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R Bässler

Publications and source records attributed to R Bässler.

At least 19 recordsLinked to original sources
PubMed2001

[Histopathologic breast diagnosis in view of consultant studies of the Mamma-Regisstry Fulda].

The Mamma-Registry Fulda, founded in 1976 by the senior co-author, is a personal service for pathologists having problems with histological diagnosis of breast diseases. From nearly 7000 cases filed up to now we selected 1112 consecutive consultations from 1996 to 1999 for this study. The aims were a critical analysis of a "submission-profile" and for each case a comparison of submitters' diagnoses with that of the register to crystallize special fields of problems in histopathological diagnosis and to make a statement about quality standards which was shown in a raster of results. The submitted cases came from pathologists in university institutes (13.9%), city hospitals (49.0%), group practices (24.2%), and single practices (11.6%). The material consisted of selected paraffin-blocs in about two thirds and of slides only in less than one third. The sendings were accompanied by letters with sufficient information on history, clinical background, and gross findings in 72%, and in an additional rate of 17.1% by copies of the histological reports already given by the submitters to their clinicians. The main reasons for consultations were a primarily uncertain diagnosis (45.8%) or the request to affirm a more or less definite diagnosis (40.7%) in cases of rare lesions or differing judgements in the submitting institution. Each diagnosis of the registry was coded in a special diagnostic key. In a raster of results the diagnosis of each case was listed as identical (55.0%) when there was complete agreement between submitter's and register's result, as included (23.9%) when one of the differential diagnoses named by the submitter fitted the register's diagnosis, and as different (6.7%) when there was only agreement about the dignity of differently classified lesions. False positive (2.3%) and false negative (4.5%) diagnoses of submitters were subclassified as clinically irrelevant (2.6%) and relevant (4.2%). The most often missed diagnostic entity in the latter group was tubular carcinoma. Overall the results of the study justify awarding a high standard of quality to histopathological diagnostics.

Breast↗
PubMed1999

Breast tumors with myofibroblastic differentiation: clinico-pathological observations in myofibroblastoma and myofibrosarcoma.

This report describes the clinico-pathological features of myofibroblastic tumors of the breast in six patients. Four women and one man presented with a benign myofibroblastoma. The sixth patient was a woman with myofibrosarcoma. All myofibroblastomas were composed of a fascicular arrangement of spindle cells embedded in dense bundles of collagen. Tumors differed with respect to their proportion of neoplastic cells and collagenous stroma as well as cellular pleomorphism. Based on this variation, the tumors could be subclassified as classic, collagenized, epithelioid and cellular myofibroblastoma. Immunohistological staining confirmed myofibroblastic differentiation by strong expression of either desmin or smooth muscle actin with coexpression of vimentin. In addition, numerous cells reacted with antibodies to CD68. Proliferative activity was rather low in the myofibroblastoma with an average of 0-2 mitotic figures per 10 HPF. DNA cytometric analysis was performed in two cases and showed diploid stem lines with minor S-phase fractions (1% and 3%). In the myofibrosarcoma, cells contained pleomorphic nuclei with some giant cells and numerous mitotic figures (6-7/10 HPF) and had infiltrating margins that were apparent even grossly. Immunohistochemically, tumor cells strongly expressed vimentin, smooth muscle actin and fibronectin. Ultrastructurally, neoplastic cells met the criteria of myofibroblasts, i.e. contained abundant intermediate filaments and myofilament bundles with focal densities as well as fibronexus junctions. DNA cytometric analysis exhibited again a diploid stemline but marked proliferative activity was present as indicated by an S-phase fraction of 20%. In conclusion, in benign myofibroblastoma there may be some cellular pleomorphism but mitotic activity is always low. The malignant counterpart, myofibrosarcoma, is characterized by marked cellular pleomorphism, infiltrating margins and high mitotic rate.

Actin Cytoskeleton↗
PubMed1997

[Mastitis. Classification, histopathology and clinical aspects].

The frequency of biopsies with different types of mastitis among all patients with benign breast diseases in twenty years was 3%. About 2/3 of the patients were younger than 50 years, the average age was 46.7 years. Comparing the frequency of the different types of mastitis the puerperal mastitis is very rare in contrast to the increasing non-puerperal and granulomatous inflammatory breast lesions. The diagnosis "granulomatous mastitis" is one of exclusion. Both non-infectious and infectious causes must be considered. The origin of the granulomatous mastitis often is unknown, but it is supposed to be an autoimmune localized response due to the retained and extravasated fat and protein rich secretions in the ducts in cases of hyperprolactinemia (drug induced or by microprolactinomas) or hormonal imbalances characterized by epitheloid cell granulomas with giant cells microabscesses around lipid drops, but without necroses. An idiopathic type of granulomatous mastitis concerns young women in relationship to parturition with a similar histological pattern predominantly of the lobules. Special types of mastitis are the B-lymphocytic autoimmune mastitis associated with a longstanding insulin-dependent diabetes mellitus type I, the sarcoidosis, panniculitis and the rare but very different infectious diseases with breast involvement. Particularly in cases without features of secretory activity a carefully bacterioscopic and microbiologic work-up of fresh material from the surgical specimens is necessary for a final diagnostic report.

Abscess↗
PubMed1997

"Diabetic mastopathy" in the male breast--a special type of gynecomastia. A comparative study of lymphocytic mastitis and gynecomastia.

Focal B-lymphocytic mastitis and focal fibrosis of the breast in young women have rarely been reported as a complication of longstanding insulin-dependent diabetes mellitus type I. We present two cases of "diabetic mastopathy" in male diabetics suffering from gynecomastia. Furthermore, these two cases were examined in comparison to a selected group of 6 patients showing gynecomastia with a marked inflammatory reaction, as well as to 24 non-selected cases of common gynecomastia. The lesion is interpreted as a diabetes-induced autoimmune reaction of the breast and may be regarded as a lympho-epithelial lesion. Its histopathological characteristics are a marked chronic periductal and perivascular mastitis with a predominance of B-lymphocytes, a focal homogenous fibrosis and so called "epithelioid stromal fibroblasts" within the fibrotic matrix. Our findings support the existance of "diabetic mastopathy" in the male and point out to the potentially misleading pattern of this benign tumor-like lesion simulating gynecomastia.

Adolescent↗
PubMed1997

Lymphocytic mastitis and fibrosis of the breast in long-standing insulin-dependent diabetics. A histopathologic study on diabetic mastopathy and report of ten cases.

Diabetic mastopathy represents less than 1% of benign breast diseases, but is more frequent (13%) in insulin-dependent diabetics. We report on 10 cases (eight females and two males) of this rare lesion of the breast in patients with additional diabetes mellitus type I. All cases showed a marked B-lymphocytic mastitis in combination with a homogenous fibrosis of the breast and with presence of epithelioid fibroblasts. In the male patients, diabetic mastopathy simulated gynecomastia. A comparative examination of 12 cases of lymphocytic mastitis without long-standing type-I-diabetes mellitus revealed a more heterogeneous pattern with lower degrees of inflammation and fibrosis. From the pathophysiologic point of view, lymphocytic mastitis in diabetic mastopathy is thought to be a diabetes-induced reaction probably of autoimmune origin. Moreover, lymphocytic mastitis with or without diabetes mellitus may represent a lymphoepithelial lesion of the MALT-type which, under certain circumstances, is considered to bear a prelymphomatous potential.

Adult↗
PubMed1995

[Pathology of breast carcinoma].

The histopathologic diagnosis with the description of the size of the tumor, its growth pattern, grading, lymph node involvement, hormonal receptor status and pTNM-classification are basic requirements the treatment of breast cancer. In addition to the conventional methods new bio- or immunohistochemical factors can be determined, which have variable predictive values. The pTNM-classification is essential for the evaluation of clinical treatment results and prognosis. This histopathologic survey summarizes frequent and rare types of breast cancer, of which about 24 entities and 22 subtypes are known. The clinically important criteria of the intraductal carcinoma and of the lobular carcinoma in situ are described and their differentiation forms are mentioned. This review will illustrate the development in the detailed histopathologic diagnosis of breast cancer. Finally some aspects of lymphatic spread are outlined and the incidence and the sits of metastases.

Breast Neoplasms↗
PubMed1994

[A rare etiology for HBs-Ag negative acute hepatitis B--coinfection by hepatitis B and delta].

An unusual case of a 25-year-old male Italian is reported. The patient endured an acute hepatitis without detectable HBs-antigen by coinfection with hepatitis-B and Delta. Coincidently, a cured hepatitis-C was present. Firstly hepatitis-B-virus DNA could be demonstrated in a small quantity by serodiagnosis (6 pg/ml, hybridization technique). Subsequently, the identification of B-virus DNA was only possible in liver tissue (PCR-technique), but no longer by serodiagnosis. The probable enduring inhibition of hepatitis-B-virus replication by Delta virus resulted in a self limitation of the disease within 2 months (HDV-RNA negative, HBs-Ag and HBe-Ag negative; Anti-HBs negative, Anti-HBe and Anti-HBc positive). In spite of negativation of replication markers for hepatitis-B a subsequent reactivation of the infection was possible by viral material which persisted in liver tissue.

Acute Disease↗
PubMed1993

[Life-threatening arterial bleeding in hemorrhagic-necrotizing salmonella ileitis].

A 23-year-old man in otherwise good health had diarrhoea for two days during a holiday on Maldives. Two months later he suddenly collapsed and had to be admitted to hospital. Haemoglobin concentration was found to be 76 g/l, with a haematocrit of 0.22, WBC count of 17,800/microliters and platelets of 22%. Massive passage of bright red blood in the stools (none previously) could not be explained by abdominal sonography, oesophagogastroduodenoscopy, coloscopy, technetium scintigraphy or angiography of the superior mesenteric artery. Exploratory laparotomy revealed severe inflammatory changes in the terminal ileum with enlargement of the regional lymph-nodes and spurting bleeding from a branch of the ileocolic artery. Histological examination showed focal necrotizing, ulcerative and haemorrhagic ileitis. After ileocaecal resection and end-to-end anastomosis to the ascending colon the patient quickly recovered. Salmonella Livingstone was isolated from the stool and the infection was treated with ciprofloxacin, 200 mg twice daily intravenously for 5 days. Subsequent stool samples were negative but follow-up continues.

Adult↗
PubMed1993

Pregnancy-associated ectopic decidua (deciduosis) of the greater omentum. An analysis of 60 biopsies with cases of fibrosing deciduosis and leiomyomatosis peritonealis disseminata.

Ectopic decidua (deciduosis) of the omentum was investigated in biopsies taken during cesarean sections and in tubal pregnancies in 60 cases. An ectopic decidua of various abdominal organs was present in 48 further cases. All omentum biopsies showed decidual reactions:focal deciduosis in 97% and diffuse deciduosis in 3%. With increasing duration of pregnancy, there was vacuolar degeneration and fragmentation of the decidua cells as a manifestation of regressive changes. Co-expression of antibodies to vimentin, desmin and actin can be detected immunohistochemically. Ectopic decidua is a physiological phenomenon of pregnancy and arises from a progesterone-induced metaplasia of the pluripotential cells of the "subcelomic mesenchyma". The involution of the decidua takes place in the fourth to sixth week post partum. A fibrosing deciduosis of the omentum with development of a collagenous connective tissue at its surface is described as metaplasia of the hormone-dependent "subcelomic" mesenchyma. Immunohistochemically, a second case with leiomyomatosis peritonealis disseminata from the same investigation material shows the transformation of desmin- and actin-positive decidual cells into myofibroblasts and leiomyocytes in the form of a direct metaplasia. As pregnancy-associated mesenchymal metaplasias, ectopic decidua, fibrosing deciduosis and leiomyomatosis peritonealis disseminata depend on hormone and may regress post partum.

Adolescent↗
PubMed1992

Histopathology of myoepithelial (basocellular) hyperplasias in adenosis and epitheliosis of the breast demonstrated by the reactivity of cytokeratins and S100 protein. An analysis of heterogenic cell proliferations in 90 cases of benign and malignant breast diseases.

This study on the different types of epithelial hyperplasia in fibrocystic disease was inspired by the observation of myoepithelial (basocellular) hyperplasia identified by strong expression of S100 protein and a weak reaction with antibodies against cytokeratin (KL1) in cells forming solid and acinar buds. The cells do not contain immunohistochemically detectable actin or desmin. Glandular transformation and proliferation give rise to basocellular circumductal adenosis. Normal breast tissue, 51 cases of fibrocystic disease with mild, florid and atypical hyperplasias, 7 fibroadenomas and 20 cases of carcinoma in situ were studied and a semiquantitative analysis revealed basal buds and adenosis in less than 40% of cases of mild hyperplasia and up to 73% in florid hyperplasia. Epitheliosis is characterized by a heterogeneous cell pattern with cells positive for S100 protein in 30-60%, but in small ducts up to 100% with an immediate connection to the basal cell layer were positive. Carcinoma in situ contained very rare tumour cells positive for S100 protein. The cells expressing S100 protein in terminal ducts, in adenosis and epitheliosis showed only some of the characteristics of myoepithelial cells, since they lack immunoreactivity with antibodies against actin. These basal clear cells are interpreted as transitional or indeterminate cells with features of myoepithelial precursor cells, but with the ability to develop basocellular nodular and glandular hyperplasia in the ductulo-lobular units in cases of adenosis and juvenile fibroadenoma.

Adenofibroma↗