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W Böcker

Publications and source records attributed to W Böcker.

At least 181 records · Page 10Linked to original sources

[Morphology and prognosis of follicular thyroid cancer--a clinico-pathologic and DNA cytometric study of 95 tumors].

A retrospective study of 95 follicular thyroid carcinomas was conducted to evaluate the prognostic value of different morphological and clinical features. The biological behaviour of these tumours was primarily influenced by presence or absence of a capsule type of confinement: the frequency of lethal outcome among widely invasive carcinomas was six times higher than among encapsulated neoplasms. Furthermore, dismal prognosis could be demonstrated for tumours occurring in older patients (with a sharp break in the prognosis at the age of 52 years) and for those lesions which displayed oxyphilic metaplasia. The same effect was shown for presence of lymph node metastasis, tumour invasion of the cervical soft tissue and, for the case of encapsulated carcinomas, distant haematogenous spread. Conversely, the degree of differentiation and the patients' sex proved to have no significant influence on prognosis. In 22 carcinomas, cytophotometric and flow-cytometric determinations of DNA values were performed. These procedures revealed to have only limited diagnostic value, since for the majority of the tumours, benignancy or malignancy could not be judged from the DNA histograms. However, DNA measurements proved to contribute valuable information for the prognosis in individual cases of widely invasive follicular carcinomas. The discussion focuses on the diagnostic, therapeutic and prognostic relevance of these findings and on their impact on subclassification of follicular thyroid carcinomas.

Adenocarcinoma↗

Patterns of expression of cytoskeletal proteins in human thyroid gland and thyroid carcinomas.

By two-dimensional gel electrophoresis of proteins insoluble in detergents and high-salt buffer and immunofluorescence microscopy with a panel of polypeptide-specific antibodies to proteins of intermediate filaments (IF) and desmosomes, we have characterized the cytoskeletons of normal human thyroid gland, several kinds of benign lesion (goiter, Hashimoto's and Graves' diseases, adenomas), and the major thyroid carcinomas (follicular, papillary, medullary, and anaplastic). In all these tissues, desmoplakins and cytokeratins 7, 8, 18, and 19 were identified. While cytokeratins 8 and 18 occurred in all epithelial cells and cytokeratin 7 was also rather widespread, cytokeratin 19 occurred in amounts variable between the different types of tissues and in normal thyroid gland was restricted to certain clusters of follicular epithelial cells. Of all samples studied, in none did we detect cytokeratins commonly associated with stratified epithelia such as cytokeratins 4-6, 10, and 13-17, indicating that these are infrequent, if at all present, in such tissues. Coexpression of cytokeratins with vimentin appears to occur constitutively in follicular epithelial cells of normal thyroid gland and is also frequent in the diverse carcinomas, though to various degrees. Medullary carcinomas are exceptional, not only because they express neuroendocrine markers, but also because they coexpress combinations of cytokeratin IFs with neurofilaments and/or vimentin IFs in some cases, but not all. The results are discussed in relation to states of cell differentiation in normal and diseased thyroid gland and with respect to their value in tumor diagnosis.

Cytoskeletal Proteins↗

[Occult papillary thyroid carcinoma. Clinical significance and morphology of a common tumor].

In a systematic analysis of surgical specimens of 388 carcinomas of the thyroid 34 occult papillary tumours were revealed. In 18 of the 34 patients cervical lymph-node metastases were demonstrated, which in 16 had been the indication for operation. In 15 patients the tumour was a chance finding in a thyroid resected for other reasons. Postoperative follow-up over an average of ten years demonstrated a uniformly favourable course in all, regardless of tumour size or type, age, sex or lymph-node status. There were no local recurrences or metastases beyond those known at time of thyroidectomy.

Adult↗

Intermediate-filament expression in thyroid gland carcinomas.

Paraffin-embedded specimens of 200 primary thyroid carcinomas were examined immunohistologically for the expression of intermediate-filament (IF) protein of the cytokeratin, vimentin and neurofilament type. In 36 cases, snap-frozen tissue was available, and double label immunofluorescence microscopy was performed in 23 of them. Cytokeratin reactivity was found in all cells of all follicular, papillary and medullary carcinoma cases examined. Using a monoclonal vimentin antibody, positive staining was found in many, though not all cells of the papillary tumours and in approximately 50% of the follicular and the medullary carcinomas. Among anaplastic carcinomas, some tumours were positive for cytokeratins, with or without coexpression of vimentin. Neurofilaments could only be demonstrated in approximately 13% of medullary tumours which in general also exhibited vimentin positivity. The differences of IF expression in follicle and C-cell thyroid carcinomas and the broad variation of cytokeratin and vimentin immunoreactivity among anaplastic tumours of this organ is discussed in relation to the possible intrinsic heterogeneity of these tumours and the diagnostic value of these markers.

Adenocarcinoma↗

Morphological demonstration and quantification of TSH binding sites in neoplastic and non-neoplastic thyroid tissues. An autoradiographic study using 125I-labelled thyrotropin.

We have developed a morphological method to portray TSH binding sites in intact tissue specimens. Frozen sections were incubated with 125I-labelled TSH so as to localise binding sites by autoradiography. The proof of specificity was substantiated by: the competitive inhibition of 125I-TSH-labelling with cold TSH, the lack of binding in non-target tissues and a lack of binding in TSH target tissues after incubation with 125I-hCG or free 125I. In applying this method to a total of 22 surgical specimens of thyroid, striking differences came to light in respect of the degree to which 125I-TSH binding occurred in the various thyroid disorders. When compared with histologically normal tissue, labelling was generally decreased in toxic adenomas, non-functioning adenomas (cold nodules), and thyroids affected by Graves' disease, whereas non-toxic colloid goitre cases clearly exhibited denser binding. Medullary and anaplastic carcinomas exhibited no specific labelling whilst binding varied in the differentiated carcinomas between no effective binding or a level resembling that found in normal thyroid tissue.

Autoradiography↗

Clear-cell carcinomas of thyroid gland: a clinicopathological study of 13 cases.

Thirteen primary thyroid clear-cell carcinomas and eight thyroid metastases of renal carcinomas are described. A broad variety of features is shown to be responsible for this follicle cell phenotype, some of which also occur in renal carcinomas. In biopsy specimens these two conditions can only be distinguished by immunohistochemistry. Clinical follow-up disclosed that in the papillary and follicular categories of thyroid cancer the biological behaviour of clear-cell tumours exhibits no significant difference to their non clear-cell counterparts. In the case of eight follicle cell carcinomas, various samples were available for study. These revealed some striking variations in histology at different stages, and even during the same stage, of disease. Both reversal of clear cell change and transitions towards other kinds of metaplasia occurred. Morever, maintenance of follicle cell function was documented in several of these lesions by estimations of serum thyroglobulin levels and radioiodine scans. On the basis of these findings the concept of regarding the clear-cell variant as a distinct subtype of thyroid cancer is refuted. Previous statements on the causal mechanism of clear-cell change are discussed and it is suggested that metaplastic transformation accounts for this phenomenon in at least some instances of this heterogeneous condition.

Adolescent↗

Characterization of breast carcinomas by two monoclonal antibodies distinguishing myoepithelial from luminal epithelial cells.

Two monoclonal antibodies, KA 1 and KA 4, raised against human epidermis, were biochemically and immunologically characterized and were shown to react with specific cytokeratin polypeptides. On frozen sections of human mammary gland, these antibodies distinguish between myoepithelial and luminal epithelial cells. We present evidence that in these cells KA 1 antibody recognized cytokeratin 5 and KA 4 antibody cytokeratin 19. In normal mammary tissue, KA 4 antibody invariably reacted with the epithelial cells lining the lumina of acini, ductules, ducts, and sinus. In contrast, KA 1 antibody decorated only the myoepithelial and basal epithelial cells of acini, ducts, and sinus. In ductules, however, KA 1 also stained the luminal cells. All 73 invasive lobular and ductal carcinomas studied reacted with KA 4 antibody; five of these were also positive, apparently in the same tumor cells, with KA 1. The tumor cells of in situ carcinomas were also stained in a homogeneous pattern with KA 4 antibody; KA 1 antibody reacted only with the surrounding myoepithelium. In epithelial hyperplasias, the proliferating cells were decorated by KA 1 and KA 4 antibodies in a heterogeneous pattern. Other antibodies were used for comparison. The results are discussed with respect to epithelial differentiation and pathogenesis and to the application of such antibodies for immunohistodiagnosis of mammary lesions.

Adenoma↗

[Sonographically controlled fine punch biopsy of the thyroid gland].

Under local anaesthesia and under ultrasound guidance punch biopsy with a cutting biopsy needle was performed in 50 patients, providing 65 biopsy specimens. In 57 instances the indications for biopsy were nodular goitre, in 8 diffuse parenchymal involvement. Focal alterations were reliably hit if they were larger than 1 cm in diameter. The punch biopsy was performed without clinical complications. In 60 of 65 instances (92%) a sufficiently large tissue specimen was obtained for adequate histological assessment. In 13 patients with clinical indications for operation, surgical intervention was avoided because the biopsy proved the tissue to be benign. In 7 patients the accuracy of the punch biopsy was demonstrated, agreeing with the findings of biopsy obtained at operation or post-mortem. A close positive correlation existed between echogenicity of thyroid lesions and their histologically demonstrated colloid content. Although punch biopsy under ultrasound guidance is technically more complex than fine-needle aspiration cytology, it has the advantage that structural histological changes can also be assessed. This increases the diagnostic accuracy of the morphological diagnosis.

Adenoma↗

Immunohistochemical demonstration of carcinoembryonic antigen (CEA) in 120 mammary carcinomas and its correlation with tumor type, grading, staging plasma-CEA, and biochemical receptor status.

Antisera to CEA were used for the immunohistochemical localization and quantification of this antigen in 120 Bouin-fixed, paraffin embedded mammary carcinomas. These results were compared to tumor type, grading, staging, biochemical receptor status, cytosolic CEA-levels of the same tumors, and preoperative plasma CEA-levels. Mammary carcinomas were usually characterized by a low percentage of CEA-positive tumor cells: 50.9% of the cases contained more than 5% CEA-positive tumor cells and were therefore defined as being CEA-histopositive in this study. A relation could be shown between CEA-histopositivity and the histologic tumor type. The majority of invasive lobular carcinomas, tubular, and cribriform carcinomas was CEA-negative (72%). Conversely, 70% of invasive ductal carcinomas were CEA-positive. There was a significantly higher percentage of CEA-histopositivity in grade III tumors than in grade I/II carcinomas. The results obtained by quantification of the immunohistochemical staining of CEA were positively correlated with the results obtained by cytosolic CEA-assay. The overall concordance between tissue and plasma determinations of CEA was found to be 57.1%. A positive trend could be found between CEA-positivity and staging. However, no correlation was observed between CEA-positivity and estrogen receptor status.

Adult↗

Comparison of histology and immunohistochemistry with thyroglobulin serum levels and radioiodine uptake in recurrences and metastases of differentiated thyroid carcinomas.

The importance of lightmicroscopical and immunohistochemical features of 38 recurrent differentiated thyroid carcinomas (27 papillary carcinomas (PC), 11 follicular carcinomas (FC] for post-operative serum thyroglobulin (TG) concentrations was analysed in regard to pre-operative serum TG levels with tumour type, histological and cytological differentiation, volume fraction of TG synthesizing tumour cells (TG immunohistomorphometry), tumour volume and radioiodine uptake (RIU). Serum TG concentrations increased with tumour size and the number of TG synthesizing tumour cells (r = 0.5). PC and FC did not differ in their volume proportions of TG synthesizing tumour cells, while TG serum levels in FC significantly exceeded those of PC of similar size. The low TG serum levels found in PC might be explained by a specific defect in thyroglobulin secretion. Carcinomas with partial or total cytologic metaplasia (e.g. oxyphilic carcinomas) had low volume proportions of TG synthesizing cells and low serum TG levels. Thirteen of the 38 differentiated carcinomas (34.2%) showed both high TG serum levels and positive RIU, 17 (44.7%) disclosed only elevated TG serum levels and 6 (15.8%) a positive RIU. In two cases (5.3%) TG serum levels were not elevated and RIU's were negative. TG immunostaining was positive in all 38 cases. In summary, TG serum levels depend on the following morphologic factors in differentiated thyroid carcinomas: 1) Number of TG synthesizing tumour cells, 2) Mode of TG secretion and 3) Cytological differentiation of the tumour cells. Serum TG levels did not predict total body iodine scan.

Adolescent↗

Signet-ring-cell thyroid tumors. Follicle cell tumors with arrest of folliculogenesis.

This study describes three carcinomas and three benign follicle-cell lesions that consisted of vacuolated thyrocytes. In five of these tumors the neoplastic cells, wholly or in part, had the same unique signet-ring-cell feature as recently described for a mucinous microfollicular thyroid adenoma case. On electron microscopy, however, intracellular lumina that were bordered by microvilli were shown. Serial sections of the epon-embedded material and the results of mucin stains and thyroglobulin-immunostaining excluded primary mucin-producing tumors of the thyroid and in each of our six thyroid lesions gave evidence of an arrest of folliculogenesis.

Adenocarcinoma↗

Lipomatous lesions of the thyroid gland: a review.

Described are rare thyroid lesions which either contain mature adipocytes or consist of lipid-rich follicle cells. Of the former, diffuse lipomatosis and adenolipoma of the thyroid are most likely to be derived from heterotopic islands of fat cells included in the gland during embryogenesis. On the other hand, metaplastic origin of fat cells from stromal fibroblasts due to chronic tissue hypoxia is presumed responsible for the presence of fatty tissue in amyloid goiters. Massive steatosis of follicle cells, as seen in the lipid-rich variant of clear cell thyroid adenomas and carcinomas, is, however, claimed to most likely result from metaplastic transformation of neoplastic thyrocytes. Pathomorphological and clinical features of the aforementioned lesions are discussed.

Adenocarcinoma↗