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Biomedical subjects

R Erlemann

Publications and source records attributed to R Erlemann.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Aneurysm of a persistent sciatic artery. Case report and review of the literature].

A persistent sciatic artery results from lack of regression of the fetal arterial blood supply of the leg and is often combined with an abnormally developed superficial femoral artery. A rare case of bilateral persistent sciatic artery with unilateral thrombosed aneurysm of the right buttock was found. The right sciatic artery was completely developed and terminated in the popliteal artery, which showed thromboembolic occlusion. The right superficial femoral artery was hypoplastic and showed no connection with the popliteal artery. The left sciatic artery was incompletely developed, and the popliteal artery was fed by a normal superficial femoral artery. All of the 104 cases published of persistent sciatic artery were reviewed according to the degree of development, side localization, clinical signs and frequency of aneurysms, as well as the morphology of the ipsilateral superficial femoral artery.

Aneurysm↗
PubMed1994

[Determination of the growth rate of tumor-like space-occupying lesions of the bones. A study of 1154 lesions of the long tubular bones].

In 1088 primary and secondary bone tumors and tumorlike lesions and in 66 inflammatory lesions, the growth rate was graded according to the Lodwick classification. Grade IA and grade IB were correlated with benign lesions in 99.8% and 91.3% of cases, respectively. In contrast, grade III and grade II were associated with malignant tumors in 100% and 89.6%, respectively. With increasing age, the proportion of malignant tumors among those graded as IB or II increased significantly. Tumors classed as grade IC were benign in 57.5% and malignant in 42.5% of cases. The growth rates of the individual tumor entities were analyzed.

Adolescent↗
PubMed1993

Spindle cell (leiomyomatous) rhabdomyosarcoma, a rare variant of embryonal rhabdomyosarcoma.

A rare case of the leiomyomatous variant of embryonal rhabdomyosarcoma is reported. A 13-year-old boy presented with a recurrent painless mass on the ventral side of the right forefoot. Microscopically, the tumor consisted of spindle-shaped and round tumor cells in a fascicular or storiform, focally hemangiopericytoma-like growth pattern. The cytoplasm of the spindle-shaped tumor cells was eosinophilic and fibrillary, in some areas resembling smooth muscle cells. Immunohistologically, all tumor cells were vimentin-positive, most of them also stained with antibodies to desmin and muscle specific actin (MSA). In addition, many tumor cells showed a co-expression of alpha-sarcomeric actin and myoglobin. All tumor cells were negative with alpha-smooth muscle actin. Two years after surgical treatment and chemotherapy the patient is well with no evidence of distant metastases. The clinicopathological features and differential diagnostic problems are discussed.

Adolescent↗
PubMed1993

[Aneurysmal bone cyst or giant cell tumor. The value of x-ray diagnosis for differential diagnosis].

Depending on analysis of radiographic morphology, location and patient's age of 72 aneurysmal bone cysts (ABC) and 47 giant cell tumours (GCT), the following criteria suggest an ABC with a high positive predictive value: location in the diaphysis (100%), in the shaft (92%), in the metaphysis or metadiaphysis (86%), patient younger than 17 years (97%) and growth rate grade Lodwick-IA (88%). GCT were selected via the following criteria: epimetaphyseal location (82%) and growth rate grade Lodwick-II (100%). In 14% of the cases, differential diagnosis between both entities is radiologically impossible.

Adolescent↗
PubMed1993

[X-ray morphology of eosinophilic granuloma other than skull and spine].

The radiological findings in 39 patients with a manifestation of eosinophilic granuloma (e.g.) other than skull and spine were evaluated. The localisation was found in the femur (26%), clavicula (20%) and ribs (20%). The lesions were located in 81% in the diaphysis and in 9.5% either in the epi-metaphysis or epi-metadiaphysis. Associated periosteal reactions were observed in 38% of the patients, and were solid in 25%, lamellar in 10%, and in 3% complex. The majority of the tumours were classified as Lodwick IB lesions (41%). Lodwick IC lesions were seen in 13%, Lodwick II lesions in 25.5% and Lodwick III lesions in 20.5% of the patients. In patients below the age of 20 years the eosinophilic granuloma is characterised by a Lodwick IB lesion without or with a solid periosteal reaction, which allows differentiation from Ewing's sarcoma or osteomyelitis. Contrariwise, in patients above 20 years of age the e.g. appears with a higher Lodwick grade. Hence, differentiation, X-ray morphology, between e.g., metastasis, lymphoma, and multiple myeloma does not seem possible.

Adolescent↗
PubMed1993

[Localization dependent patterns of findings in chondroblastoma].

In a retrospective study the radiographs of 48 chondroblastomas from the files of the Bone Tumour Registry of Westphalia were evaluated. The purpose of the study was to investigate whether chondroblastomas display localisation-dependent radiographic patterns. All radiographs were analysed using the Lodwick criteria. All chondroblastomas (mean age: 18 y., m:f = 1.25:1) showed a geographic pattern of bone destruction. 32 lesions affected long bones, 10 short bones, and 6 flat bones. Chondroblastomas localised in flat bones (Lodwick IA: 0%, IB: 33%, IC: 67%) demonstrated more aggressive patterns of bone destruction compared to lesions affecting long bones (Lodwick IA: 56%, IB: 31%, IC: 13%) or short bones (Lodwick IA: 40%, IB: 50%, IC: 10%). There was no difference between the three bone types in other radiographic patterns (periostitis, calcification, trabeculation).

Adolescent↗
PubMed1993

[Tumorous space-occupying lesions of the tibia. A radiological analysis of 459 cases].

The patients' age, location and radiography of 459 bone tumours and tumour-like lesions of the tibia were analysed retrospectively. 79.2% of all lesions were benign, and the portion of malignant tumours increased with increasing age. Predominantly malignant tumours were found in a distal central metadiaphyseal (100%), in proximal central epimetadiaphyseal (90%) and in a proximal central metadiaphyseal (63%) location. Lesions showing a growth rate according to Lodwick IA and those to IB were benign in 99.5% and in 95.4%, respectively. In contrast, tumours showing a grade II or III were malignant in 85.2% and 100% of cases, respectively. Through the construction of subgroups by combination of patients' age, location and growth rate special tumours were selected in that way, that they were predominantly found in that subgroups.

Adolescent↗
PubMed1992

Case report 699. Primary localized skeletal cryptococcosis (torulosis) of the right tibia at its proximal end.

The case of a 58-year-old man with a normal immune status with primary localized skeletal cryptococcosis of the right tibia was presented. Radiologically it appeared as an osteolytic lesion with marginally indistinct borders in the epimetaphyseal region of the proximal tibia. Histologically, necrotizing granulomatous inflammation was associated with a prominent fibrohistiocytic reaction. The presence of cryptococci was confirmed by special stains. Clinicopathological features and the therapeutic aspects of this rare infective bone lesion were discussed. It is uncommon today, particularly in developed countries, to encounter a localized skeletal fungal infection. Therefore, radiologists and pathologists generally may be unfamiliar with the appearance of the lesion and tend not to consider the possibility of fungal osseous disease in the differential diagnosis. Unless it is remembered that fungal infection may cause a localized bone lesion with varied histological responses, the diagnosis may be overlooked, and bacteriologic proof may not be sought.

Bone Diseases↗
PubMed1992

(Sub)periosteal Ewing's sarcoma of bone.

Ewing's sarcoma is a small malignant round-cell tumour that arises from mesenchymal cells, predominantly in the medullary cavity of bone. In exceptional cases it originates in the soft tissues and subsequently invades the underlying bone. A (sub) periosteal origin of Ewing's sarcoma is a very rare condition: only a few cases have been published so far. Three cases of (sub)periosteal Ewing's sarcoma, having received neoadjuvant chemotherapy and radiation therapy as well as wide excision, are reported.

Adolescent↗
PubMed1992

Chondroblastoma of bone. A clinical, radiological, light and immunohistochemical study.

The clinical and morphological findings of 53 chondroblastomas in the files of the Bone Tumour Registry of Westphalia are presented. The mean age of all patients was 19.2 years. The male-to-female ratio was 1.5:1. Forty-two of the tumours (79.8%) were located in the long tubular bones and short tubular bones of the hands and were closely related to the growth plate. Six cases (11.3%) were found in the flat bones, 4 cases (7.5%) in the tarsal bones and 1 case (1.9%) in the craniofacial bones. The characteristic radiological feature of 44 investigated lesions was a mostly eccentric radiolucency with a geographic pattern of bone destruction and matrix calcifications. Periosteal reaction was evident in 9% of the cases. Most tumours demonstrate the typical morphological features of chondroblastoma, but 3 cases resembled a giant cell tumour. In 2 cases a haemangiopericytoma-like growth pattern was observed. Nine of the tumours had an aneurysmal bone cyst-like component. Vascular invasion was seen in 1 case. Immunohistochemically most cells in 30 of the cases and fetal chondroblasts in 3 cases were strongly positive with vimentin and S-100 protein. Collagen type II was positive in the chondroid matrix of the tumours and in fetal cartilage tissue; collagen type VI was present focally around individual tumour cells and was always seen in the chondroid matrix of the lesions and in fetal cartilage. These findings support the cartilaginous nature of these tumours. In paraffin sections, 46.6% of the cases revealed a distinct positive reaction of some tumour cells with the monoclonal cytokeratin antibody KL1 (molecular weight 55-57 kDa). Only 4 of them demonstrated a coexpression with the other monoclonal cytokeratin antibody CK (clone MNF 116, molecular weight 45-56.5 kDa). In paraffin sections all fetal chondroblasts were negative with both cytokeratin antibodies. Frozen sections of 3 tumours showed a strong positive reaction with both cytokeratin antibodies in many chondroblasts, indicating an "aberrant" cytokeratin expression. Osteoclast-like giant cells stained positive with leucocyte-common antigen (LCA) and with the macrophage-associated antibody KP1, but were negative with the other macrophage-associated antibody MAC 387. Recurrence rate was 10.7%. The clinical course of all tumours was benign.

Adolescent↗
PubMed1992

"Solid" variant of aneurysmal bone cyst.

A case of the so-called "solid" variant of aneurysmal bone cyst is reported. A 12-year-old girl with a few weeks' history of backache presented with a tender palpable mass located thoraco-spinal in the back at Th 3. Radiologically, the lesion was consistent with conventional aneurysmal bone cyst. Morphologically, it showed fibroblastic, fibrohistiocytic, fibromyxoid, osteoclastic and osteoblastic components as well as small aneurysmal sinusoids. Based on four other well documented cases, the clinico-pathological features and the differential diagnostical problems are discussed.

Bone Cysts↗
PubMed1992

[The MR tomography of hemophilic osteoarthropathy with special reference to the synovial and chondrogenic changes].

52 knee and ankle joints of hemophiliacs were examined by MRI using FLASH and FISP-3-D sequences; and the degree of synovial hypertrophy and of cartilage destruction were assessed. Findings of synovial hypertrophy varied between thin membranes and tumorous tissue destroying the joint cartilage. Degree of cartilage destruction varied between focal signal decrease and total loss. In spite of recurrent joint bleedings no synovial or cartilaginous changes were seen in 31% and 29% of joints, respectively. Changes were more frequently seen and degree was more marked in the ankle than in the knee joints. With the exception of cysts, osseous destruction was more obvious with radiographs. MRI is suitable for the investigation of joints of hemophiliacs showing no osseous destruction.

Adolescent↗
PubMed1992

[Dynamic MR tomography in the diagnosis of inflammatory and tumorous space-occupying lesions of the musculoskeletal system].

In 216 inflammatory and tumorous lesions of bone and soft tissue, dynamic Gd-DTPA enhanced MR imaging was performed. For that purpose, 12 FLASH sequences (TR = 40 ms/TE = 10 ms/NSA = 2/flip angle = 90 degrees) were acquired within 4 minutes; and Gd-DTPA bolus injection was administered following the first sequence. Slopes from the signal intensity curves were calculated. Estimated slopes allowed an assessment of the malignant potential of a lesion with an accuracy of 88%. Further more, a reliable differentiation between vital and necrotic tissue and between tumour and peritumoral edema was reliably possible. With this technique, response of malignant tumours to preoperative chemotherapy was correctly predicted in 83% of the cases. No differentiation of inflammatory from tumorous lesions was possible.

Bone Neoplasms↗
PubMed1991

Comparison of technetium 99m polyclonal human immunoglobulin and technetium 99m monoclonal antibodies for imaging chronic osteomyelitis. First clinical results.

The accuracy of technetium-99m human immunoglobulin (HIG) for the detection of chronic osteomyelitis (OM) was compared with white blood cell scintigraphy using 99mTc-labelled monoclonal mouse antibodies (MAB). Seventeen patients suspected of having OM in 20 lesions went through three-phase skeletal scintigraphy, HIG scintigraphy and MAB scintigraphy. The final diagnosis was established by open surgery, histology and bacteriology. Chronic OM was proved in 14/20 lesions. Six of these 14 infections were located in peripheral areas without active bone marrow and 8/14 in central areas with active bone marrow. In peripheral OM, 5/6 with HIG and 6/6 with MAB were true positives. In the central skeleton all 8/8 infections appeared as cold lesions in the MAB study, which were defined as being false negative due to their non-specificity. Using HIG, 5/8 central infections were determined to be truly positive by showing photon-rich lesions. These 5 lesions were located in the hip region and in the pelvis, whereas 3 lesions of the spine were missed. There were no false-positive results in either studies. In conclusion, MAB was superior to HIG in peripheral OM concerning sensitivity, anatomical landmarks and differentiation of soft tissue versus bone infection. In central OM MAB detected all lesions accurately, but no differential diagnosis was possible due to the non-specificity of photon-low areas. In this respect HIG seems to be more specific due to the increased accumulation even in central infection sites.

Adult↗
PubMed1991

Case report 669: Osteonecrosis of bone associated with intraarterial therapy using cisplatin.

A case is presented of an 18-year-old women who suffered pain and swelling after intraarterial cisplatin chemotherapy for osteosarcoma of the left fibula. Radiological studies showed minimal changes at the metadiaphyseal portion of the left tibia. Bone scans and MR studies were highly suggestive of necrosis of bone and muscle of the proximal end of the tibia. Multiple biopsies of the tibia at the time of excision and 2 years later showed histological features consistent with a slowly healing osteonecrosis of bone. Review of the literature reported transient pain and swelling after intraarterial chemotherapy but did not demonstrate the association with necrosis of bone and muscle. It can be anticipated that as intraarterial chemotherapy of malignant tumors of bone and soft tissues becomes more widely used, these complications will be observed more frequently.

Adolescent↗
PubMed1991

[The place of magnetic resonance tomography in the diagnosis of diseases of the shoulder joint].

In a prospective study 43 patients with shoulder pain were examined by sonography and MRI. The findings were controlled by plain radiography, arthrography, and CT arthrography. Joint effusions and humeral head defects were equally identified by MR and sonography. In the diagnosis of labrum lesions, rotator cuff lesions, subacromial spurs, and synovial inflammatory disease sonography was not as accurate as MR. A special MR scoring system improved the diagnosis of an impingement syndrome.

Adult↗