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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 371 (1976), S. 331-350 
    ISSN: 1432-2307
    Keywords: Islet cell tumors ; Insulinomas ; Gastrinomas ; Staining characteristics ; Immunohistology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer ersten Untersuchungsserie werden die Färbeeigenschaften, insbesondere die Argyrophilie und Metachromasie, normaler endokriner, immunologisch identifizierter Zellen der Pankreasinsel und der Gastroduodenalmukosa untersucht. In einem zweiten Schritt werden diese Färbeeigenschaften an Insulinomen und Gastrinomen geprüft. Während die normalen B-Zellen mit Aldehydfuchsin und Pseudoisozyanin positiv und generell nicht argyrophil nach Grimelius reagieren, lassen sich die neoplastischen B-Zellen nur unregelmäßig mit den konventionellen Methoden anfärben. Sie enthalten aber häufig argyrophile Strukturen. Immunhistologisch kommen praktisch in allen gutartigen Insulinomen reichlich, in den metastasierenden Formen dagegen kaum insulinhaltige Zellen zur Darstellung. Die Malignome weisen jedoch eine besonders ausgeprägte Grimelius-Argyrophilie auf. Die Tumorzellen von Gastrinomen sind wie normale G-Zellen Grimelius-argyrophil, bzw. leicht metachromatisch und lassen sich nur ausnahmsweise wie A1-Zellen mit der Methode von Hellerström versilbern. Trotz der großen Zahl von Grimelius-positiven Tumorzellen reagieren meist nur wenige mit Antigastrinserum. Dennoch ist die Immunhistologie die zuverlässigste Methode für die Diagnose von Gastrinomen. Die Elektronenmikroskopie liefert dagegen oft schwer interpretierbare Resultate, da in Gastrinomen ähnlich wie in undifferenzierten oder malignen Insulinomen vorwiegend atypische Sekretgranula vorhanden Scin können.
    Notes: Summary In a first step of our investigation the staining characteristics, especially the argyrophilia and metachromasia, of immunohistologically identified endocrine cells of the pancreatic islets and of the gastroduodenal mucosa were tested. These staining characteristics were then examined on insulinomas and gastrinomas. Contrary to normal B cells which generally react positively with aldehyde fuchsin and pseudoisocyanine but not argyrophilic with the Grimelius method, the neoplastic B cells give inconsistent results with conventional staining methods. Yet neoplastic B cells often show argyrophilic structures. Immunohistologically, most benign insulinomas are rich in insulin-containing cells, whereas in malignant types such cells are rare. The carcinomas, however, show a typical and distinct Grimelius argyrophilia. The tumor cells of gastrinomas are Grimelius argyrophilic and slightly metachromatic, as normal G cells, yet, contrary to A1 cells, they are only exceptionally stainable with the Hellerström method. Despite the great number of Grimelius positive tumor cells, generally only a few reacted with antigastrin serum. Nevertheless, the immunohistology is the most reliable method for the diagnosis of gastrinomas. Electron microscopic results are often difficult to interpret, since gastrinomas, as well as undifferentiated or malignant insulinomas, may predominantly contain atypical secretion granules.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 370 (1976), S. 41-54 
    ISSN: 1432-2307
    Keywords: Testicular neoplasms ; Nomenclature
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 61 Autopsiefällen mit metastasierenden malignen Keimzelltumoren der Hoden wurden sowohl die Primärtumoren als auch die Metastasen histologisch nachkontrolliert und nach den Nomenklaturen des “WHO Panel on Testicular Tumours” und des “British Testicular Tumour Panel” klassifiziert. Beide Nomenklaturen sind in Bezug auf die Einteilung der Primärgeschwülste und der Metastasen relativ einfach anwendbar. Der Vergleich der histologischen Strukturen der Primärtumoren mit denjenigen der zugehörigen Metastasen ergibt aber gewisse strukturelle Abweichungen, die je nach Tumorkategorie verschieden ausgeprägt sind. Seminome bilden eine anscheinend recht einheitliche Gruppe; sie metastasieren in der Regel auch als Seminome. Anaplastische Seminome können aber unter Umständen nicht von ausgesprochen solid wachsenden embryonalen Karzinomen unterschieden werden. Der Seminomanteil innerhalb kombinierter Tumoren scheint in der Regel nicht zu metastasieren. Die Betrachtung des histologischen Aufbaus der Metastasen und der Primärtumoren der embryonalen Karzinome kombiniert mit Teratom (maligne Teratome, Intermediärtyp nach der englischen Nomenklatur) und der reinen embryonalen Karzinome (maligne Teratome, undifferenzierter Typ) ergibt, daß diese beiden Tumorformen keinen eigenständigen Kategorien entsprechen. Der Überbegriff des malignen Teratoms der Briten trägt dieser Tatsache Rechnung, umfaßt er doch auch diese Übergangsformen zwischen Teratomen und embryonalen Karzinomen. Reine Choriokarzinome sind ausgesprochen seltene Hodengeschwülste. Unsere Patienten mit primären Choriokarzinomen im Rahmen von Teratomen, also Choriokarzinome kombiniert mit anderen histologischen Tumortypen, wiesen jedoch ebenfalls nur Metastasen von rein choriokarzinomatöser Struktur auf. Sie starben zudem alle innerhalb eines Jahres an ihren Metastasen. Die Unterscheidung reiner und kombinierter Formen von Choriokarzinomen, wie das die WHO vorschlägt, ist deshalb klinisch ohne Bedeutung. 10% unserer Patienten mit metastasierenden Keimzellgeschwülsten wiesen Hodenläsionen auf, die als sogenannte ausgebrannte Hodentumoren bezeichnet werden. Eine entsprechende Tumorkategorie fehlt in beiden Nomenklaturen.
    Notes: Summary 61 autopsy cases with malignant germ cell testis tumors were examined. Both the primary tumors and their metastases were classified histologically according to the nomenclature of the WHO Panel on Testicular Tumours and to the modified nomenclature of the British Testicular Tumour Panel. The classification of the primary and metastatic tumor tissues is relatively easy to handle with both nomenclatures. The comparison of histological structures of the primary tumors with their metastases evoked a variety of deviations, depending on the tumor categories investigated and the nomenclature applied. The seminomas are a very homogenous tumor category usually metastasizing as seminoma. However, anaplastic seminomas can be indistinguishable from solid embryonal carcinomas. The distinct seminomas combined with nonseminomatous germ cell tumors do not seem to metastasize. From the point of view of histologic patterns of metastases and primary tumors, the embryonal carcinoma combined with teratoma i.e. teratocarcinoma (malignant teratoma intermediate) and the pure embryonal carcinoma (malignant teratoma undifferentiated) are not distinct entities. The term of malignant teratoma for these tumor types used by the British authors interprets these events more adequately, reflecting the occurrence of transitional types between teratoma and embryonal carcinoma supported by the appearance of different histologic types of metastases. Pure forms of choriocarcinoma are extremely rare. Yet in our cases of choriocarcinoma combined with other types, the metastases are always of the pure choriocarcinomatous type, and clinical courses were rapidly fatal in less than one year. The distinction of pure forms from combined forms of choriocarcinoma is not of great clinical relevance. 10% of our patients with metastatic germ cell tumor disease revealed testicular lesions referred to as so-called “burned-out” testis tumors. A tumor category of “burned-out” testis tumors is proposed.
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 377 (1977), S. 67-78 
    ISSN: 1432-2307
    Keywords: Testicular neoplasms ; Neoplasm regression, spontaneous
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In 6 von 61 nachkontrollierten AutopsiefÄllen mit metastasierenden Seminomen und Teratomen finden wir in den Hoden Narben oder Rudimente differenzierter Teratome und Seminome, Bilder, die denjenigen sogenannter ausgebrannter Hodentumoren entsprechen. Seminome lösen hÄufig eine ausgeprÄgte granulomatöse Reaktion aus, so da\ vollstÄndig ausgebrannte Formen, wie in einem Fall beobachtet, an und für sich zu erwarten sind. Aber auch Teratome können weitgehend vernarben und damit leicht übersehen werden. Bei 5 Patienten mit teratomatösen Metastasen sind in 3 FÄllen kleine differenzierte Hodenteratome von 1, 3 und 12 mm Durchmesser zu erkennen, in 1 Fall eine Rete testis-nahe Narbe von 10 mm Durchmesser und in einem letzten Fall ein mikroskopisch kleines intra- und extratubulÄres Seminom. In 3 dieser 5 FÄlle lassen sich atypische Keimzellen und in 2 FÄllen kleine Seminomreste von 3 und 13 mm Durchmesser in der Umgebung der Tumorrudimente nachweisen. Atypische Keimzellen und Seminomreste können damit für den Nachweis kleiner, mikroskopisch kaum fa\barer Teratomherde wegleitend sein. Diese 6 Beobachtungen machen ungefÄhr 10% unserer AutopsiefÄlle mit Keimzelltumoren aus. Weitere Probleme der Diagnostik werden diskutiert.
    Notes: Summary Of 61 cases of metastasizing seminomas and teratomas that came to autopsy at the Institute of Pathology, University of Zürich, 51 had been known to originate in primary testicular neoplasms, while in the remaining 10 the scrotal contents were clinically unremarkable. Of these, the testicles of two cases were devoid of tumor even on histologic examination; in a third case the right testicle had been absent since birth, suggesting its possible intraperitoneal location and malignant transformation. Yet another case displayed a malignant teratoma primarily infiltrating the mediastinum, while an isolated focus of a generalized large-cell lymphoma in the lower pole of the left testicle was mistaken for its origin. The remaining six cases, however, demonstrated histologic alterations that suggest “burned-out” testicular malignancies. Out of five of these patients with exclusively teratomatous metastases, three had differentiated testicular teratomas, varying in diameter between one and twelve mm; a fourth manifested a scar 10 mm in length in the vicinity of the rete testis; the fifth displayed an intra- and extratubular seminoma of microscopic dimensions. In two of these five cases, small foci of seminoma could be seen in close relationship to the teratomas, and in three patients, atypical germ cells were found within seminiferous tubules. It may well be that the presence of atypical germ cells and foci of seminoma are indicative of small teratomatous lesions which have escaped microscopic scrutiny. Finally, one testis in a patient with metastases typical of seminoma consisted of scar tissue to an extent that is unusual even for seminomas with a marked stromal reaction. These observations represent approximately 10% of our autopsy cases with germ cell tumors.
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 381 (1979), S. 269-281 
    ISSN: 1432-2307
    Keywords: Testis ; Testicular biopsies ; Arteriolar hyalinosis ; Morphology ; Frequency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Das häufige Vorkommen arteriolärer Hyalinosen in Hoden verstorbener Patienten ist bekannt. Gleiche Gefäßveränderungen können auch in Hodenbiopsien und operativ entfernten Hoden gefunden werden. Um uns ein Bild über die Häufigkeit machen zu können, untersuchten wir eine Serie von 2400 Hodenbiopsien und einzelnen operativ entfernten Hoden systematisch lichtmikroskopisch, teils auch histochemisch und elektronenoptisch im Hinblick auf arterioläre Hyalinosen. Dabei konnten in 3,75% der Patienten typische Herde nachgewiesen werden (Durchschnittsalter 34 Jahre). An Hodengrundkrankheiten findet man vor allem tubuläre Atrophien (58%) oder Kryptorchismus (22% der Fälle mit Gefäß Veränderungen). Die histochemischen Reaktionen lassen vermuten, daß der Hauptteil der eingelagerten Substanz aus Lipoiden, besonders Lecithinen besteht. Daneben sind auch Mukopolysaccharide abgelagert. Elektronenoptisch handelt es sich vorwiegend um fein granuläre Depots mit Vakuolen und seltenen Myelinfiguren. In späteren Stadien ist subendothelial ferner elastinartiges Material zu sehen, an der Peripherie der Herde sind Kollagenfasern nachweisbar. Die pathogenetische Bedeutung dieser arteriolären Hyalinoseherde und ihre Ursache sind unklar.
    Notes: Summary Arteriolar hyalinosis is a common post mortem finding in the testes of even young men. Identical arteriolar hyalinoses can be demonstrated in testicular biopsies of patients with infertility or in patients operated on for cryptorchidism. In a series of such biopsies from 2400 patients, the frequency of arteriolar hyalinosis was examined. In 7 cases with positive findings, histochemical studies were carried out and in an additional 14 biopsies electron microscopy was performed. Arteriolar hyalinosis was found in 3.75% of the 2,400 patients with disturbances of fertility or cryptorchidism. The mean age of these patients was 34 years. In 58% of the cases with arteriolar hyalinosis the basic testicular lesion was tubular atrophy, in 22% cryptorchidism. The arteriolar lesions were due to deposits of lipoids and mucopolysaccharides. Electron microscopy revealed a granular material with vacuoles and rarely myelin bodies below the endothelial layer and between myocytes and fibrocytes of the arteriolar wall. In later stages elastin-like material could be demonstrated in the vicinity of the endothelial cells and collagen fibers at the periphery of these deposits. The etiology of testicular arteriolar hyalinosis and its pathogenetic significance are not yet clear.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 383 (1979), S. 59-67 
    ISSN: 1432-2307
    Keywords: Seminoma ; Syncytiotrophoblastic giant cells ; Human chorionic gonadotropin (HCG)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Testicular seminomas may occur in various forms, of which the classical and spermatocytic are distinct, the anaplastic or atypical seminomas, however, less clearly defined. Lately, a separate group of particular clinical significance, comprising seminomas with syncytiotrophoblastic giant cells (STGC), has been specified. Although this type of seminoma had been recognized morphologically long ago, recent investigations have shown its ability to secrete HCG, a fact that raises serious difficulties in its differential diagnosis with combined seminomas and choriocarcinomas. Two cases of seminomas with STGC are presented and pertinent clinical and morphologic problems discussed.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Cell & tissue research 161 (1975), S. 55-70 
    ISSN: 1432-0878
    Keywords: Human fetal testis ; Gonocytes ; Fetal spermatogonia ; Electron microscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Electron microscopic studies of the testis were performed on 12 human embryos and fetuses between 9 and 30 weeks post conceptionem. According to their ultrastructural features, the fetal germ cells could be divided into the following three stages of differentiation: 1) gonocytes, 2) intermediate cells, and 3) fetal spermatogonia. Sertoli cells were present among the germ cells in all the testes studied. The gonocytes showed the highest nucleo-cytoplasmic ratio. Their round nucleus contained a centrally located, prominent nucleolus. The cytoplasm displayed a well developed Golgi apparatus, lipid droplets and parallel arrays of short cisternae of the rough surfaced endoplasmic reticulum (rER). Microfilaments were numerous, particularly just beneath the cell membrane. The intermediate cells were found to extend several cytoplasmic processes and to contain a moderate number of long, branched and/or widened rER cisternae which were frequently connected to the perinuclear cisterna. Intermediate cells were often connected to one another by intercellular cytoplasmic bridges. The fetal spermatogonia also displayed cytoplasmic bridges. These cells showed the lowest nucleo-cytoplasmic ratio and a more condensed nuclear chromatin. The mitochondria were situated close to the nucleus. Many of them were connected by a cementing substance. Lipid droplets and rER cisternae were rare in these cells. Infoldings of the inner nuclear membrane were often present in the gonocytes and in the intermediate cells, but were rarely observed in the fetal spermatogonia. Glycogen particles, polyribosomes, and chromatoid bodies (“nuage”) were present in all the three germ cell types. With the maturation of the fetus, the number of gonocytes was found to decrease, whereas the number of fetal spermatogonia increased. The Sertoli cells also changed their ultrastructure, showing an increase in the number of rER cisternae, as well as of microfilaments, lipid droplets, and secondary lysosomes.
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Cell & tissue research 197 (1979), S. 295-312 
    ISSN: 1432-0878
    Keywords: Thyroid gland ; C cells ; Ultimobranchial body ; Immunocytochemistry ; Morphometry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Summary Thyroid tissue of 300 routine autopsies was processed in a standardized manner. So-called solid cell nests (SCN) were found in 21 patients (7 %). These cases were investigated carefully by serial step sectioning. In order to explore the correlation of SCN to the C-cell system, the sections were stained by silver impregnation and the immunoperoxidase method. Morphometric analyses revealed a significant increase in the density of C cells in the proximity of the SCN. With progressive distance from the SCN, the C-cell density decreased and reached normal values. In 30 % of the cases argyrophilic and calcitonin-positive cells were found lying within the SCN. Occasionally, mixed follicles could be discerned: These were lined on the one side by a multilayered squamous epithelium, on the other side by normal monolayered cubic follicular epithelium, and contained a peculiar granular material. In one case, SCN were associated with intrathyroid portions of the parathyroids and adult adipose tissue, in a second case with adipose tissue only. Most probably SCN are vestiges of the ultimobranchial body and should be interpreted as such, despite the fact that other authors have expressed different views. The lack of disturbances in the calcium metabolism of the patients and the absence of medullary carcinoma in their family histories led us to interpret locally confined C-cell hyperplasia not as reactive nor premalignant, but rather as normal.
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