstellen.
    Notes: Summary A case of a primary thymic carcinoid tumour of a 32 year old male is reported, and the previously published 25 cases are reviewed. The neoplasms occur in adults, predominantly in males: they are located in the anterior or antero-superior mediastinum. The only sufficient treatment is the surgical excision; through radiotherapy may be indicated in some cases, too. The tumour is characterized by the formation of rosettes, ribbons and garlands; sheet-like or medullary areas, and large clusters with central necrosis. The tumour is positive for the Grimelius argyrophil silver stain. Ultrastructurally numerous dense-core “neurosecretory” granules are observed. The formal pathogenesis is similar to that of carcinoid tumours of other locations; particularly of those arriving from derivates of the foregut, respectively from the APUD cell system. At present it cannot be decided whether this particular tumour of the thymus represents an autochthonic thymic carcinoid or simply a teratoma with a differentiation in one direction in the sence of a simplified teratoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00284746
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  • 7
    Electronic Resource
    Electronic Resource
    Vergleichende ultrastrukturelle und klinische Studie zum Ablauf des M. Whipple (1970)
    Springer
    Virchows Archiv 350 (1970), S. 368-388 
    Details
    ISSN: 1432-2307
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Unter antibiotischer Therapie kommt es zu grundlegenden Veränderungen des klinischen und histomorphologischen Erscheinungsbildes des M. Whipple. Das floride, unbehandelte Stadium ist gekennzeichnet durch wäßrige Diarrhoen bzw. Steatorrhoen, Mangelsymptomatik im Sinne eines Malabsorptions-Syndroms und Kachexie. Histomorphologisch bzw. elektronenoptisch lassen sich zahlreiche SPC-Zellen, erweiterte Lymphgefäße und extracellulär gelegene Gram-positive Bakterien nachweisen. Unter antibiotischer Therapie tritt sehr bald eine weitgehende Normalisierung der klinischen Symptomatik ein. Elektronenoptisch kann etwa zur gleichen Zeit ein massiver Bakterienabbau objektiviert werden. Gleichzeitig kommt es zu einer Sklerosierung des Stratum proprium. Die günstigen therapeutischen Effekte und die elektronenmikroskopisch nachweisbaren Abbauvorgänge an den Bakterien lassen eine infektiöse Genese des M. Whipple als wahrscheinlich erscheinen.
    Notes: Summary The clinical and histomorphological signs and symptoms of Whipple's disease are fundamentally altered by antibiotic therapy. The florid, untreated stage is demonstrated by watery diarrhoea and steatorrhoea, signs of deficiencies due to malabsorption and cachexia. Numerous SPC cells, dilated lymph vessels and extracellular Gram-positive bacteria can be demonstrated in light and electron microscopy. With antibiotic therapy a rapid return to near normal clinical conditions ensues. At the some time a massive destruction of bacteria can be demonstrated in the electron microscope. Simultaneously the stratum proprium becomes sclerosed. The favourable therapeutic effect and the catabolic effects on the bacteria seen electron microscopically allow one to postulate an infectious genesis of Whipple's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00578544
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  • 8
    Electronic Resource
    Electronic Resource
    Congenitale Muskeldystrophie (1971)
    Springer
    Virchows Archiv 352 (1971), S. 324-339 
    Details
    ISSN: 1432-2307
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über die licht- und elektronenmikroskopischen Befunde bei 4 Kindern mit kongenitaler Muskeldystrophie berichtet. Alle Patienten boten bereits bei der Geburt das typische klinische Bild mit Schwäche und Hypotonie einer mangelhaft angelegten Muskulatur. Die lichtmikroskopischen Veränderungen entsprechen weitgehend dem Endstadium der progressiven Muskeldystrophie. Im einzelnen werden erhebliche Kaliberschwankungen (atrophierte und pseudohypertrophierte Muskelfasern), hyalin-wachsartige und vacuoläre Degenerationen, grobschollige Verklumpungen des Sarkoplasma, discoide Fragmentierungen und granuläre Zerfallsprodukte anisotroper A-Streifen gefunden. Das interstitielle, endo- und perimysiale Binde- und Fettgewebe ist vermehrt (interstitielle Fibrose und Lipomatose). Lichtmikroskopisch ist eine Differentialdiagnose zwischen congenitaler Muskeldystrophie und progressiver Muskeldystrophie nicht möglich. Elektronenoptisch finden sich überwiegend Myofilamentalterationen, während die für die Frühphase der progressiven Muskeldystrophie typischen mitochondrialen und ergastoplasmatischen Alterationen fehlen. Hinsichtlich der Elektronenmikroskopie ist eine Differentialdiagnose beider Erkrankungen also durchaus möglich. Es wird diskutiert, ob die congenitale Muskeldystrophie eine besondere Gruppe der progressiven Muskeldystrophie darstellt, deren aktive, progredient-dystrophische Phase bereits während der Fetalperiode abläuft.
    Notes: Summary The light and electron miscroscopic findings in four cases of congenital muscular dystrophy are described. A severe muscular hypotonia and generalized weakness is characterized the clinical picture from birth. The histological findings resemble those seen in progressive muscular dystrophy. The light microscopic picture of the muscle is characterized by hyalin and vacuolar degenerations, coarse-grained aggregations of the sarcoplasm, discoidal fragmentations, granular disintegrations of the anisotrope A-disc, and endo- and perimysial fibrosis. Other histological features do not differ from those of other types of muscular dystrophy. The ultrastructural picture reveals significant disaray of contractile elements with minor changes of the sarcoplasmic reticulum, mitochondria and nuclei. The question is discussed therefore whether or not it is permissible to consider congenital muscular dystrophy as a variant of muscular dystrophy. In congenital muscular dystrophy that stage is already reached at or soon after birth. One must assume, therefore, that the active dystrophic process, ie, progressive weakening and wasting of muscle, took place before birth.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00542716
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  • 9
    Electronic Resource
    Electronic Resource
    Primary intestinal lymphomas (1981)
    Springer
    Virchows Archiv 391 (1981), S. 9-31 
    Details
    ISSN: 1432-2307
    Keywords: Intestinal lymphoma ; “Benign ulcerative non-granulomatous jejunitis” ; Coeliac disease ; Ulcerative colitis ; Immunohistology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The histology and immunohistology of twenty-seven malignant non-Hodgkin's lymphomas of the intestinal tract were studied. Nine of these cases were in the small intestine, ten in the ileocaecal region, two in the appendix and four in the large intestine. In one case, several locations in the gastrointestinal tract were involved. The so-called Kiel-Classification was applied. We have found thirteen lymphomas with low grade (lymphocytic, lymphoplasmacytic, centrocytic, centroblastic/centrocytic) and fourteen with high grade of malignancy (centroblastic, lymphoblastic, immunoblastic). For most of the lymphoplasmacytic and immunoblastic lymphomata a monoclonal pattern of intracellular immunoglobulin (IgM/kappa) was identified by the immunoperoxidase method. Tumour cells of lymphocytic, centrocytic, centroblastic/centrocytic, centroblastic and lymphoblastic lymphomas were always Ig-negative. The immunoperoxidase technique helped considerably in distinguishing between (monoclonal) malignant lymphomas and (polyclonal) lympho- or immunoproliferative processes. Six out of twenty-seven malignant lymphomas had developed from immuno-inflammatory diseases of the gut. Four of these were complications of coeliac disease. One had developed from a “malabsorptive” dermatitis herpetiformis Duhring, and one from a complication of a long-standing ulcerative colitis. In two patients with coeliac sprue and “malabsorptive” dermatitis herpetiformis Duhring respectively the ulcerating small intestinal lymphomas were initially misinterpreted as “benigne ulcerative non-granulomatous jejunitis”. The evidence from the literature summarized suggests strongly that the benign non-granulomatous jejunoileitis, lymphomatous ulcer, intestinal “pseudolymphoma” and malignant lymphoma, when associated with villous atrophy of adjacent mucosa and malabsorption symptoms, are all one condition, namely, malignant lymphoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00589792
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  • 10
    Electronic Resource
    Electronic Resource
    The epithelial framework of the thymus in normal and pathological conditions (1981)
    Springer
    Virchows Archiv 392 (1981), S. 7-20 
    Details
    ISSN: 1432-2307
    Keywords: Keratin ; Filaments ; Epithelium ; Thymus ; Tumour diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Autopsy specimens of normal human thymus, from cases of accidental involution, follicular hyperplasia, thymomas and a teratoma were investigated by immunocytochemistry using specific immune sera to small and large keratins. Keratin antisera represent a “marker” of both Hassall's corpuscles (HC) and so-called epithelial reticular cells. There were no apparent differences in keratin polypeptides distribution between cortical and medullary thymic epithelial cells. In accidental involution, the epithelial framework became prominent: epithelial cortical borders and epithelial perivascular sheaths appeared often to be discontinous structures. The central and occasionally cystic spaces of HC did not react with keratin antisera. In follicular hyperplasia, almost solid epithelial aggregates were seen which were located around germinal centers. In thymic tumours, neoplastic epithelial cells displayed a marked immunorectivity with keratin antisera. Immune sera against keratin filaments represent an interesting tool in thymus research and in the diagnostic pathology of thymic tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00430544
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