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A Morresi-Hauf

Publications and source records attributed to A Morresi-Hauf.

15 recordsLinked to original sources
PubMed2005

[The ovarian hyperstimulation syndrome -- a rare differential diagnosis of a unilateral pleural effusion].

This case presentation describes a 29 year-old female who developed a severe ovarian hyperstimulation syndrome (OHSS) with ascites and a right-sided pleural effusion following in-vitro-fertilisation. A total of 4,2 l of pleural fluid was removed during 3 thoracocenteses. The symptoms as well as the fluid production ceased after 2 weeks. The OHSS is altogether a rare, but potentially life-threatening complication of in-vitro-fertilisation. Due to the well-characterized clinical setting in which the syndrome appears, there are only few differential diagnoses to consider. OHSS is likely to originate from altered capillary permeability, but its pathogenesis is not yet fully understood. Clinical symptoms usually resolve within 2 weeks of supportive therapy. In case of persistency, however, especially pulmonary embolism and infectious causes of pleural fluid production have to be excluded.

Adult↗
PubMed2004

[Endobronchial lipoma: successful therapy by bronchoscopical laser resection vs. surgery].

BACKGROUND: Endobronchial lipoma is a very rare benign lung tumor. Therapeutic alternatives are the interventional bronchoscopic laser resection or surgical treatment. METHODS: From 1996 to 2002 we diagnosed 16 patients with endobronchial lipoma in our institution. We examined the clinical data of the patients and their influence on the individual patient treatment. RESULTS: 14 (88 %) out of the 16 patients (60 +/- 14 y.) were male. Clinical symptoms were cough (81 %), dyspnea (75 %), pulmonary infiltration (63 %) and fever (31 %). In the right lung 11 lipomas (69 %) were located, in the left lung 5 lipomas (31 %). The distribution to main bronchus, upper lobe, middle lobe and lower lobe bronchus were 2 (12.5 %), 6 (37.5 %), 2 (12.5 %) und 6 (37.5 %). 14 (88 %) lipomas were found in the central airways, 2 were located in the periphery of the lung. All lipomas in the central airways were successfully treated by bronchoscopic laser therapy with a mean of 1.1 +/- 0.3 laser sessions. One patient died of concomitant bronchial carcinoma before therapy. Surgical treatment was only necessary in a very peripherally located huge lipoma and a lipoma with extensive parenchym destruction. CONCLUSIONS: Bronchoscopic laser resection should be considered as first line therapy in cases of endobronchial lipoma. It is safe, successful, rapid and less expensive compared to surgical resection. Surgery should only be indicated in patients with lipomas with very peripherally localisation or parenchym destruction, extrabronchial growth, suspected malignancy or technical problems at bronchoscopic resection.

Adult↗
PubMed2003

[Pulmonary infiltrates with blood eosinophilia in a 62-year-old patient].

A 62-year-old woman was admitted because of chronic cough and bilateral infiltrates on chest roentgenogram. Additional history revealed that the patient had been taken diclofenac emulgel during the previous 10 years for arthrosis. Diagnostic bronchoscopy showed eosinophilic alveolitis. After ruling out infectious, parasitic or systemic diseases drug-induced eosinophilic pneumonia was diagnosed due to topical diclofenac therapy and subsequent percutaneous drug absorption. No previous case of eosinophilic pneumonia to topical diclofenac was discovered in our review of the literature. The diclofenac therapy was discontinued. Oral corticosteroid therapy cleared bilateral infiltrates on CT scan within seven days. Drug reactions are the most common cause of pulmonary infiltrates with blood eosinophilia and/or eosinophilic alveolitis and should be considered as a differential diagnosis.

Administration, Topical↗
PubMed2003

[Micronodular pneumocyte hyperplasia in pulmonary lymphangioleiomyomatosis and tuberous sclerosis].

An open lung biopsy was performed in a 28-year-old woman with tuberous sclerosis and with spontaneous pneumothorax and interstitial changes in the chest X-ray. Microscopically a micronodular pneumocyte hyperplasia in addition to a lymphangioleiomyomatosis was found. The micronodular pneumocyte hyperplasia is considered to be a very rare lesion. Only 27 well documented such cases have been recorded so far, 24 in women and 3 in men. The age of the patients ranged between 20 and 57 years, with an average of 36 years. The micronodular pneumocyte hyperplasia occurs mainly in patients with tuberous sclerosis (20 of 27 cases) and it is often combined with a lymphangioleiomyomatosis (19 cases). In the differential diagnosis the atypical adenomatous hyperplasia is to be considered in the first place. In contrast to it, the proliferating cells of the micronodular pneumocyte hyperplasia show no atypia. The differentiation from a papillary adenoma can be difficult in small biopsies.

Adult↗
PubMed2002

Inhalation of aerosolized vitamin a: reversibility of metaplasia and dysplasia of human respiratory epithelia -- a prospective pilot study.

The objective of this preliminary uncontrolled study was twofold: First, to assess the feasibility of retinyl palmitate inhalation and second, to analyze the changes of metaplastic lesions of the respiratory epithelium (metaplasia or dysplasia) following retinyl palmitate inhalation. The response to a daily dose of 18.000 I.U. retinyl palmitate by inhalation over a period of 3 month was assessed in 11 subjects (9 smokers, 2 ex-smokers). Using white-light bronchoscopy combined with autofluorescence bronchoscopy, bronchial biopsies were taken before and after a 3 month-period. The biopsy samples were evaluated blind by a referee lung pathologist. The overall response rate (remission or partial remission) was 56% (95% CI 0.30 0.79; p<0.05). These data suggest that inhalation of retinyl esters could be a promising therapeutical approach for chemoprevention of lung cancer. Vitamin A; chemoprevention; lung cancer; squamous metaplasia; dysplasia; retinoids

Administration, Inhalation↗
PubMed2002

[Choristoma of the diaphragm. Case report of a rare tumor and approach through lateral thoracotomy].

Tumors of the diaphragm are rare and caused by there special localisation difficult to diagnose. We describe the case of a 31 year old man with a choristoma of the left diaphragmal crux where the localisation and genesis could only be cleared through lateral thoracotomy. Nor the CT guided puncture or the laparoscopy-although sufficient samples for the pathology could be gained-allowed the right diagnose. The importance of good diagnostic approach to select the right operative procedure-in this case the anterolateral thoracotomy-is described.

Adult↗
PubMed2001

Significance of lymphangiosis carcinomatosa at the bronchial resection margin in patients with non-small cell lung cancer.

BACKGROUND: Treatment options for patients with microscopic residual disease at the bronchial margin (R1-resection) after resection for non-small cell lung cancer include observation, radiotherapy, reoperation, or even systemic therapy. The present study was performed to identify a parameter that would estimate the prognosis of these patients more precisely to permit a well-founded treatment recommendation for the individual patient. METHODS: A total of 1,162 patients with resected non-small cell lung cancer were analyzed in this retrospective study. Fifty-four patients (4.6%) had R1-resections at the bronchial margin. Type of residual disease (mucosal, extramucosal, or involvement of the entire bronchial wall) and occurrence of tumor cells in the lymphatic vessels (lymphangiosis carcinomatosa) were recorded as distinct parameters and analyzed by univariate and multivariate analyses (Log rank test; Cox regression model). RESULTS: Lymphangiosis carcinomatosa at the bronchial margin was detected in 22 patients (40.7%) and was associated with a significantly shortened survival (median survival with lymphangiosis carcinomatosa, 13.3 months; without lymphangiosis carcinomatosa, 20.1 months; p = 0.026). Early stage patients (stage I-II) without lymphangiosis carcinomatosa showed a median survival of 49 months. Multivariate analysis revealed that lymphangiosis carcinomatosa at the resection margin is an independent prognostic parameter (p = 0.038). Even after postoperative radiotherapy the prognosis was still poor if a lymphangiosis carcinomatosa was detected (median survival, 17.1 months). All other parameters (T-stage, N-stage, tumor histology, type of bronchial wall involvement) were not of prognostic significance in R1-resected patients. CONCLUSIONS: Lymphangiosis carcinomatosa at the bronchial resection margin predicts a poor prognosis in patients with non-small cell lung cancer. It is more than questionable whether these patients would benefit from local treatment options like radiotherapy.

Aged↗
PubMed1999

[Polyvinylpyrrolidone deposits in the pleura].

We report on the case of a 45-years old woman with repeated pleural effusions lasting for 2 years. She had a history of breast carcinoma 6 years ago, which was treated by breast amputation and radiation. After repeated histological and cytological examinations no tumorous compromise of the pleura or other cause for the effusions could be found. A pleural resection was performed. On the histological and electron microscopical examination deposits of a foreign substance were found, which was identified as polyvinylpyrrolidone. This substance was obviously introduced in the pleural cavity by the attempts to treat the effusions by pleurodesis with Diclofenac and Tetracycline (Vibravenös). The diagnosis is suggested by the histological findings, but it must be confirmed by anamnesis, also for PVP deposits in other organs.

Breast Neoplasms↗
PubMed1998

[Primary bronchial malignant melanoma].

A 53-year-old man presented a melanotic lung tumor which was based in the bronchus of the left lower lobe and closed the left main bronchus. After laser therapy, left lobectomy with sleeve resection was carried out. Complications after the surgery required resection of the rest of the left lung and thoracoplasty. Based on the histological and immunohistochemical findings, the tumor was classified as a malignant melanoma. There was no past history of an excision or a fulguration of a cutaneous, mucous membrane, or ocular lesion. Examination of the skin and the eyes did not yield any evidence of another primary tumor. We conclude that the lesion represents a primary malignant melanoma of the respiratory tract, a rare neoplasm of which only 21 cases have been confirmed. The patient does not have any evidence of tumor in the relatively short follow-up period of 10 months.

Biomarkers, Tumor↗
PubMed1997

[Lymphoepithelioma-like lung carcinomas].

Having observed 2 cases of lymphoepithelioma-like carcinoma of the lung in a 49-year-old female and in a 66-year-old male patient, we present a review on this entity, which was described for the first time in 1987. Essentially this neoplasm has the same histological appearance as a Schmincke-Regaud tumor, but it is possible that a certain morphological variety exists. In the differential diagnosis, a metastasis of a Schmincke-Regaud tumor and a malignant lymphoma should be considered. Including our 2 cases, a total of 30 cases have been reported: 14 male patients aged between 33 and 73 years and 12 female patients between 38 and 70 years; in 4 cases there was no reference to sex or age. Most of the patients were Asians, mainly Chinese. These tumors presented with nearly the same frequency in both lungs. They mostly appeared as peripheral coin lesions in the chest X-ray study. Lymph node metastases were found in approximately 25% of the cases. Hematogenous metastases seldom occurred and were observed almost only in the skeletal system. In most cases a lobectomy was performed. At present, no exact assertion is possible regarding the prognosis. An association with an Epstein-Barr virus infection was observed in the Asian patients, but not in the Caucasian patients.

Adult↗
PubMed1997

[Atypical morphologic lung manifestations of Pneumocystis carinii infection in AIDS patients].

We report on unusual presentation forms of Pneumocystis carinii infection of the lung in two patients with AIDS. A 36-years-old woman presented a cavitation in the lung middle lobe and bullous changes in the apical portion of the right upper lobe on the chest x-ray. The biopsy of these lesions was not diagnostic and the patient was operated on. The surgical specimen of the removed lung segment showed a cavitary lesion with a border of granulation tissue with giant cells, focal recent and older hemorrhages, rests of fibrinous exudate and dystrophic calcifications. In the surrounding tissue there were Pneumocystis carinii in the alveolar spaces and also in the alveolar walls, this tissue invasion through the organisms being most probably the cause of the cavitary change. A cytomegalic virus infection was also found. A 30-years-old man presented patchy pulmonary infiltrates on his x-ray. The examination of bronchial secretion and bronchial washing specimens revealed P. carinii. In addition, the organisms were demonstrated in the walls of pulmonary vessels and in the stroma of the bronchial mucosa on the biopsy. In a sample of lung tissue which was taken after death, there were no Pneumocystis carinii anymore, but some proliferations of connective tissue with giant cells and calcification, which could represent residual changes of the Pneumocysts carinii infection. Besides, persisting changes of cytomegaly were found. We conclude that a Pneumocystis carinii infection should be considered in all HIV-positive or AIDS patients with any kind of lung lesions.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Regeneration of bronchial mucosa after short-term repetition of biopsy versus bronchial carcinoma].

We report on two patients, 74 and 73 years old, each of whom had had biopsy of the bronchial mucosa elsewhere. Histologically, normal mucosa and mild bronchitis was seen, respectively. In both patients a second biopsy specimen from the same site was taken, 4 and 7 days after the first biopsy. Now the diagnosis was carcinoma in situ (not excluding early squamous carcinoma) and squamous carcinoma, respectively. One of the patients came to our lung clinic for operation on the basis of the mentioned diagnosis. A third biopsy was performed for control purposes. It revealed just a perforation of a lymph node in the bronchial wall and some epithelioid granulomas without evidence of acid-fast bacilli. There was no evidence of malignancy in this specimen. Because of the discrepancy, the pathologist at the first institution was asked to send us the previous slides. On review of these slides, the described findings were seen, but they were interpreted as regenerative-atypical. In this way, an unnecessary surgical intervention was avoided. After a follow-up of 3 1/2 years the patient is healthy. In the other patient, because of the diagnosis of squamous carcinoma a lobectomy was undertaken by a surgeon elsewhere. The pathologist could not find any carcinoma in the surgical specimen. The biopsy material was reviewed in our department, the findings being interpreted as atypical, originating in reparative changes. Like the postoperative pathologist, we did not find any carcinoma in the surgical specimen. In both cases, therefore, regenerative-atypical changes after re-biopsy were first misinterpreted as a malignant process.

Aged↗
PubMed1997

Native pulmonary muscular proliferation.

Four cases with native pulmonary muscular proliferation (NPMP) are reported. The etiology of this rare condition is unknown. A hamartomatous process is discussed. In spite of its rarity the correct diagnosis of this condition is important. Both clinically and histologically in transbronchial biopsies, NPMP may be mistaken for pulmonary lymphangioleiomyomatosis (PLAM). Distinction of these 2 conditions is adamant, as PLAM has a poor prognosis, and, moreover may be associated with general disease, as with tuberous sclerosis. Whereas the typical distribution of more mature desmin positive muscle cells in a dense center core and more immature desmin negative radiating peripheral muscle cell proliferation with fascicular pattern in NPMP may be recognized in open lung biopsy, these differences may not become evident in small transbronchial biopsies. Immunohistochemical methods play an important role in the differential diagnosis--as with PLAM estrogen and progesterone receptors may be expressed and, most importantly, the reaction of the HMB45-antibody appears consistently positive in muscle cells of PLAM, while negative with NPMP. Thus, recognition of this clinically innocent disease is also possible in small tissue particles.

Actins↗
PubMed1996

[Anticytoplasmic antibodies (cANCA) in syphilitic nodules of the lung].

HISTORY AND CLINICAL FINDINGS: A chest radiograph was done in a 75-year-old man with cough productive of a whitish sputum. It showed round foci in the right middle and upper lobes. Serum anticytoplasmic antibody (cANCA) was 1 : 160, suggesting Wegener's granulomatosis. But the pulmonary foci actually increased in size on administration of prednisolone, 10 mg daily. INVESTIGATIONS: As the lung biopsy was not diagnostic, a diagnostic thoracotomy with biopsy was done and the anterior segment of the right middle lobe resected. Histological examination revealed a gumma. Active syphilis was confirmed by a TPHA-Test with a titre of 1 : 40960. TREATMENT AND COURSE: Antisyphilitic treatment was given for 35 days, at first 1 mega (Penicillin E daily for five days, then erythromycin, 1000 mg, for five days, a penicillin rash having occurred. Serial serology showed a continual fall of the lues and cANCA titres. Four months postoperatively the titre in the TPHA test had fallen to 1 : 640, and was nonreactive after five years. cANCA titre fell to 1 : 16 and was negative 42 weeks after resection. CONCLUSION: The connection between pulmonary gumma and the presence of antiplasmatic antibodies remains unclear. Inflammatory changes in the vascular wall, which occur in both Wegener's granulomatosis and tertiary syphilis, may have played a role.

Aged↗