[The fine structure of uterine sarcomas (author's transl)].
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Biomedical subjects
Publications and source records attributed to W Böcker.
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A 55-year-old patient with reticulo-nodular infiltrations of both lungs and eosinophila had previously been living in the tropics for several months. The clinical triad suggested filarial infection. But the final diagnosis proved to be metastasizing adenocardinoma of the lung, as demonstrated at autopsy.
The reaction of X-rays on the incapsulation of subcutaneous implantation of silastic prosthesis and further development of the capsules was studied in an experimental investigation on the basis of 14 rabbits. An influence of X-rays on type and thickness of the capsule as well as constrictive fibrosis was not ascertained. On account of our histological investigations we may say that the cause for a fibrous capsule formation is a similar process which causes Dupuytren's contracture.
CT findings in 50 patients with histologically verified soft tissue sarcomas are presented. In nearly all the cases the cross-sectional view and the higher resolution of density make it possible to determine exactly location of the tumors, their size and relationship to adjacent structures. Thus CT opens a new dimension, which is of great value for staging and therapy treatment planning. The high rank of CT in the follow-up after therapy and the detection of recurrent tumor is demonstrated. The contribution of CT, however, to the anatomic characteristics and its prospective value with the regard to soft tissue tumor is less important. Further limits of the method are discussed.
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In statistical analyses the rate of malignancy of solitary cold thyroid nodules is estimated between 3 to 50%. In our records the incidence of malignancy is 6,6%. Concerning the pathogenicity of these thyroid nodules no conclusions can be drawn which are only based on the results of such analyses. Each thyroid nodule has to be classified either according to its clinical and morphological characteristics or to its morphology alone. The condition for an optimal diagnosis and therapy is provided by the surgeon and pathologist being acquainted with the criteria for morphological classification or clinical data respectively.
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Histologic, immunhistochemical and electron microscopic changes in 8 cases of scintigraphically proven autonomous thyroid adenomas are described and compared with non-functioning adenomas. Adenomas with a light microscopic appearance suggesting autonomy show follicles which are mainly small or normal sized and lined by columnar thyroid cells with a partly vacuolated and eosinophilic cytoplasm. Immunhistochemically a high content of thyroglobulin corresponds to the amount of rough endoplasmatic reticulum. Typical ultrastructural criteria are a well developed cytocavitary network, numerous mainly apically localized lysosomes, prominent Golgi fields with sprouting vesicles and autophagic vacuoles. The cell surface is, when compared to non-functioning adenomas, enlared apically by numerous long microvilli and basally by deep infoldings. On contrast to experimentally TSH-stimulated animal thyroids, colloid droplets and pseudopodia are rare. The morphological findings are compared with recent biochemical results and the diagnostic value of electron microscopy is discussed.
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An endodermal sinus tumour of the ovary from a 12 year old girl is analysed light- and electron microscopically. The histological appearance is characterized by glandular-papillary structures and microcystic-reticular areas with inclusion of occasional endodermal sinuses. By electron microscopy immature and highly differentiated cells can be distinguished. In analogy to certain structures in the human yolk sac the most differentiated cells in the tumour are regarded as neoplastic endoderm. On the basis of transitional forms between immature and differentiated cells a development of the latter from the former is suggested. The cells in mesenchyme-like areas differ from those of solid and glandular parts merely in the degree of cytoplasmic differentiation but are otherwise believed to represent the same "cell line". In addition to other possible cell functions the cytoplasmic features of the differentiated cell indicates a protein synthesis and secretion. From our observations it is concluded that the endodermal sinus tumour originates from germ cells and differentiates into yolk sac endoderm. The ultrastructural differences between this tumour and clear cell carcinomas of the ovary are discussed.
An embryonal rhabdomyosarcoma of the nasopharynx of a 10 year old boy is analysed with light and electron microscopy. With regard to cell shape and cytoplasmic features the following four tumour cell types could be distinguished: 1. Undifferentiated mesenchymal cells with a big loosely packed nucleus and a small cytoplasmic rim with only few cell organelles; 2. Undifferentiated tumour cells with a broad cytoplasmic body which contains a dense network of nonspecific intermediate filaments with a diameter of about 100 A; 3. Immature rhabdomyoblasts with randomly orientated specific myofilaments; 4. Fully differentiated rhabdomyoblasts with well developed myofibrils often showing a sarcomeric pattern. Glycogen deposits which were seen in great masses in many tumour cells were regarded to result from degenerative processes within the tumor. The cellular stages in the development of rhabdomyoblasts are basically identical to those known from the embryogenesis and regeneration of striated muscle. From these observations the two following developmental pathways are suggested: 1. Origin of the tumour from an undifferentiated mesenchymal cell; 2. Atypical regeneration of striated muscle which terminates in malignant progressive tumour growth. At present, the body of information about rhabdomyosarcomas supports the assumption of an origin from immature mesenchymal cells. Nevertheless, the second theory cannot be totally excluded.
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38 endometrial sarcomas were studied light microscopically, 5 of them additionally with the electron microscope. According to their histological appearance these tumours were classified as homologous stromal sarcomas (13 cases), pure heterologous (4) and mixed mesodermal sarcomas (21). The ultrastructure is described with reference to the cytoplasmic differentiation of the tumour cells. A basic immature cell type was present in all endometrial sarcomas irrespective whether they were of pure homologous or of mixed type. In regard to the striking similarity between this cell and cells of the early proliferating endometrium an origin of all endometrial sarcomas from immature stromal cell is suggested. The mixed tumours contain a number of highly differentiated cells like smooth muscle cells, rhabdomyoblasts, fibroblasts etc. As there was a number of cells intermediate in cytoplasmic appearances between immature and differentiated end stages it seems likely that the latter develop from the former. Thus the undifferentiated cell represents the stem cell from which the differentiation processes of all cell lines take their origin. A transition from neoplastic epithelium to neoplastic mesenchyme could not be demonstrated in thed that the mixed epithelial-mesenchymal endometrial tumours originate by a simultaneous malignant transformation of cells with a fixed differentiation potency.