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C Hedinger

Publications and source records attributed to C Hedinger.

At least 55 records · Page 3Linked to original sources
PubMed1981

Geographic pathology of thyroid diseases.

The thyroid is one of the organs which demonstrates clearly the influence of extrinsic and especially geographically determined influences in the development of diseases. Endemic goiter and cretinism are the most typical examples. The question as to whether thyroid cancer arises more frequently in goiters that in normal thyroids, cannot be answered definitely as yet. But without doubt, the relative frequency of different types of thyroid neoplasms in goiter areas is not the same as in region without endemic goiter. The most common type of thyroid carcinoma observed in a nonendemic region is papillary carcinoma. Follicular and anaplastic carcinomas, however, are more often associated with goiter. Under the influence of iodine prophylaxis, the relative frequency of the different types of thyroid carcinoma approaches that of these carcinomas in nongoiter regions. The malignant hemangioendothelioma is observed nearly exclusively in some Alpine goiter areas. Since the introduction of preventive measures in Switzerland, its occurrence has diminished progressively. In contrast to endemic goiter, focal thyroiditis and even Hashimoto's disease seem to be on the increase since institution of iodine prophylaxis of endemic goiter. As the development of malignant lymphoma may be related to thyroiditis, a possible increase of such tumors should be considered.

Congenital Hypothyroidism↗
PubMed1981

[Atypical intratubular germ cells and testicular germ cell tumors in children (author's transl)].

Intratubular atypical germ cells are quite frequent in seminiferous tubules of tumor-free tissue adjacent to germ cell tumors of the adult testis. Atypical germ cells are considered by several authors to be totipotent stem cells for different types of germ cell tumors. If this theory is correct, atypical germ cells should be demonrable in the vicinity of germ cell tumors of children as well. We reviewed 30 testicular germ cell tumors of children aged 6 months to 6 1/2 years (17 yolk sac tumors and 13 mature teratomas). In five cases no tumor-free testicular tissue was present. In the remaining 25 cases - 15 patients with yolk sac tumors and 10 patients with mature teratomas - no atypical germ cells, neither intra-nor extratubular in location, could be found. The question arises, therefore, whether these so-called atypical germ cells are really the precursor cells of germ cell tumors or if they represent, at least in some cases, a reactive phenomenon due to the presence of a germ cell tumor.

Child↗
PubMed1981

[Congenital lymphangiectasis of the lungs (so-called primary and secondary forms) and lymph vessel dilation in hyaline membrane syndrome].

In five cases of congenital pulmonary lymphangiectasis, light microscopic features of the lungs and measurements of their lymph vessel lumina are presented. All lung sections show the same histologic characteristics: a network of partly tubular, partly cystically enlarged lymph vessels within large areas of connective tissue. The lung sections in four cases with pulmonary vein outflow obstruction, the so-called secondary form according to NOONAN et al. [28], do not differ from those in primary lymphangiectasis without obstruction in the pulmonary vein outflow area. The author's own observations are discussed together with 57 cases from the literature. Among the 26 cases of secondary lymphangiectasis are 15 children with aberrant pulmonary veins, and 11 children with hypoplasia of the left side of the heart. Clinically, both forms present with neonatal asphyxia and massive respiratory distress, usually with a fatal outcome within the first few days of life. Hyaline membrane disease may be accompanied by pulmonary lymphangiectasis to a degree that renders its distinction from congenital lymphangiectasis difficult. The lungs in 5 cases with hyaline membrane disease are compared to those in 5 cases of congenital lymphangiectasis. In the former, distended lymphatics are primarily interlobular in location, while in congenital lymphangiectasis they are also found in the subpleural and periarterial tissues. In addition, they are widened to a lesser degree than in the congenital form. In the latter the lymphatic vessel walls are markedly thickened, and the pulmonary lesions, particularly the signs of immaturity, typical for hyaline membrane disease, are lacking.

Diagnosis, Differential↗
PubMed1980

[Morphology of the adrenal cortex in Cushing's syndrome].

Histological slides of the adrenals of 54 patients who underwent uni- or bilateral adrenalectomy for Cushing's syndrome at the Zürich University Hospital Department of urology between 1960 and 1977 were reexamined. In 29 patients (53.7%) Cushing's disease was due to diffuse bilateral adrenocortical hyperplasia, in 4 (7.4%) to micronodular cortical hyperplasia and in 3 (5.6%) to macronodular cortical hyperplasia and in 3 (5.6%) to macronodular hyperplasia. Two patients (3.7%) presented with primary bilateral nodular cortical dysplasia (so-called microadenomatosis). In 12 cases of Cushing's syndrome (22.2%) the basic lesion was a cortical adenoma and in 4 cases (7.4%) a cortical carcinoma. The histologic diagnoses corresponded well with biochemical findings, clinical diagnoses and further development of the disease. Histopathologic diagnosis of diffuse and micronodular hyperplasia presents no difficulties. Differential diagnosis of macronodular hyperplasia, cortical dysplasia, adenoma, and carcinoma may, however, be somewhat more problematic.

Adenoma↗
PubMed1980

Familial Cushing's syndrome with primary adrenocortical microadenomatosis (primary adrenocortical nodular dysplasia).

Cushing's syndrome was found in 2 of 4 siblings all of which also had other malformations. After bilateral adrenalectomy no hyperpigmentation was noted. Morphologically the adrenals of both siblings with Cushing's syndrome showed the typical lesions of the so-called microadenomatosis or primary adrenocortical nodular dysplasia with foci of eosinophilic giant cells. This is a new form of Cushing's syndrome due to an inborn error of the adrenals and no hypothalamic-pituitary dysfunction.

17-Hydroxycorticosteroids↗
PubMed1979

Seminoma with syncytiotrophoblastic giant cells. A special form of seminoma.

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 secret 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.

Adult↗
PubMed1979

[Arteriolar hyalinosis in testicular biopsies (author's transl)].

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.

Adult↗
PubMed1979

The relation between solid cell nests and C cells of the thyroid gland: an immunohistochemical and morphometric investigation.

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.

Adipose Tissue↗
PubMed1978

[Sertoli-cell-only-syndrome. Histology and pathogenesis].

The Sertoli-cell-only syndrome is characterized histologically by complete loss of the germinal epithelium in testicular tubules, and clinically by aspermia, i.e. lack of spermatozoa and their earlier stages in the ejaculate. In our opinion the term Sertoli-cell-only syndrome should be used exclusively for these lesions, although some authors also use it for cases with oligo- or azoospermia in which the tubules still retain some remnants of germinal epithelium. The etiology of the Sertoli-cell-only syndrome is obscure. Maldevelopment, with failure of the primordial germ cells to migrate into the future gonads, and secondary destruction of the germinal epithelial layer are discussed. In the hope of finding distinct histologic differences that would indicate either malformation or an acquired lesion, we examined 53 cases of Sertoli-cell-only syndrome out of a series of 2700 testicular biopsies from our Institute. All 53 patients had aspermia, and no remnants of germ cells were identifiable in the testicular biopsies. The microscopic lesions in all cases were more or less identical. Two small groups could be distinguished in which the histologic alterations appeared to fulfil the criteria for germ cell aplasia and germ cell atrophy respectively. The majority, however, belonged to an intermediate group showing all states of transition between these lesions. It is likely that the varying histological patterns simply represent different grades of testicular destruction with loss of germinal epithelium, rather than different etiologies. Our study does not allow conclusions as to the cause of the Sertoli-cell-only syndrome.

Germ Layers↗
PubMed1978

Elastic fibers in the tunica propria of the seminiferous tubules. Light and electron microscopic investigations.

Histological examination of numerous biopsies from mature testes, repeatedly showed irregularities of the elastin staining in the tunica propria of the seminiferous tubules. Even when abundant elastic fibers were visible by light microscopy, no elastic fibers were demonstrable in the electron microscope in ultrathin sections of testicular tubules embedded in Epon and contrasted with phosphotungstic acid (PTA). In 43 biopsies from 22 men aged 17-39 years (19 investigations of sterility and three patients with hypogonadotropic hypogonadism) we therefore checked for the occurrence of elastic fibers in the wall of the seminiferous tubules. Matrix loci of elastic fibers could indeed by demonstrated by electron microscopy using PTA and potassium permanganate (KMnO4), but only after embedding in araldite. Under these conditions, light and electron microscopic findings agreed with each other. The appearances of moderate and severe testicular tubular atrophy differed slightly from one another with regard to the amount of elastin. In the "Sertoli cells only syndrome", elastic fibers were demonstrable only outside the hyalinized inner layer. In the Klinefelter syndrome, only "uncertain" elastin loci were present, but greatly increased microfibrils were to be seen using the electron microscope. No elastic elements and only very sparse microfibrils were present in the tunica propria of the tubules of young men with hypogonadotropic hypogonadism.

Adolescent↗