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Biomedical subjects

W Böcker

Publications and source records attributed to W Böcker.

At least 145 records · Page 8Linked to original sources

Immunohistochemically demonstrated metallothionein expression in malignant melanoma.

Metallothioneins are ubiquitous proteins with a high affinity for heavy metal ions, e.g. zinc, copper and cadmium. Experimentally, metallothionein over-expression in cell lines derived from a variety of cancers has been associated with resistance to anticancer drugs and irradiation therapy. Using a monoclonal antibody (E9) to metallothionein we investigated immunoreactive expression in routinely fixed and paraffin-embedded tissue from 63 cases of malignant melanoma and 13 secondary deposits. Whereas a variety of cells in normal skin showed metallothionein expression, all forms of benign naevi studied were uniformly negative. In contrast 13/30 'thin' (< or = 1.5 mm; 0.7 +/- 0.4), 25/29 'thick' malignant melanoma (> 1.5 mm; 5.5 +/- 3.9) and 12/13 metastases were positive. Six patients with thin and 19 with thick melanoma with metallothionein expression died during a mean observation period of 6.4 +/- 1.8 and 3.6 +/- 2.5 years, respectively, their survival distribution function analyses giving statistically significant results for both the vertical tumour thickness (P < 0.0001) and metallothionein expression (P < 0.0001). These immunohistochemical results, based on routinely processed paraffin-embedded tissue, suggest that metallothionein expression in malignant melanoma is significantly associated with progressive disease and might therefore be a useful prognostic indicator.

Adult↗

Myofibroblast-like cells produce mRNA for type I and III procollagens in chronic active hepatitis.

In chronic active hepatitis the rate of collagen biosynthesis is largely determined by intracellular mRNA concentrations. To localize procollagen mRNA-producing cells, we investigated biopsy specimens from five patients with hepatitis B surface antigen-positive chronic active hepatitis and five patients without liver disease by in situ hybridization. We used type I and III procollagen cDNAs for transcription to (35S)-labeled probes. Parallel sections were stained with anti-actin monoclonal antibodies. Our results show that cells in which collagen synthesis is ostensibly enhanced can be localized by in situ hybridization of procollagen mRNAs. These cells were also anti-actin-positive in parallel sections and were localized in areas of inflammatory cell infiltration and necrosis. We conclude that myofibroblast-like cells may express procollagen mRNAs in chronic active hepatitis. Moreover, in situ hybridization may be a valuable diagnostic tool for providing additional morphologic information on the degree of fibrogenesis activity.

Actins↗

[Intravascular ultrasound in peripheral calcified vascular lesions: comparison with direct magnification radiography].

Intravascular ultrasound can detect calcified peripheral arteriosclerotic lesions by hyperdense echo patterns and shadowing of subintimal layers. Nevertheless, 20 MHz ultrasound systems have not been validated for the detection of peripheral calcifications; besides, it is unknown whether the depiction of calcified lesions by intravascular ultrasound depends on the morphology of the calcification. Histological evaluation of severely calcified arteries is difficult because the preparation of those specimens often causes artefacts, e.g., fracture of calcified structures. Direct magnification radiography, currently used in forensic medicine or skeleton examination, is based on a minimized focus and enables the edge-enhanced views of calcifications with high discrimination. In this in-vitro-study direct radiological magnification was used to validate intravascular ultrasound. Forty-nine segments of human peripheral arteries were fixed in formalin, examined with intravascular ultrasound and, as a reference, radiographically magnified using a newly developed microfocus x-ray tube. Sensitivity, specificity, positive and negative predictive value, and accuracy of intravascular ultrasound for the detection of calcified wall areas were determined and compared to the appearance (configuration, circumferential and areal expansion, density, number of fragments) of these calcifications. Thicknesses of 110 single calcified structures were estimated on sonograms and radiograms. The overall sensitivity of the 20 MHz intravascular ultrasound system for the detection of calcification in 913 sectors was 70%, specificity 53%, positive predictive value 66%, negative value 58% and accuracy 62%. The depiction of calcified regions by direct magnification radiography showed that the sensitivity strongly depended on the density of the calcification. Sensitivity was 81% with calcified lesions of high density, but only 51% with lesions of low density.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗

Immature teratomas of different origin carried by a pregnant mother and her fetus.

We describe the case of a pregnant mother and her fetus who both carried teratomas during the pregnancy. The fetus was diagnosed at 38 weeks' gestation to have an intracranial mass, which was later determined to be an immature teratoma. During a cesarean section delivery, an ovarian tumor was found in the 27-year-old mother that was also diagnosed to be an immature teratoma. Because of the similar histology of the tumors carried by both mother and child, a single clonal origin was suspected. Using polymerase chain reaction (PCR) and electrophoresis of highly polymorphic DNA satellite sequences, we determined that the origin of the intracranial teratoma carried by the child was independent of the mother's tumor. We also examined the p53 tumor suppressor gene in constitutional cells from both mother and child for the possible presence of a cancer-predisposing inherited mutation, but none was found. To our knowledge, this is the first report of the simultaneous occurrence of independent malignant immature teratomas in a mother and child during pregnancy.

Adult↗

[Medullary thyroid carcinoma. Immunohistochemical markers in histopathology and research].

Medullary thyroid carcinoma, a tumour derived from the calcitonin-producing C cells, is a rare tumour. Nevertheless it has evoked considerable interest in the past two decades amongst pathologists, clinicians, and human geneticists. Medullary thyroid carcinoma occurs either sporadically or as part of the inherited MEN II syndromes. The introduction of sensitive biochemical screening tests for the detection of early, clinically occult disease, and the advent of specific immunohistochemical staining methods have proved ideally for the study of this tumour. Immunohistochemical confirmation of the diagnosis of medullary thyroid carcinoma and the demonstration or exclusion of concomitant C cell hyperplasia (which precedes medullary thyroid carcinoma) are regarded as mandatory. Immunohistochemical markers used in routine histopathology and/or research of medullary thyroid carcinoma are reviewed and briefly discussed in the present paper.

Biomarkers, Tumor↗

[Diagnostic value of intravascular ultrasound diagnosis in peripheral arteriosclerotic blood vessel changes].

Intravascular ultrasound is an adjunct for the diagnosis of atherosclerotic peripheral vessels. In this in-vitro study, 69 segments of human peripheral arteries were fixed in formalin, examined with intravascular ultrasound and pathomorphologically evaluated. Sensitivity, specificity, both positive and negative predictive value and accuracy of intravascular ultrasound for the detection of irregular lumen contours, intraarterial structures and intimal thickening were determined for each of four quadrants. Sonographic features (echogeneity, homogeneity, shadowing of echoes) were compared to the architecture of lesions. Intravascular ultrasound detected regular (normal) lumen contours with high specificity (96.5%), a sensitivity of 65.0%, and an accuracy of 88.4%; intraluminal structures were detected with a sensitivity of 88.6%, a specificity of 97.8%, and an accuracy of 96.4%. Most atherosclerotic lesions could be localized with a sensitivity of 86.1%, a specificity of 99.1%, and an accuracy of 86.9%. Slight intimal thickening was detectable with a sensitivity of 85.9%, a specificity of 87.8%, and an accuracy of 86.2%. Comparison of sonographic features and the pathomorphological architecture of atherosclerotic lesions revealed that fibrous, atheromatous, and complex lesions without calcification did not show shadowing of echoes. The majority of fibrous or atheromatous lesions presented with homogeneous echoes; these lesions showed hypo-, hyper- and normodense echoes. The homogeneity of echoes did not help to identify the different components of combined atherosclerotic lesions. Thus, intravascular ultrasound is able to detect irregular lumen contours, intraluminal structures, and intimal thickening, but further sonographic criteria are needed to identify the architectural structure of combined lesions.

Aorta, Abdominal↗

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↗

Osteofibrous dysplasia of long bones--a reactive process to adamantinomatous tissue.

The most controversial aspect of osteofibrous dysplasia (OFD) is its possible histogenetic relationship to adamantinoma of long bone. Evidence is recently beginning to accumulate that OFD may be a reactive process to regressive adamantinoma. To verify the concept, 13 lesions of OFD were studied again by immunohistochemistry for cytokeratins of different molecular masses, as well as by conventional stainings. In addition, 2 adamantinomas and 6 fibrous dysplasias of the tibia were studied for reference. A small number of spindle- or ovoid-shaped cells scattered individually in the fibro-osseous stroma showed positive reactions for cytokeratins of 55-57 kDa in 2 lesions, and for those of 45-56.5 kDa in 8 lesions of 13 OFDs, although no definite epithelial island could be detected even by immunohistochemistry. Adamantinomas also showed single cytokeratin-positive cells dispersed in fibroblastic stroma, in addition to epithelial islands positive for cytokeratins of both 55-57 kDa and 45-56.5 kDa. All cases of fibrous dysplasia were negative for cytokeratins. During the observation, no case of OFDs progressed to classic adamantinoma. The present study, demonstrating the existence of an intermediate stage between "differentiated adamantinoma" and total elimination of adamantinomatous components, gives further support for the concept that OFD is a secondary reactive process to adamantinomatous tissue. In practice, the existence of single scattered cytokeratin-immunoreactive cells in otherwise typical OFDs may not indicate the truly malignant behaviour of classic adamantinoma, unless discrete epithelioid cell nests are also found.

Adolescent↗

An immunohistochemical study of the breast using antibodies to basal and luminal keratins, alpha-smooth muscle actin, vimentin, collagen IV and laminin. Part I: Normal breast and benign proliferative lesions.

The distribution of simple epithelial (K8/18/19) and basal (myoepithelial) (K5/14) keratins, alpha-smooth-muscle actin, vimentin, collagen IV and laminin in normal mammary glands and in benign proliferative lesions was studied using monoclonal antibodies (mAbs). These antibodies (Abs) identified myoepithelial cells and luminal cells specifically. In lesions with adenosis and papillomas, the two-layered formation resembled that of normal glands with a purely myoepithelial-epithelial differentiation. In scleradenotic lesions, the main cell was of myoepithelial immunophenotype with intermixed trabecular-tubular proliferations of simple-type epithelium. The sclerosis seems to be the result of an irregular basal lamina synthesis by the myoepithelial cells. In contrast to these lesions, epitheliosis represents a purely intraluminal cell proliferation of clearly simple epithelial immunophenotype and of cells with a basal keratin phenotype, lacking myoepithelial differentiation antigen actin. The basal keratin type epithelium may represent post-stem or intermediate cells developing into luminal epithelium. Epitheliosis appears to be a purely epithelial hyperplasia with striking similarity to the regeneration of normal breast epithelium. The different proliferative patterns may give an explanation for differences in potential cancer risks of patients with these lesions.

Actins↗

An immunohistochemical study of the breast using antibodies to basal and luminal keratins, alpha-smooth muscle actin, vimentin, collagen IV and laminin. Part II: Epitheliosis and ductal carcinoma in situ.

A detailed immunohistochemical study has been carried out on 63 breast lesions with epitheliosis, ductal carcinoma in situ and clinging carcinoma (lobular cancerization), using antibodies directed against keratins 5/14 and 14, 15, 16, 18, 19, vimentin, smooth muscle actin, collagen IV and laminin. The results have shown that epitheliosis on the one hand and ductal in situ and clinging carcinoma on the other are immunohistochemically different epithelial lesions. Epitheliosis appears to be epithelial hyperplasia with keratin 5/14 and keratin 14, 15, 16, 18, 19-positive cells. Compared to epitheliotic cells tumor cells of clinging carcinoma, lobular cancerization and ductal carcinoma in situ expressed only luminal keratins 14, 15, 16, 18, 19 in 85% of the cases studied; whereas in 15% there was a basal keratin expression. From our results we conclude that the clinging carcinoma (lobular cancerization) represents the initial morphological step in the development of ductal carcinoma in situ and thus may be interpreted as a minimal ductal neoplasia. With the immunohistochemical demonstration of basal and luminal keratins it may be possible in individual cases to differentiate between benign and malignant in situ lesions of the breast.

Actins↗

Immunohistochemical comparison of chromogranins A and B and secretogranin II with calcitonin and calcitonin gene-related peptide expression in normal, hyperplastic and neoplastic C-cells of the human thyroid.

Normal and hyperplastic thyroid C-cells and 14 cases of medullary thyroid carcinoma were investigated immunohistochemically with antibodies against chromogranins A and B, secretogranin II, calcitonin and calcitonin gene-related peptide (CGRP). Normal and hyperplastic C-cells showed strong calcitonin and chromogranin A immunoreactivity whereas CGRP, chromogranin B and secretogranin II expression was less intense. Strong calcitonin and chromogranin A immunoreactivity was also found in the majority of tumour cells in medullary thyroid carcinoma. The CGRP, chromogranin B and secretogranin II staining observed was present in variable patterns. In some cases CGRP, chromogranin B and secretogranin II could only be demonstrated in isolated tumour cells with elongated processes suggestive of neuronal differentiation of these cells. The biological function(s) of the chromogranins/secretogranins remain(s) still unclear. There is evidence that these proteins are pro-peptides which give rise to functionally active compounds. Studies on normal C-cells and medullary thyroid carcinoma may elucidate the role of chromogranins/secretogranins in endocrine and neuronal cells.

Adult↗

[Non-Hodgkin's lymphoma with primary osseous manifestation, from the files of the Bone Tumor Registry of Westphalia].

30 cases of non-Hodgkin-lymphoma with primary bone manifestation were selected from the files of the Bone Tumor Registry of Westfalia from 1975 until 1992. Clinical data and radiologic aspects were evaluated. 60% of the lesions were localized within the long bones (femur 10, humerus 6, tibia 2). The lymphomas were classified based on paraffin-embedded material in combination with immunohistochemical findings according to the updated Kiel-classification. 29 B-cell lymphomas and one T-cell lymphoma of medium-sized pleomorphic type were found. 5 B-cell lymphomas were of low and 23 of high malignancy. Almost 50% of the tumors were of centroblastic type. The Kiel-classification was not applicable for one lymphoma, 3 others could not be subclassified because of shrinking artefacts. Prognosis in patients with localized disease (9 cases) was favorable, whereas only 25% of patients with generalized disease (12/cases) survived for 3 years or longer.

Bone Neoplasms↗

CA 19-9 expression in subacute (de Quervain's) thyroiditis: an immunohistochemical study.

Carcinoma antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) expression was immunohistochemically investigated in 48 cases of subacute granulomatous (de Quervain's) thyroiditis, two of focal lymphocytic thyroiditis, three of Hashimoto's thyroiditis, two of Graves' disease, and seven follicular adenomas, 27 follicular carcinomas, and eight papillary carcinomas of the thyroid. CA 19-9 expression was found in all cases of subacute thyroiditis, lymphocytic thyroiditis, and papillary carcinomas examined and in approximately 50% of follicular adenomas and carcinomas. The strongest CA 19-9 staining was demonstrated in late stage subacute thyroiditis and in papillary carcinomas with marked sclerosis. Occasionally CA 19-9 expression was present in seemingly normal thyroid parenchyma adjacent to the thyroid lesions investigated. CEA was found in the center of the granulomatous lesions in acute stage subacute thyroiditis. All neoplasms were CEA negative. CA 19-9 and CEA could be demonstrated occasionally in multinucleated giant cells of subacute thyroiditis, which may suggest that these giant cells are of either histiocytic or follicular cell origin. Immunohistochemical investigation with antibodies against CA 19-9 and CEA may help to histomorphologically define subacute granulomatous thyroiditis.

Adenoma↗

Distribution patterns of apolipoproteins A1, A2, and B in the wall of atherosclerotic vessels.

Atherosclerotic vessels were analysed histochemically for distribution, quantity, and composition of apolipoprotein (Apo) types in the vascular wall. The specimens comprised all stages of atherosclerosis, from very discrete intimal changes to complicated lesions. The vessel specimens were marked with antibodies against human Apo A1, A2, and B. Apo A1 can be demonstrated in even the earliest stage of atherosclerosis, and increases with the progression of the disease. In the initial stage, Apo A1 is found first in lumen-adjacent layers of the intima, and is evident in deeper layers of the wall as the disease progresses. Arteries of muscular type show accumulation of Apo in an earlier stage (or in greater quantity at the same stage) than arteries of elastic type. At all stages, the amount of Apo A1 always exceeds that of A2 and B. In the intima, Apo B is higher than Apo A2, the media contains hardly any Apo B, and the adventitia has less B than A2. Within the intimal layer, Apo A1 and A2 are found in an intracellular (mainly in foam cells) or in an extracellular location, according to the stage of atherosclerosis. Apo B is almost exclusively extracellular; only cases of advanced atherosclerosis show some intracellular localization (mostly in foam cells), visualized as electron dense lamellar organelles, probably of lysosomal origin. In the media, Apo A1 and A2 are accumulated in intracellular deposits, whereas the extracellular storage of Apo A1, A2 and B is observed only in cases with the most severe damage. Our investigations suggest that the accumulation of apolipoproteins in the vascular wall is affected not only by insudation from the plasma, but also by neosynthesis and/or metabolism by locally derived cells or cells immigrating in the process of atherosclerosis. The presence of Apo A1 and A2 in the vessel wall is now documented, and their role at this site apparently differs from that in the plasma.

Aorta↗

Immunohistochemical double labeling of macrophages, smooth muscle cells, and apolipoprotein E in the atherosclerotic plaque.

To find out which cell types in the atherosclerotic plaque are actively involved in apolipoprotein-secretion, we stained tissue samples from the ascending aorta of patients undergoing coronary bypass surgery. We used monoclonal antibodies against macrophages, smooth muscle cells and apolipoprotein E. The present in situ-study of the atherosclerotic plaque has shown that apolipoprotein synthesis is predominantly secreted by macrophages transformed into foam cells. Besides this, there are obviously some smooth muscle cells equally transformed to foam cells, which also carry apolipoprotein E in their cytoplasm. Our data suggest that both cell types in the atherosclerotic plaque are actively involved in apolipoprotein secretion.

Apolipoproteins E↗