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C Hedinger

Publications and source records attributed to C Hedinger.

At least 19 recordsLinked to original sources
PubMed1989

Malignant haemangioendothelioma of the thyroid, immunohistochemical evidence of heterogeneity.

26 cases of malignant haemangioendothelioma (MHE) of the thyroid gland were investigated immunohistochemically with the endothelial marker UEA-1 lectin and the panepithelial marker Lu-5. The results were compared with the results of staining for factor VIII-related antigen in the same cases observed in a previous study of Pfaltz et al. The 26 cases were classified on light microscopic grounds without reference to the immunohistochemical results as classical MHE (15 cases) and borderline cases intermediate between MHE and undifferentiated carcinoma (11 cases). 7 of the 15 classical MHE revealed one or both of the vascular markers, but did not express the epithelial marker. One case showed no staining and another reacted only with Lu-5. Vascular and epithelial markers were found in 6 cases of the 15 classical MHE and in 2 of the 11 borderline cases. These findings indicate that MHE of the thyroid may represent a heterogeneous group of lesions. Tumours positive only for endothelial markers strongly support the hypothesis that MHE is of endothelial origin, whereas tumours which reacted only to the epithelial marker may be undifferentiated carcinomas. Cases with both epithelial and endothelial features on immunohistochemical investigation may represent either tumours in which the malignant cells are in transition from epithelial to mesenchymal differentiation as suggested by Eckert et al. or are tumours of malignant endothelial cells with epithelial differentiation particularly of their cytoskeleton.

Aged↗
PubMed1988

[Bilateral germ cell tumors of the testis].

Before the introduction of effective chemotherapy for testicular germ cell tumours, the relative frequency of bilateral germ cell tumours was about 1.6%. Now, as more patients with unilateral tumours survive, an increase in this percentage is to be expected. We therefore compared a series of 397 patients with testicular germ cell tumours observed between 1950-1975 with a series of 333 patients with such tumours observed between 1976-1985, after the introduction of chemotherapy with cis-platinum. In both series 7 patients had bilateral germ cell tumours, i.e. 1.8% of cases in the first series and 2.1% of cases in the second series. Since the second series of cases with a much shorter follow-up has an unbalanced ratio of seminomatous to non-seminomatous tumours, an increase in bilaterality can be expected. The prophylactic and therapeutic implications of an increase in bilateral germ cell tumours of the testis are discussed.

Adolescent↗
PubMed1988

Haemangioblastoma. An immunohistochemical study of ten cases.

Ten cases of cerebellar haemangioblastoma were studied using the immunoperoxidase technique for glial fibrillary acidic protein (GFAP), Factor VIII-related antigen (F8RA), Ulex europeus agglutinin 1 (UEA-1), S-100 protein, neurone-specific enolase (NSE), leucocyte common antigen, synaptophysin, chromogranin and eight polypeptide hormones (bombesin, pancreatic polypeptide, somatostatin, thyroglobulin, calcitonin, glucagon, insulin and gastrin). GFAP and S-100 were demonstrated at the periphery of all tumours and in small groups of cells in the centre of four cases. Most of these cells had the morphology of reactive astrocytes but some had the appearance of stromal cells. In general stromal cells gave negative results. F8RA and UEA-1 stained the endothelial cells in each case but there was no stromal cell reactivity. NSE was present in the stromal cell component of all tumours. There was no staining for synaptophysin, for chromogranin, or any of the polypeptide hormones. It therefore appears that some haemangioblastomas contain an admixed non-neoplastic astrocytic element. NSE, F8RA and UEA-1 staining demonstrates that the endothelial and stromal cell parts of the tumour are antigenically distinct. Recent reports of polypeptide hormone expression cannot be confirmed and it is therefore unlikely that stromal cells originate from primitive peptidergic neurones.

Adolescent↗
PubMed1988

Solid cell nests (SCN) in Hashimoto's thyroiditis.

In Hashimoto's thyroiditis squamous metaplasia has been described by several authors. Such foci resemble the so-called solid cell nests (SCN) of the thyroid, epidermoid structures thought to be remnants of the fourth endodermal pouch. These cell nests can be identified by their particular histological appearances and by their positive reaction with polyclonal anti-CEA. In order to study this phenomenon more closely we examined the H & E-stained histological sections of 79 cases of Hashimoto's thyroiditis systematically. In 39 cases cell nests of three different types could be demonstrated: Small groups of elongated cells organized into solid epidermoid clusters, larger epithelial cells forming solid nests or similar epithelial but cystic structures. 29 of these 39 cases were further investigated immunohistochemically for the presence of thyroglobulin, CEA (polyclonal antiserum) and calcitonin. The first type of cell nest did not show any CEA-positivity, whereas the second and third type contained CEA-positive cells in 73% of the cases. In no cases were thyroglobulin- or calcitonin-positive cells identified in these epidermoid foci. Slide series of 25 of the 39 cases have further been investigated immunohistochemically for the presence of CEA (monoclonal antiserum), chromogranin, keratin and the epitope for Lu-5. In these additional series foci of epidermoid cells could be demonstrated in up to 15 of the 25 cases. They showed a positive reaction for the monoclonal CEA antiserum in only 3 of 15 cases, for anti-keratin in 5 of 14 cases and for Lu-5 in 13 of 15 cases. Immunoreactions for chromogranin were negative in all cases. Our findings suggest that epidermoid cell nests in Hashimoto's thyroiditis more closely resemble SCN than foci of follicular cell squamous metaplasia.

Adolescent↗
PubMed1988

Structure and motility of primary cilia in the follicular epithelium of the human thyroid.

In order to clarify contradictory reports concerning ciliary structure and function, follicular epithelium from macroscopically normal portions of 37 surgical specimens of human thyroid were processed for video-microscopy and/or transmission electron microscopy. The cilia of living cells were immotile. In transverse sections the cilia revealed a 9 + 0 pattern at the base of the shaft, whereas towards the distal end the number of microtubular doublets diminished. Dynein arms, radial spokes and central microtubules were absent. The immotility and structure of these primary cilia implies that their function is not related to motility. The phylogenetic and ontogenetic development of the thyroid suggests that tumor cells of follicular origin displaying abnormal secondary cilia may represent a pathological variant of differentiation.

Adenocarcinoma↗
PubMed1987

[Cryptococcoma of the adrenal gland].

The case is described of a 49-year-old man who developed cryptococcal meningo-encephalitis ten months before his death. Six months later complicating hydrocephalus occurred which required the implantation of a ventriculo-peritoneal shunt. A further four months later the patient, who was receiving anticoagulation therapy due to deep vein thrombosis, died from intraventricular cerebral haemorrhage. In a blood culture taken shortly before his death, growth of Cryptococcus neoformans was detected. At autopsy, which confirmed cerebral haemorrhage as the cause of death, a large cryptococcoma of the left adrenal gland was discovered as an incidental finding. We presume that this cryptococcoma was the source of the new haematogenous dissemination of the disease. We review the literature and discuss the increasing importance of cryptococcosis.

Adrenal Gland Diseases↗
PubMed1987

[Combination of heart myxoma with primary nodular adrenal cortex dysplasia. Case report of a further kinship of this rare familial syndrome].

Another case of the rare syndrome of combined papillary cardiac myxoma and primary adrenocortical nodular dysplasia is reported. The lesions were discovered incidentally at autopsy in a 64-year-old woman who had died of cerebrovascular stroke. Further investigation of the family by echocardiography revealed a small left atrial tumor in the 33-year-old son of the patient. Pathological examination after surgical resection of the tumor confirmed the diagnosis of atrial myxoma. The patient also exhibited cutaneous nodules with histologic features of myxofibroma. Some morphological aspects of this peculiar familial syndrome are discussed, with special emphasis on the finding of follicular tumors of the thyroid possibly associated with this syndrome.

Adenocarcinoma↗
PubMed1987

[Hippel-Lindau syndrome: morphology and immunohistochemistry of tumors related to this syndrome].

Hippel Lindau syndrome (HLS), inherited as a simple dominant trait, is characterized by angiomatosis in the brain and retina, and also by cysts and tumours in various abdominal organs. Microscopically there is a striking morphological similarity between some of these tumours and especially between those in the brain (hemangioblastomas) and in the kidneys (renal cell carcinomas). Biopsy and autopsy material from two patients with HLS was examined chiefly by immunohistochemical methods, to investigate further the origin of these tumours. The cerebral hemangioblastomas of both patients showed tumour cells with a positive immunohistochemical reaction for neuron-specific enolase (NSE), suggesting a neural or neuroendocrine origin, while corresponding investigation of the kidney tumours did not produce similar clear results. Systemic immunohistochemical investigation of all tumours related to this syndrome is recommended.

Abdominal Neoplasms↗
PubMed1986

[Occurrence of fibrosis in subacute de Quervain thyroiditis].

Subacute thyroiditis of de Quervain is histologically characterized by an inflammatory reaction with histiocytes and giant cells around residues of colloid, producing a tubercle-like granulomatous picture. A variable degree of fibrosis occurs, but recovery is generally almost complete. Investigation of a series of thyroid glands with de Quervain's thyroiditis gave the impression of rather extensive and increasing fibrosis in most of these glands. To substantiate this impression we reviewed the histological slides of all our cases of de Quervain's thyroiditis diagnosed at the Department of Pathology of the University of Zurich between 1940-1950 and 1974-1984. In the majority of the glands of both periods we found rather extensive fibrosis involving more than 50% of the surface. In young patients the fibrosis seemed to be more extensive than in older subjects. There was no sex difference. A certain degree of fibrosis appears to be characteristic of de Quervain's thyroiditis. Differences of frequency and degree of fibrosis between the two periods could not be demonstrated.

Adult↗
PubMed1986

Evidence of vascular differentiation in anaplastic tumours of the thyroid--an immunohistological study.

Sixteen cases of anaplastic carcinoma (ACA) and 4 cases of malignant haemangioendothelioma (HAE) of the thyroid were studied by light microscopy and immunohistochemistry. Seven cases of ACA and 3 cases of HAE were characterized by coexpression of immunohistological features of epithelial and vascular endothelial cells. Expression of vimentin was common to all tumours investigated. The present study provides evidence that ACA and HAE are partially closely related tumours showing alternating differentiation. This speaks in favour of a common neoplastic cell with the potential for epithelial and vascular endothelial differentiation.

Adenocarcinoma↗
PubMed1986

Cat scratch disease: evidence for a bacterial etiology. A retrospective analysis using the Warthin-Starry stain.

97 cases of acute necrotizing granulomatous lymphadenitis (so called "reticulozytärabszedierende Lymphadenitis") were examined retrospectively with the Warthin-Starry stain, in order to detect bacteria in patients with cat-scratch disease (CSD). 27 patients with CSD were found and among those, bacteria were demonstrated in 4. The organisms were pleomorphic rods of about 3 micron length and occurred in clumps within foci of fresh necrosis. We found the organisms in a much lower percentage than has been described in the literature. The reasons may be that many of our patients had antimicrobial treatment prior to the biopsy and that step-sectioning of the specimen may be necessary in order to detect fresh lesions. Our findings seem to confirm the observation that CSD may have a bacterial aetiology.

Bacteria↗
PubMed1985

[Hashimoto's lymphomatous thyroiditis and endemic struma].

Hashimoto's thyroiditis, a rather rare disease in endemic goiter areas like Switzerland, seems to become more frequent under iodine prophylaxis. To obtain more precise data we reviewed the microscopic slides of surgical thyroid specimens with indications of any type of inflammation from two 10-year periods with respectively lower (1940-1949) and higher (1973-1982) iodination of salt. From 1940-1949 Hashimoto's disease was never diagnosed histopathologically. A review of the histological slides, however, showed typical signs of Hashimoto's disease in 9 out of 6836 thyroid specimens, or 0.13%. In the second period, from 1973-1982, the same diagnosis was established in 32 of 4088 thyroid specimens, or 0.78%. This 6-fold increase in frequency of Hashimoto's disease seems to be due in part to a real increase, and in part to a change in the surgical material. At present fewer nodular goiters are seen than in the first period. Inflammatory infiltration in Hashimoto's disease, however, involves not the nodule but the non-nodular thyroid tissue found to a larger extent in present-day thyroid surgical specimens.

Adolescent↗
PubMed1985

[Large-cell eosinophilic tumors of the thyroid gland].

Problems surrounding malignancy of large-cell oxyphilic thyroid tumors, frequently but not quite correctly designated as Hürthle-cell tumors, are still under discussion. Whether a reliable histopathological diagnosis of malignancy can already be made on the primary lesion was tested in a series of 55 large-cell oxyphilic tumors of the thyroid seen at the Department of Pathology of the University of Zurich between 1962 and 1973, hence with a follow-up period of at least 10 years. One case was excluded due to insufficient histological slides. 34 of the remaining 54 neoplasms were reclassified histopathologically as carcinomas, 15 as adenomas and 5 as borderline tumors with doubtful malignancy. In 16 of the 35 carcinoma patients the clinical course or later pathological findings were in accordance with the histopathological diagnosis of malignancy. 6 patients had local recurrences and in 7 cases the clinical data were insufficient. Only 5 of the 34 cancer cases definitely showed no further signs of malignancy. On the other hand, only one of the 7 adenoma patients developed lung metastases, 15 years after thyroidectomy, though in this case only one histological slide could be re-examined, which is obviously an insufficient number to exclude malignancy. 3 of the 5 patients with borderline lesions followed up over a period of at least 10 years developed no signs of malignancy. In the light of these results, some 2/3 of large-cell oxyphilic thyroid tumors must be classified as carcinomas (mainly follicular) provided that only isolated tumors and not large-cell oxyphilic nodules of adenomatous goiters are considered. Benign large-cell oxyphilic tumors of the thyroid do, however, exist. Histopathologically it is quite possible to diagnose a primary lesion accurately as malignant or benign, if it is screened very carefully for capsular perforation and vascular invasion, the most reliable signs of malignancy in such tumors apart from metastases.

Adenocarcinoma↗