Biomedical subjects
Publications and source records attributed to M Jänner.
Representative of seven cases observed during the last four years, we report on two cases of subungual exostosis. We present the clinical symptoms, our radiographical and histopathological findings, as well as the possible differential diagnoses. Local curettage or excision are regarded as the treatment of choice.
Malignant melanomas of the superficial spreading type usually have an intraepidermal tumour component in their periphery which frequently displays the morphological features of a melanoma in situ (adjacent MIS). It is thus comparable to exclusively epidermal melanomas; melanoma in situ (MIS). Taking 10 superficial melanomas with a nodular component ("SSM/NM") 31 adjacent MIS regions and 36 nodular melanoma components were analysed in serial tissue slides. Planimetric estimation of the nuclear areas was employed as a measure of anisokaryosis. DNA-Feulgen-cytophotometry was applied to obtain an objective variable in judging malignancy in the DNA-histographs (paraffin material). Furthermore we investigated 8 metastases of one of the malignant melanomas applying the methods described. A comparison of the epidermal with the invasive tumour components revealed an increase in the nuclear area which, however, decrease from the superior to the inferior nodular regions and which are further reduced in melanoma metastases. Anisokaryosis is evidently less in metastases compared with all primary melanomas. The nuclear DNA-content increases from the epidermal to the invasive tumour compartments and is lower in the inferior nodular regions when compared with the superior ones. No further significant differences are, however, established in the metastases. The coefficients of variability of the DNA-contents, being a potential indicator of DNA-heterogeneity reflect higher values in the epidermal tumour components compared with the nodular regions, decreasing from the superior to the inferior nodular parts of the tumour. All metastases have smaller values than the respective primary melanoma. In the DNA-histographs 75% of the intraepidermal tumour components have obvious signs of malignancy including tumour cell stem lines in 19% of the cases. 85% of the nodular regions investigated have clear signs of malignancy, 33% of which also have aneuploid stem lines. All metastases have obvious signs of malignancy and tumour cell stem lines in 50% of the cases observed. The following conclusions can be drawn from our findings: DNA-Feulgen-cytophotometry and nuclear planimetry are additional feasible methods for judging the epidermal component of a melanocytic lesion as malignant (adjacent melanoma in situ) on paraffin material. Furthermore these methods give different results in invasive nodular versus epidermal (in situ) melanoma components. Both the DNA-histographs and our immunohistochemical investigations (monoclonal antibody P 3.58) indicate the malignant potential of adjacent MIS.(ABSTRACT TRUNCATED AT 400 WORDS)
Explore the source record for details and available documents.
Epstein-Barr virus was demonstrated electronmicroscopically in a leucoplakic area of the tongue of a man infected with HTLV-III/LAV. Oral "hairy" leucoplakia, diagnosed from the clinical findings, histology and by electronmicroscopy, in this patients is to be interpreted as the initial sign of an HTLV-III/LAV infection.
DNA-content and size of the nuclear areas in different zones of malignant melanomas of different histological types and in dysplastic naevi were measured in order to provide information on the histogenesis and proliferative behaviour of human malignant melanoma. The results were compared with those from normal epidermis, common naevi, and reactive melanocytic hyperplasias. The mitotic index of melanomas--divided into different topographic zones in an analogous way--was also determined. The DNA-histographs of all naevi and reactive melanocytic hyperplasias showed a diploid maximum, but the dysplastic naevi had a larger proportion of nuclei with hyperdiploid and tetraploid DNA-content, indicating an increased proliferative activity. The mean values (X) of nuclear areas in dysplastic naevi (DN) were about the same as in common naevi (CN) and slightly lower than in superficial spreading melanomas (SSM). The coefficient of variability (cv) as an indicator of anisokaryosis was markedly higher in DN (27.8) and SSM (29.3) than in CN (20.2). In DNA-content we found similar results: almost no difference in mean values, but DN taking an intermediate position between CN and SSM with respect to cv (CN: 12.3; DN: 21.0; SSM: 36.6). There was no unequivocal evidence in these data for DN being a precancerous stage. Superficial melanomas with a nodular component ("SSM/NM") differed from SSM and NM by increased DNA-content and greater variability of nuclear areas and showed the clearest features of malignancy in their DNA-histographs. The mitotic indices had rather low values in SSM and intraepidermal marginal zones of "SSM/NM" on one hand and markedly higher values in NM and nodular parts of "SSM/NM" on the other. The highest mitotic counts were found in the three investigated metastases.
A case of linear porokeratosis is reported. This rare disease is described and the different entities that can be grouped under the term porokeratosis are discussed.
Explore the source record for details and available documents.
Using an immunoperoxidase (skin biopsy) and an immunofluorescence (peripheral blood, bone marrow punctate) technique, and monoclonal antibodies raised against peripheral mature lymphocytes, T helper subsets, T suppressor subsets, and Langerhans cells, we found a predominant dermal infiltration with lymphocytes of the suppressor phenotype and a predominant epidermal infiltration with Langerhans cells in a patient with Sézary syndrome (cutaneous T-cell lymphoma, CTCL). Repeated peripheral blood examinations showed an increased percentage of lymphocytes of the helper phenotype. A bone marrow examination revealed a ratio of suppressor/helper subsets of 1:4. The findings in the skin seem to be inconsistent with most of the results of previous studies in patients with CTCL; the significance of these findings is discussed.
Six malignant melanomas have been examined for the type of intermediate filament they contain. All six cases showed positive staining of intermediate filaments with antibodies to vimentin, with cells containing large numbers of melanosomes being stained less strongly in general. The tumor cells did not react with antibodies to keratin, desmin, neurofilaments or glial fibrillary acidic protein. Thus typing of intermediate filaments can distinguish melanoma from undifferentiated carcinoma, but not from lymphoma or sarcoma. Since melanocytes are known to be vimentin positive, and since most of the samples we studied were from metastases, these results are a further indication that the intermediate filament type typical of the parental cell is retained in the metastases, as well as in the primaries of solid tumours. The implications of vimentin positivity for the histiogenesis of the melanocyte are also discussed.
Skin biopsies of patients with small and large plaque parapsoriasis, premycotic lesions and mycosis fungoides in different stages were examined. Special attention was paid to the relationships between Langerhans cells (LC) and the neighbouring keratinocytes and lymphocytes. At the contact areas of LC and keratinocytes as well as LC and lymphocytes, particular cell membrane phenomena were observed. Aggregations of Langerhans granules and fusions of granules with LC plasma membranes were found exclusively at LC-keratinocyte interfaces. At LC-lymphocyte contact zones cell membrane appositions were seen. In all cases investigated, virus-like particles were mainly found in LC and indeterminate cells (IDC). In 3 cases lymphocytes also contained these particles. It was of particular interest that virus-like particles were observed in skin specimens of all diseases investigated. Discrimination of these particles from other cellular organelles - especially lysosomes - was difficult, however. The significance of our findings, particularly regarding to the supposed virus aetiology of cutaneous T cell lymphomas, is discussed.
Clinical, histological and electron microscopical findings of swimming pool granuloma in a 19-year-old soldier are demonstrated. Isolation of Mycobacterium marinum and positive tests with the "Marinum Sensitin" confirmed diagnosis. Problems of treatment are discussed.
Report on a case of a 68-year-old woman suffering from a fast growing tumor, initially manifesting in the dermis. At first, the histological findings were judged as a spindle-cell sarcoma. Further histological investigations revealed that the tumor was a malignant histiocytoma. Tumors of this kind are rarely found in the scarce group of the sarcomas of the soft tissues. Since its identification as an entity, the interest in this malignant tumor has been increased. Other clinical, histological and electronmicroscopic findings in this patient are compared with those in the literature; the actual state of therapy is presented.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Report of a patient with familial melanocytic moles and melanomas as designated by Clark et al. as B-K-mole-syndrome. Beside the typical clinical and histological features, the ultrastructural changes of B-K-moles are described. Nevus cells in these moles showed lobed nuclei, active Golgi complexes and swollen mitochondriae. Membrane rich melanosomes and melanosome complexes were found. The B-K-moles had no distinctive ultrastructure. An ultrastructural differentiation between tumor cells of the B-K-moles and melanoma cells was not possible.
A rare case of plasma-cell vulvitis (Zoon) is reported in a 53 years old female. The painful erythematous plaque affected parts of the vulva. After disappointing local treatment for three years repeated intralesional injections of triamcinolone improved the condition satisfactory.
The case of a 72-year-old woman with mycosis fungoides who developed a mucinosis follicularis and two different kinds of cancer after 12 years is reported. The association of mycosis fungoides with cancer and the question of classification into the idiopathic and the symptomatic variety is discussed.
Case report about death due to veno-occlusive liver disease following Dacarbazine treatment: 9 years after surgical treatment of malignant melanoma of the trunk a 68-years old patient developed lymph node metastases in the right axilla, which were removed immediately by surgical excision. One month before the patient had undergone surgical treatment of empyema of the gallbladder: Cholecystectomy and appendectomy were performed, postoperative recovery was uncomplicated. On account of the second lymph node metastasis within nine months adjuvant treatment with Dacarbazine was agreed and started one month later. After having performed the first course of treatment without any hints to intolerance the patient suddenly exhibited severe shock symptoms on the fourth day of the second course. Clinically residual myocardial infarct or pulmonary embolism were assumed, but could not be verified. The patient delivered increasing hepatomegaly. A massive increase in transaminase values was noted. Hemostasiologic changes with decreased Quick value occurred. The patient died of cerebral hemorrhage five days after beginning the second Dacarbazine cycle. Autopsy findings were severe liver cell necroses as well as liver vein thromboses, no metastases of melanoma could be found. Hepatotoxicity of Dacarbazine and the mechanism of liver vein thrombosis are discussed with special regards to possible hemostasiologic changes and sensibilisation due to Dacarbazine and/or previous liver cell damage.