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Biomedical subjects

A Rütten

Publications and source records attributed to A Rütten.

51 records · Page 3Linked to original sources
PubMed1996

[Desmoplastic malignant melanoma. Clinical and histopathologic results of a study in 34 patients].

Clinical and histopathological findings of 34 cases of desmoplastic malignant melanoma (DMM) are summarized and compared to the literature. DMM develop mostly in sun damaged skin of elderly patients, they are rare and often nonpigmented tumors that are difficult to diagnose clinically. In all cases the tumor parameters showed level IV or V melanomas (level IV: 55.9%, level IV-V: 14.7%, level V: 29.4%) and the tumor thickness measured 3.85 mm +/- 2.31 mm (1.0-11.0 mm). In 22 cases, the follow-up time was between 2 and 7 years. Local recurrences were observed in 7 ( = 31.8%) patients, metastases in 4 ( = 18.2%) and tumor-related deaths in 3. The prognosis for our patients seems to be slightly better than that described in the literature. The main reason is an improved histological diagnosis of this special type of melanoma. Using immunohistochemical staining with anti-S100 antibody it is possible to establish the melanocytic nature of these fibrotic spindle cell tumors earlier that is, in small initial biopsies, and tumor margins can be defined more accurately. As a consequence, surgery is done earlier and is more likely to be curative.

Aged↗
PubMed1996

[Panfolliculoma. Clinical and immunohistochemical findings in 4 cases].

Panfolliculoma is a rare benign neoplasm showing morphological similarities to the trichogenic trichoblastoma of Headington and the trichoblastoma of Ackerman. Eight patients have been previously reported; we add four additional patients. Their ages ranged from the 2nd to the 6th decade. The neoplasms were primarily situated on the head and the trunk. Clinical examination revealed a skin colored or red, dermal cystic nodule. The histological appearance of the panfolliculoma was characterized by symmetry, sharp circumscription and regular aggregations of cells, which were in parts solid or cystic. Additionally, follicular germs and papillae, matrical, inner and outer rooth sheath differentiation were identified. These varied forms of follicular differentiation were confirmed by the immunohistochemical expression of cytokeratins in different epithelial cells. Panfolliculoma is a benign neoplasm with proven morphological and immunhistochemical follicular differentiation.

Antigens, CD34↗
PubMed1996

Is the mismatch repair deficient type of Muir-Torre syndrome confined to mutations in the hMSH2 gene?

The Muir-Torre syndrome (MTS) is a rare autosomal-dominant condition characterized by the occurrence of sebaceous skin lesions and internal tumours in a patient. It has been demonstrated that at least a subgroup of MTS exhibits clinical and molecular genetic features of hereditary nonpolyposis colorectal cancer, including microsatellite instability in skin and visceral tumours, because of mutations in DNA mismatch repair genes. We have identified germline mutations in the hMSH2 gene in two unrelated MTS patients ascertained because of their skin tumours. Our results, together with published MTS cases, support the hypothesis that MTS with its characteristic skin lesions is confined to mutations in the hMSH2 gene.

Adult↗
PubMed1996

Cutaneous adult myofibroma: a vascular neoplasm.

Infantile myofibromatosis is a distinctive type of fibromatosis that usually develops during the immediate perinatal period. There are variants with solitary and multiple tumors. Lesions confined to the skin, soft tissue, and bone carry a good prognosis, showing spontaneous regression. The prognosis, however, is much less favorable when visceral lesions are present and the outcome may be fatal. Only recently it became obvious that there is an adult counterpart of infantile myofibromatosis, characterized by solitary lesions that have a predilection for involve the dermis and show no tendency to regression, although they have an entirely benign biological behavior. These lesions have been named cutaneous myofibroma or solitary myofibroma of adults. We have studied the clinical, histopathological and immunohistochemical characteristics of 53 examples of cutaneous adult myofibroma. In addition, 2 cases were examined ultrastructurally. The patients were mostly adults with ages ranging from 6-83 years. The lesions presented as solitary, usually painless nodules of variable duration on the skin, usually located on the extremities. Histopathologically, four patterns were identified: nodular or cellular type, multinodular or biphasic type, leiomyoma-like or fascicular type, and vascular type. A correlation between the histopathologic pattern and the lesional age was observed: vascular type of cutaneous adult myofibroma in early lesions, nodular and multinodular lesions in fully developed lesions, and leiomyoma-like or fascicular type in late lesions. Immunohistochemically, the spindle cells were desmin negative, but expressed immunoreactivity for vimentin, pan-smooth muscle actin, and alpha-smooth muscle actin. Ultrastructurally, neoplastic cells showed characteristics of undifferentiated mesenchymal cells with features of fibroblasts, myofibroblasts and pericytes. Primitive vascular formations were seen in the form of irregular clefts between adjoining cells. We conclude that cutaneous adult myofibroma is a little-known benign vascular neoplasm probably derived from myopericytes.

Adolescent↗
PubMed1995

[Trichoblastoma. A tumor with follicular differentiation].

The purpose of this article is to inform about neoplasms with follicular differentiation, particularly trichoblastoma. In 1970 Headington divided neoplasms of the hair germ (trichogenic tumours) into four groups: purely epithelial without inductive changes (trichoblastomas), mixed epithelial-mesenchymal with inductive changes (trichoblastic fibromas), mixed epithelial-mesenchymal with inductive changes and advanced hair follicle formations (trichogenic trichoblastomas), and predominantly mesenchymal with an abortive dermal hair papilla (trichogenic myxoma). Meanwhile a new classification of neoplasms with follicular differentiation has been presented, according to which every neoplasm with follicular differentiation, benign structure (symmetrical, circumscribed, with vertical growth), and predominance of follicular germinative cells is called a trichoblastoma. Whether this neoplasm is malignant and if so to what degree is under discussion. This classification is gaining in acceptance among histopathologists but has not been accepted in the field of clinical dermatology.

Basal Cell Carcinoma↗
PubMed1995

The implementation of health promotion: a new structural perspective.

Although health promotion has become a critical concept in public health, both research and practical projects in this area are almost devoid of theory. The present article uses a theory of complexity and structure to organize the different elements of health promotion in a new perspective. This perspective involves (1) new ways for looking at patterns of behavioral risk factors and health-related lifestyles. It (2) relates health promotion to policy making. In particular, it (3) focuses on a comprehensive model of the implementation process, revealing the true interrelationship of relevant elements to the concept of health promotion. In this context, it (4) becomes obvious that the reflexivity and recursiveness of scientific analyses are an integral part of the structure of health promotion. Thus, the professional role of the social scientist with regards to the implementation and utilization of scientific knowledge in the field of public health policy will be discussed. Finally, the role of appropriate theory is emphasized as a strategy for improving the practice of health promotion and to further the development of a new public health.

Forecasting↗
PubMed1994

[Differences between plaque-like variants of dermatofibrosarcoma protuberans and plaque-like dermal fibromatosis (dermatomyofibroma)].

On the basis of two cases the differences between the plaque-like variant of dermatofibrosarcoma protuberans (PDFSP) and the plaque-like dermal fibromatosis (synonym: dermatomyofibroma; PDF) are presented. PDFSP and PDF are two clinically very similar dermal fibrous proliferations, but differentiation is important because of their different therapy and prognosis. Histologically and immunohistochemically PDFSP and PDF can be recognized as separate entities.

Aged↗
PubMed1993

[Acquired benign myofibroma of the skin (adult myofibroma)].

Adult myofibroma is an acquired skin tumour that is histologically identical to infantile myofibroma. Histologically, four tumour variants can be distinguished: leiomyoma type, cellular spindle cell type, haemangiopericytoma or glomus type, and biphasic type. Practical help in diagnosis is supplied by the hamartomatous composition of the leiomyoma-type, hyalinized spindle cell whorls, endothelium-lined haemangiopericytoma-like vascular channels, and desmin-negative, muscle-actin-positive myofibroblasts, which may show spindle cell or undifferentiated mesenchymal cell differentiation. The tumours clinically present as firm, occasionally bluish cutaneous or subcutaneous nodules. Adult myofibroma should be recognized as a distinct benign neoplasm, most probably of vascular origin. Clinicians and dermatopathologists must be aware that lesions identical to those of infantile myofibroma can occur in adults.

Adolescent↗
PubMed1990

[Cutaneous manifestation of fungal infection].

A 50-year-old patient with an aplastic syndrome developed disseminated purpuric, necrotic lesions on his skin. Histological examination revealed fungal sepsis. The clinical appearance, the course of the disease are described and the importance of histological examination is pointed out.

Agranulocytosis↗
PubMed1990

[Gardner syndrome with pilomatrixoma-like hair follicle cysts].

Gardner's syndrome is accompanied by numerous cutaneous neoplasias, cysts of hair follicles being the most frequent. We report a case of Gardner's syndrome with multiple hair follicle cysts. Histologically, parts of the cyst linings showed features of pilomatricomas. We discuss the histopathological findings and their significance as possible markers for the disease.

Adult↗
PubMed1989

[Cutaneous metastatic Crohn disease].

A 27-year-old patient had firm, subcutaneous nodules on both legs. Histological examination revealed that they were epitheloid granulomas with necrotic areas. After the exclusion of infectious granulomas this finding suggested an association with Crohn's disease. Clinical investigations showed an acute form of Crohn's disease. We interpreted our findings as a cutaneous granulomatous reaction in Crohn's disease. In the literature this is referred to as metastatic Crohn's disease.

Adipose Tissue↗
PubMed1989

[Palmoplantar purpura in Duhring's herpetiform dermatitis].

Dermatitis herpetiformis Duhring (DHD) is characterized by polymorphism of its clinical picture. Haemorrhagic maculae on the palms and soles are rarely described. However, knowledge of this symptom is important because it may be the only clinical sign of DHD. We report two patients with DHD who presented with reddish-brown maculae on the flexure surface of their fingers and toes. The pertinent literature is reviewed.

Adult↗
PubMed1988

Seasonal ultrastructural changes of the hypophyseal pars tuberalis in the hedgehog (Erinaceus europaeus L.).

The comparison of the hypophyseal pars tuberalis in active and in hibernating hedgehogs reveals different cytological characteristics in the specific secretory cells. In active animals, these cells show oval nuclei and the cytoplasm contains numerous secretory granules near or attached to the cell membrane, suggesting exocytotic release. In hibernating animals, the specific secretory cells are characterized by irregularly shaped and often invaginated nuclei. Clusters of secretory granules lying within the cytoplasm are often joined by lysosomes. These areas are observed to be encircled by cisterns of the endoplasmic reticulum. Degenerative processes in the structures sequestered in this way are interpreted as signs of crinophagy which has no equivalent in the cell types of the pars distalis.

Animals↗
PubMed1987

Initial lesions of HIV-related Kaposi's sarcoma--a histological, immunohistochemical, and ultrastructural study.

Kaposi's sarcoma (KS) in human immunodeficiency virus infection (HIV) has become a rather frequent manifestation of the previously rare disease with fatal outcome. Initial lesions of KS were studied by means of histopathology, immunohistology, and electron microscopy in order to define the earliest alterations. The histopathological changes of initial lesions were distinct, consisting of (1) discrete proliferation of capillary vessels, (2) dissection of collagen by proliferating spindle cells which formed slits, (3) atypical spindle cells arranged in an Indian file pattern, and (4) the lack of any inflammatory cellular infiltrate. Double staining with antibodies against vimentin and immunohistochemical markers for endothelial cells revealed that slits forming vimentin-positive spindle cells displayed laminin, factor VIII, and PAL-E. Atypical vimentin-positive spindle cells arranged in an Indian file pattern inconsistently expressed laminin and factor VIII, but not PAL-E. KS cells rarely stained with the lectin UEA I, not even in case of less advanced dedifferentiation. Electron microscopy showed gradual transformation between spindle cells forming slits and those having lost the ability to form incomplete vessel walls. The present findings support the view that KS develops from the endothelial cells of the blood vessels. The proliferation of atypical endothelial cells as early as in initial lesions and the lack of inflammation favors the primary neoplastic genesis of KS.

Acquired Immunodeficiency Syndrome↗