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M Vyberg

Publications and source records attributed to M Vyberg.

34 records · Page 2Linked to original sources
PubMed1990

Surecut 0.6 mm liver biopsy in the diagnosis of cirrhosis.

Liver biopsy with the 0.6 mm (23 gauge) Surecut needle was compared to conventional Menghini biopsy in the diagnosis of cirrhosis. Seventy-seven consecutive patients (mainly alcoholics) with a clinical indication for liver biopsy had both biopsies performed simultaneously. In 71 patients sufficient material for a morphological diagnosis concerning liver architecture was obtained with both biopsy techniques (Surecut insufficient in 5 cases and Menghini insufficient in 2 cases). The biopsies were classified as cirrhosis or non-cirrhosis. There was agreement in 69 cases (97%, confidence limits 90-100%). Using the result of the Menghini biopsy as the final diagnosis, the predictive values for a positive and negative diagnosis for the Surecut needle were 96% and 98%, respectively. There were no complications to either of the biopsies. It is suggested that the 0.6 mm Surecut biopsy may be used in the diagnosis of cirrhosis in cases where conventional Menghini needle biopsy is contraindicated.

Biopsy, Needle↗
PubMed1990

Immunohistochemical identification of neuron-specific enolase, synaptophysin, chromogranin and endocrine granule constituent in neuroendocrine tumours.

Immunohistochemical identification of neuroendocrine tumour markers in paraffin embedded material from 22 tumours (5 small cell carcinomas of the lung (SCCL), 12 carcinoids, 2 medullary thyroid carcinomas, 2 pheochromocytomas and one paraganglioma) with electron microscopically verified dense-core granules revealed neuron-specific enolase in all but one tumour, synaptophsin in 15/22 (2 SCCL and 6 carcinoids negative), chromogranin in 16/22 (all SCCL and one carcinoid negative), and endocrine granule constituent in 18/22 (4 SCCL negative). The Grimelius silver methods stained 13/22 (all cases of SCCL and 4 carcinoids negative).

Adrenal Gland Neoplasms↗
PubMed1989

Diverticular bile duct lesion in chronic active hepatitis.

Liver needle biopsies from patients with non-A, non-B chronic active hepatitis and so-called abnormal bile duct epithelium were studied with a three-dimensional method. Photographs of bile duct structures in serial sections were transferred to acrylic plates. Five bile duct lesions of a not previously described diverticular type were revealed. The diverticuli were of varying shape with a diameter of 30 to 110 microns and a length of 75 to 150 microns budding from small (12 to 25 microns), slightly ectatic bile ducts. The diverticular epithelium was disordered. Some cells appeared as bile duct cells, but most were larger, with rounded nuclei, prominent nucleoli and abundant eosinophilic cytoplasm, sometimes with periodic acid-Schiff-positive, diastase-resistant granules. The lesions were only partly surrounded by a basement membrane. They were all embedded in a tight mononuclear inflammatory infiltrate associated with pronounced periportal piecemeal necrosis. In two cases, a germinal center was adjacent to the epithelium. The pathogenesis of the diverticular bile duct lesion is unknown, but the diverticuli probably represent Hering ducts and groups of periportal liver cells which have escaped the piecemeal necrosis.

Adult↗
PubMed1988

Perivenous and perisinusoidal collagen content in the acinar zone 3 in the "normal" liver. A light microscopical study.

The thickness of the terminal hepatic vein wall (TTHV) and the content of perisinusoidal collagen in 989 zone 3 areas in Picro-Sirius-stained sections from 117 liver biopsies with normal morphology or slight non-specific changes were analyzed. TTHV varied from 0.4 micron to 21.3 microns (median 3.8 microns). A positive correlation was found between TTHV and the diameter of the terminal hepatic vein. The average TTHV of the individual biopsies was not correlated to age, sex or liver morphology. The average zone 3 collagen content did not exceed that of zones 2 and 1, with the exception of biopsies with slight steatosis, where a minimal increase in zone 3 collagen was found. The normal variability of TTHV and the correlation to the diameter of THV must be considered in the evaluation of perivenular fibrosis. Even a slight increase in perisinusoidal collagen content may be suggestive of a pathological condition.

Adult↗
PubMed1987

Acute cholangitis and pancreatitis associated with sulindac (clinoril).

A 68-year-old man without previous hepatobiliary or pancreatic disease was admitted after five attacks of nausea, vomiting, abdominal pain and high fever. Laboratory investigations indicated cholestatic liver disease and pancreatitis. For 1.5 years the patient had occasionally been taking a non-steroidal anti-inflammatory drug, sulindac (clinoril, MSD, New York), for osteoarthritis. On suspicion of a drug-associated disease, a rechallenge experiment was performed with sulindac. Five hours after drug administration symptoms recurred. There was a pronounced increase in serum alkaline phosphatase and amylase. A liver biopsy 3 d later showed portal tract inflammatory infiltration and abnormal interlobular bile ducts with degeneration and necrosis of the epithelium and neutrophilic infiltration of the ducts. Sulindac-induced cholangitis has not been described previously. The pathogenetic mechanism is considered to be an immunoallergic idiosyncratic reaction to the active metabolite of sulindac absorbed by the bile duct epithelium. The lesion is apparently reversible.

Acute Disease↗
PubMed1987

Pattern of progression in liver injury following jejunoileal bypass for morbid obesity.

Liver biopsies from 34 patients with morbid obesity, performed before and 5-9 months after jejunoileal bypass, were studied. The patients were divided into four groups according to preoperative findings: A: no or slight steatosis (15 patients), B: moderate-severe steatosis (6), C: steatohepatitis (steatosis + lobular lymphocytic inflammation) (8), D: steatofibrosis (steatosis + pericellular fibrosis) (5). In Group A, 12 patients showed postoperative progression to either moderate/severe steatosis, steatohepatitis, or steatofibrosis. In Group B, all patients progressed to steatohepatitis or steatofibrosis, and one developed septate fibrosis. All patients in Group C progressed to steatofibrosis, and 5 developed septate fibrosis or cirrhosis. In Group D, 3 developed bridging fibrosis. Mallory bodies appeared postoperatively in 11 patients (32%), all of whom preoperatively had either severe steatosis, steatohepatitis, or steatofibrosis. Only patients with postoperative pericellular fibrosis and Mallory bodies developed deranged architecture: 6 septate/bridging fibrosis, and 3 cirrhosis. Five patients, all with deranged architecture, developed reversible liver insufficiency. Progressive liver injury after jejunoileal bypass appears to reflect aggravation of a pre-existing liver lesion. The sequence of events: increasing steatosis, lobular lymphocytic inflammation, pericellular fibrosis, Mallory bodies, and deranged architecture is similar to that of the alcoholic liver lesion, indicating common pathogenetic mechanisms.

Biopsy↗
PubMed1987

Detection of early zone 3 liver fibrosis in chronic alcoholics. A comparison of four connective tissue staining methods.

Fibrous deposits in the perisinusoidal space in the acinar zone 3 are early and prognostically important features of the alcoholic liver lesion. Four connective tissue staining methods: van Gieson's Picro-Fuchsin (VG), Gordon & Sweets' reticulin (GS), Chromotrope Aniline Blue (CAB), and Picro-Sirius (PS) were evaluated concerning their relative sensitivity in the detection of early zone 3 fibrosis. A selected area in 60 liver biopsies with preserved architecture, obtained from chronic alcoholics, were studied. A semiquantitative registration of the degree of fibrosis was made. A comparison between the scores of the various staining methods by means of Pratt's test revealed PS to be significantly the most sensitive method. GS was insignificantly more sensitive than CAB while VG (which in contrast to the other three methods leaves reticulin unstained) was the least sensitive. In five biopsies which only revealed fibrosis in PS, perisinusoidal collagenization was confirmed by transmission electron microscopy. In the histological detection of early zone 3 fibrosis, PS is therefore recommended.

Alcoholism↗
PubMed1986

Cecal angiodysplasia localized by 99mtechnetium blood-pool scintigraphy and specimen venography.

Angiodysplasia of the right colon may be difficult to diagnose. The usual methods of choice, selective abdominal angiography and colonoscopy, may be impracticable or fail. When bleeding occurs, 99mtechnetium blood-pool scintigraphy is a simple and reliable method of localizing vessel leakage. We present a case of an 84-year-old woman with severely bleeding angiodysplasia, where the source of bleeding was localized by means of scintigraphy using 99mTc in vivo labeled red blood cells. After right hemicolectomy, the angiodysplastic lesion was confirmed by specimen venography utilizing a barium gelatin mixture.

Aged↗
PubMed1986

Combined adrenal myelolipoma and adenoma associated with Cushing's syndrome.

A case of Cushing's syndrome in a 31-year-old woman is presented. The resected left adrenal gland revealed a tumor consisting of cortical cells intermingled with myelolipomatous tissue comparable to that of normal bone marrow. The adjacent cortex was atrophic. Postoperative plasma cortisol concentrations have remained quite low. Previously, 28 cases of surgically removed adrenocortical tumors with a main diagnosis of myelolipoma have been published. Of these, three cases (two pituitary Cushing's disease, one steroid 21-hydroxylase deficiency) were associated with endocrine dysfunction. The combination of a myelolipoma and a true adenoma has only been described once before (in a case of virilization) and never in connection with Cushing's syndrome. The etiology of myelolipoma is discussed, and a local trigger mechanism related to adrenocortical growth disturbances is suggested.

Adenoma↗
PubMed1984

Abnormal bile duct epithelium accompanying septicaemia.

A 56-year-old female without previous hepatobiliary disease developed a severe obstructive cholestasis following E. coli urinary tract infection with septicaemia. Liver biopsy showed cholangitis and a unique abnormality of almost all the interlobular bile ducts; the epithelium was irregular with polymorphic, angular, and hyperchromatic or pyknotic nuclei. Some ducts were ectatic , others narrowed due to protrusion of proliferating epithelium. In some areas the ducts were blurred or completely destroyed. Cholangitis or granulomas were, however, not present. Abnormal interlobular bile ducts have to our knowledge not previously been described in septicaemia. The lesion is morphologically distinguishable from other types of abnormal bile ducts. It is considered to be caused by endotoxaemia and seems to be reversible. The cholestasis may be due to endotoxic alteration of biliary secretion, bacterially induced inspissation of bile, and/or mechanical obstruction to the bile duct lesions.

Bile Ducts, Intrahepatic↗
PubMed1984

Histological sampling with a 23 gauge modified Menghini needle.

A 23 gauge modified Menghini (Surecut) needle biopsy technique for obtaining tissue core biopsies was compared with the conventional fine needle aspiration biopsy technique in the diagnosis of ultrasonically detected abdominal mass lesions. In 30 consecutive cases (19 malignant and 11 benign), adequate material for histological examination was obtained in 87% and for cytological examination in 97%. The diagnostic accuracy with respect to malignancy was 84% for histology and 89% for cytology. The predictive value of malignancy was 100% in both. The histological material provided additional information in four cases of malignancy, concerning the type and origin of the tumours, and in nine cases of benign lesions, indicating the type of lesion that appeared as a tumourlike mass in the ultrasound study. The Surecut needle biopsy has been found valuable in obtaining histological material from abdominal mass lesions and may supplement or even replace the fine needle aspiration biopsy in such lesions.

Abdominal Neoplasms↗
PubMed1983

Diagnostic accuracy of endoscopic gastrobiopsy in carcinoma of the stomach. A histopathological review of 101 cases.

101 gastrobioptic series from 93 consecutive patients with a final diagnosis of carcinoma of the stomach were reviewed. 20 false negative cases were found. Of these, ten cases were missed because of erroneous histopathological interpretation, two because of too few sections, and eight because carcinoma was not represented in the biopsies. The frequency of false negatives was slightly larger in ulcerating carcinomas than in polypoid and diffusely spreading carcinomas, mainly due to seven cases of ulcerating carcinoma being missed by the pathologist. There was no correlation between false negatives and histological type. The rate of false negatives was significantly higher in cases, where the number of biopsies taken was below seven. The rate of histopathological misinterpretations was significantly higher in cases, where the number of actually positive biopsies was below four. Attempts to increase the positive yield should be based on not only an evaluation of the biopsy technique, but also an analysis of the histopathological method and interpretation.

Biopsy↗
PubMedDate not supplied

Primary leptomeningeal T-cell lymphoma: a case and a review of primary T-cell lymphoma of the central nervous system.

A case of primary leptomeningeal T-cell lymphoma of pleomorphic large cell type is presented. The lymphoma, which was first diagnosed at autopsy, occurred in a 67-year-old man, who had no personal or family history of immunodeficiency disorders. Review of the literature reveals only 13 immunocytochemically well-documented cases of primary T-cell lymphoma in the CNS. In five of these cases the lymphoma was apparently confined to the leptomeninges. The relatively high frequency of leptomeningeal presentation may indicate that this tumor form is more common with primary T-cell lymphoma of the CNS than with B-cell neoplasms.

Aged↗
PubMedDate not supplied

Mutations in the tumor suppressor gene p53 in human liver cancer induced by alpha-particles.

The p53 tumor suppressor gene is mutated in varying fractions of almost all tumor types studied. The rate of mutations and the mutational spectrum in some tumors are specific for environmental mutagens assumed to be involved in the carcinogenic process. Thus, hepatocellular carcinomas supposedly induced by aflatoxin exposure often contain a specific point mutation in codon 249, and in lung cancers of miners with heavy radon exposure, another specific point mutation in codon 249 suggestive of an alpha-particle-specific mutation has been shown. The interpretation of studies linking the mutational spectrum with specific environmental exposures is complicated by the multifactorial or unknown genesis of most tumors. However, people given injections of the X-ray contrast medium Thorotrast (Th) in the past have experienced an enormous risk of liver tumors, and virtually all of these are supposedly induced by alpha-particles from the decay of 232Th. The examination of these tumors may provide evidence as to whether specific p53 point mutations are relevant in alpha-particle carcinogenesis. Therefore, we collected paraffin-embedded, formalin-fixed archival tissues from 18 hepatocellular carcinomas, 9 cholangiocarcinomas, and 9 hepatic angiosarcomas from Thorotrast-exposed patients. The tissues were analyzed for p53 protein expression by immunohistochemical staining by using the mAb DO-7 and for mutations of exons 5-8 by PCR and constant denaturant gel electrophoresis. G --> T transversions of the third base of codon 249 of the p53 gene were specifically screened for by restriction enzymes. No high score for p53 protein expression (i.e., positive staining of >20% of examined cells) was observed; lower scores were seen in 5 of 18 (28%) hepatocellular carcinomas, 1 of 9 (11%) cholangiocarcinomas, and 0 of 8 (0%) hepatic angiosarcomas. Only one p53 mutation, a heterozygous T --> G transversion of the first base codon 176, occurred in a hepatocellular carcinoma. The rate of p53 point mutations in alpha-particle-induced liver tumors seems to be lower than in European hepatocellular carcinomas in general. The study does not exclude the possibility that alpha-particle carcinogenesis may involve inactivation of p53 by gross deletions of the gene, but it speaks against the proposed specificity of point mutations of codon 249 in cancer supposedly induced by alpha-particles from radon progeny.

Adolescent↗