Biomedical subjects
K Dirschmid
Publications and source records attributed to K Dirschmid.
[Clinical aspects of pseudomyxoma peritonei].
On the basis of two cases the problems of peritoneal pseudomyxoma (PP) are discussed with respect to pathogenesis, clinical diagnosis and therapy. The abundant quantities of mucus present in the peritoneal cavity in this syndrome originate primarily in ruptured histologically malignant or benign mucous ovarian cystomas or benign mucocele or mucogenic carcinomas of the appendix, respectively. Independent of the histological findings the clinical course and consequently the prognosis of PP basically depends on the amounts of mucus present. Besides extirpation of the primary tumour therapy consists primarily in removing mucus as completely as possible, even in the form of repeated interventions. Additional measures are mainly confined to radiotherapy and cytostatic treatment. Recently new possibilities in preoperative diagnosis and postoperative control have been opened up by ultrasound and computed tomography.
Ileal adenomas in adenomatosis of the large intestine.
A report is given of 2 cases of adenomatosis of the colon in which adenomas of the ileum had been demonstrated. The clinical problems of these hitherto rarely observed neoplasias are discussed with reference to the available literature.
[Telangiectatic anastomoses polyp of the stomach].
Teleangiectatic polyps (TP) of the stomach arise from granulation OFFsue mostly in elderly people in the area of gastrojejunostomy decades after surgery. During endoscopy usually polyps of a size up to 2 cm can be found with a diffuse erosion of the surface and bleeding immediately upon being touched; this may cause the clinical symptomatology of acute gastric bleeding or chronic anemia as a consequence of blood loss. TP has to be differentiated in the first line from gastric carcinoma. Therapy is difficult especially in patients with big polyps because of the bleeding tendency, 5 case reports of TP are given.
[Generalized cytomegalic inclusion disease (author's transl)].
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[Chronic erosion of the stomach in the anastomotic region (authors' transl)].
Report about 5 cases with a chronic erosion with granulation tissue formation of the mucosa of the resected stomach in the gastroenterostomotic area. These lesions appeared endoscopically as discoloration, or as small elevation of the mucosa or as a distinct polyp. One case with a more extensive granulation tissue formation clinically exhibits a hemorrhage due to the richness of capillary vessels of this peptic lesion. The histogenesis of this peculiar peptic-erosive lesion can be explained by streaming up mesenchymal elements of the submucosa in the tunica propria of the mucosa of the anastomotic region.
[The so-called gastritis cystica polyposa].
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Carcinomatous metastases to the colon simulating Crohn's disease.
Multifocal lymphatic and hematogeneous metastatic infiltration of the colon by anaplastic carcinoma is described. The radiological and endoscopic examinations gave reason to believe that the patient was suffering from Crohn's disease. Only deep biopsy revealed the correct diagnosis. Clinical and pathological problems arising in the diagnosis are discussed.
[Polyps of the gastric stump (author's transl)].
The incidence of polyps of the gastric stump was investigated retrospectively in a group of 1292 patients having undergone gastric surgery. The classification as proposed by Elster was used; polyps could be found only in 0,7% of the cases, which is about the same incidence as in stomachs not operated upon. All different types of the classification mentioned could be found. The small number of polyps found does not allow statistically significant analysis of the subgroup incidence. However it was noteworthy, that about 1/3 of the polyps showed characteristics of malignancy.
[Early gastric carcinoma in Ménétrier's disease].
Case report about Ménétrier's disease with development of early cancer, type II b:sm, histologically mixed type, in a 69 year old white female, presenting an albumin-globulin ratio of 40/60 in the serum. Problems concerning early diagnosis of gastric cancer within this high risk condition are discussed.
[Morphology of the liver in anthracosilicosis (author's transl)].
Histological sections of the liver taken at the autopsy of 26 patients with anthracosilicosis of different degrees of severity were investigated retrospectively. Single macrophages containing dust were found in the portal fields, as well as dust storing Kupfer cells proliferating centroacinarity. Granuloma of the walls of central and sublobular veins could be observed, containing infiltrates of lymphocytes and plasma cells, proliferating fibroblasts including histiocytes, and fibrosis and hyalinisation in later stages. It may be assumed, that dust pigments are being transported by blood and taken up by Kupler cells in the first line, to be transmitted directly to the central vein and to a lesser degree by way of lymph drainage into the portal mesenchyma in a later stage. These morphological changes of the liver apparently did not cause any clinical symptoms; they could be found in a high percentage of all patients, which did not have cirrhosis of the liver, and they could be found in all degrees of severity of anthracosilicosis. Thus liver biopsy will yield valuable diagnostic results in this granulomatous disease of the liver as well.
[Pseudodiverticulosis of the esophagus (author's transl)].
The autopsy of a 59 years old male incidently revealed a pseudodiverticulosis of the esophagus. Histologic examination demonstrated typical cystic ectasies of all glandular ducts in the esophagus; they appeared on radiologic examination and are visible at endoscopy as little yellowish cystic lesions. The disease usually is of chronic nature and comprises disturbance of motility and passage. Chronic alcoholism, like in our case, often constitutes a concomitant disease. The etiology of this disorder is unknown. Certain clinical aspects should be considered.
[Lipoma and pseudolipoma of the liver (author's transl)].
Tumors and tumorlike lesions of fatty tissue arise only rarely in the liver. Those solitary nodules usually do not extend 2 cm in size and therefore remain clinically asymptomatic. Their gross appearance demands differential diagnosis from other tumorous or granulomatous lesions by means of biopsy and histological examination. Two characteristic cases with review of the literature are presented.
[Giant condyloma of the anal canal].
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[Cancer formation in a hyperplasiogenic gastric polyp (author's transl)].
Patients carrying hyperplasiogenic polyps are considered to be a higher risk in regard to carcinogenesis, since a high incidence of cancer has been demonstrated in this group. Usually cancers however originated in other parts of the stomach wall and not in the polyps. Formation of cancer in a polyp is a very rare event. A case report is given of a patient carrying a hyperplasiogenic polyp from which originated cancer. Carcinogenesis is discussed from a formal and causal point of view.
[Liver cirrhosis due to a breast neoplasm metastasis. So-called metastatic-carcinomatous cirrhosis].
A case is presented which, 9 years after surgical removal of a scirrhous breast cancer, exhibited morphologically atypical metastasis in the liver with fibrosis and reduction of liver parenchyma, as well as typical features of cirrhosis including portal hypertension and esophageal varices. Problems posed by the differential diagnosis and pathogenesis of this rare type of metastasis (known in the literature as metastatic carcinomatous cirrhosis) are briefly discussed.
[Biopsy findings of liver parenchyma in presence of metastasis (author's transl)].
In 107 liver biopsies with metastatic tumor infiltration morphological changes of liver tissue are demonstrated. Observance of these lesions yields particular directions especially for pathologists, with regard to handling and interpretation of biopsy material. The knowledge of these changes is of interest because unperceived metastatic lesions of the liver are relatively common.
[Osseous metaplasia of renal medulla (author's transl)].
Bone formation in renal medulla arises from papillary necrosis and is observed almost exclusively following chronic pyelonephritis and chronic interstitial nephritis. Since papillary necrosis occurs in the early stage of chronic interstitial nephritis, this kind of osseous metaplasia has specific diagnostic significance. By means of a case report formal pathogenesis, experimental basis, clinical diagnostic considerations and prognosis of the bone formation in renal medullary parenchyma are discussed.