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Biomedical subjects

W Kühn

Publications and source records attributed to W Kühn.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Lymphangiosis carcinomatosa of the skin in ovarian cancer simulating scleroderma].

Skin metastases, as the first site of manifestation of ovarian carcinoma, are very uncommon. A report on a case of dermal lymphatic carcinomatosis of the lower part of the body and the breast with the clinical appearance of scleroderma is made. Skin biopsies were performed several times and an invasion of cutaneous lymphatic vessels by carcinoma cells and psammoma bodies due to ovarian cancer was observed, which led to the correct diagnosis of ovarian carcinoma.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1990

[Extent of psammoma carcinomas of the ovary--a clinical, DNA flow cytophotometric and morphometric image analysis study].

There is no agreement in literature on the biological behavior of psammoma carcinomas of the ovary. The majority of authors consider psammoma bodies to be the result of tumour regression, associating the occurrence of psammoma bodies with longer survival. On the other hand, several studies reveal a poor prognosis for psammoma carcinomas, similar to that of other epithelial malignant tumours. In our study, the psammoma body content in 174 serous carcinomas stage III/IV was morphometrically quantified by image analysis and the results correlated to survival time and progression time. In 20 carcinomas the psammoma body content was extremely high. In such cases, DNA flow cytometry revealed these tumours to be slowly-growing. The DNA index was 1.0 (DNA-diploid) and the number of S phases was low (max. 5.9%). The five year estimate survival was 50%, as opposed to 10% for other tumours. If no methods are available for cell kinetic analysis and for objectification and quantification of psammoma body content in serous carcinomas it is sufficient to make a semiquantitative assessment of the psammoma body content to differentiate tumours with longer survival from carcinomas of poor prognosis.

Cystadenoma↗
PubMed1990

[Clinical aspects and morphology of extra-ovarian serous cancer of the pelvis].

An extraovarian peritoneal serous carcinoma is characterised macroscopically by ovaries without pathology, histologically, however, by a serous carcinomatous structure in the pelvis, in an advanced tumour stage of usually marked peritoneal carcinomatosis. Extraovarian pelvic serous carcinomas are rarely described in literature. In our study on five patients with such carcinomas, laparotomy findings revealed peritoneal carcinomatosis as in advanced ovarian carcinomas, but without ovarian involvement. Histogenesis does not reveal any difference between the extraovarian mesothel, which is of Mullerian origin and the serous ovarian carcinoma. Therapy of extraovarian peritoneal carcinoma is similar to that of ovarian cancer with maximal tumour reduction and cisplatinum or carboplatinum containing chemotherapy. The prognosis is extremely unfavourable with little expectation of lengthy remission and survival rates are short. Extraovarian serous carcinomas deserve better recognition because they are underreported. They must be differentiated from malignant mesotheliomas, which are not of Mullerian origin.

Adult↗
PubMed1989

DNA flow cytometry, clinical and morphological parameters as prognostic factors for advanced malignant and borderline ovarian tumors.

Patients with malignant ovarian (n = 111) and borderline (n = 8) tumors (FIGO stage III/IV) underwent surgery and chemotherapy and were analyzed clinically (age, residual tumor after surgery) and morphologically (type, grade, psammoma body content), and by means of flow cytometry (DNA ploidy, S-phase fraction). Follow-up was 12-72 months for investigation of survival. Patients under 60 years of age (n = 18) with malignant tumors showed longer survival than patients over 60 (n = 93) (P = 0.078). Residual tumor was relevant for prognosis in malignant tumors only if macroscopically there was no residual disease (n = 13). There were no significant differences between residual tumors less than or equal to 2 cm (n = 61) and greater than 2 cm (n = 37). WHO typing was of little importance for survival analysis. Compared to borderline tumors (n = 8), serous (n = 65), endometrioid (n = 13), nonclassifiable (n = 12), mucinous carcinomas (n = 8), and nonepithelial tumors (n = 12) had a poor prognosis. Psammoma bodies were found in 25 patients with serous carcinomas, 7 of them had a high content. The prognosis for these 7 patients was much better than that for patients with a moderate or low psammoma body content (P = 0.006). Twenty-three epithelial tumors were graded G1, 28 were G2, and 47 were G3. However, grading was considered only as a prognostic factor in serous carcinomas (n = 65) (P = 0.028). A total of 199 DNA histograms from 119 patients were analyzed by flow cytometry (FCM). There were no correlations between tumor type and DNA ploidy or S-phase fraction. Seven of eight borderline tumor and all serous carcinomas with a high content of psammoma bodies were diploid combined with a low (less than or equal to 4%) S-phase fraction. DNA ploidy and S-phase fraction were excellent prognosticators. Of 99 epithelial malignant tumors, 35 were diploid and 64 were aneuploid. An S-phase fraction less than or equal to 4% was found in 39 patients, 4.1-10% in 73 patients, and greater than 10% in 23 patients. Diploid tumors and tumors with a low S-phase fraction showed the best survival (P = 0.007, resp. 0.0001). Our study emphasizes the importance of an accurate histology, including information on psammoma body content, and the importance of DNA flow cytometry. The advantage of FCM is that the results are simple, reproducible, and objective.

Age Factors↗
PubMed1989

[Proliferation index, axillary lymph node status, hormone receptors and age as prognostic factors in primary breast cancer].

A total of 233 primary carcinomas of the breast (n = 68 nodal negative and n = 165 nodal positive) of 77 woman patients of less than 50 years of age and pf 156 women patients of 50 years of age or older were examined for the prognostic significance of a proliferation index (in vitro chemoresistance assay). The prognostic significance of the proliferation index (high vs low proliferation) is compared with other prognostic factors that have already been in clinical use (age, axillary lymph node status, oestrogen and progesterone receptor status). The total median observation period was 4.8 years (3-9.1 years). Determination of the proliferation index proved to be the most important prognostic factor both for premenopausal and postmenopausal, nodal negative and nodal positive primary tumours when assessing the total survival time and the time that remains free from recurrences. A simultaneous assessment of low proliferation index and positive hormone receptor as a so-called low-risk situation shows in comparison to a high-risk situation (high proliferation index, negative receptor status) the most pronounced differences. For premenopausal women (younger than 50 years of age) the hormone receptor status has no prognostic significance as far as our group of patients is concerned, whereas for women of 50 years of age or older the receptor status is of great prognostic relevance. Besides the lymph node status, the proliferation index shows in a Cox regression model the greatest prognostic importance for the further course of a primary carcinoma of the breast.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1989

[Cytologic diagnosis of Paget's disease of the vulva].

Unlike exfoliative cytology for detection of cervical neoplasia and its precursors, the cytologic detection of invasive and intraepithelial neoplasia of the vulva still presents some problems. In cases of Paget's disease of the vulva--a special form of intraepithelial neoplasia with typical histological features--primary cytologic diagnosis is possible. The cytologic criteria that led to preoperative detection are demonstrated on two cases of Paget's disease of the vulva. However, a Paget carcinoma has still to be excluded histologically.

Aged↗
PubMed1989

[Giant cell sarcoma: a rare breast tumor].

This is a case report on a giant cell sarcoma or malignant osteoclastoma of the mammarian gland. Clinical diagnosis of this very rare tumor was of an exulcerating breast carcinoma. Histologically, this tumor shows epulis-like giant cells. Pathogenetically, a metaplasia of stromal cells, and of the glandular epithelium, is discussed. A simple mastectomy with extirpation of the axillary lymph nodes was performed. No metastases were found.

Aged↗
PubMed1989

[Prognostic significance of cell kinetic parameters of endometrial cancer].

In 120 patients suffering from carcinoma of the endometrium of a wide variety of histological types, conventional clinical and morphological criteria of prognosis were compared with the DNA index (DI) and the S-phase fraction. The cellular kinetics parameters were obtained via flow cytophotometry. Adenocarcinomas (n = 101) were more frequently DNA diploid and had a lower S-phase share (less than 5%) than adenoacanthomas, clear-cell carcinomas and malignant Müller's mixed tumors. There are close correlations between the conventional prognostic factors such as FIGO stage, relative tumor invasion depth, grading and oestrogen or progesteron receptor content and the DNA content or S-phase fraction. Carcinomas with a DI less than or equal to 1.1 (n = 83) and the S-phase fraction less than 5% (n = 77), have a significantly longer survival time and recurrence-free interval than DNA-aneuploid tumors with a high S-phase fraction. The studies underline the need to use flow cytophotometry in the prognostic assessment of the carcinoma of the endometrium. The method is superior to histological grading, since the results obtained can be objectively assessed.

Aged↗
PubMed1989

[Primary malignant non-Hodgkin lymphoma of the uterus].

Primary extranodal malignant lymphomas of the uterus are rare. Of this type lymphoma of the cervix are the most frequent. This is a case report on a patient with a primary malignant lymphoma of the corpus uteri, who became symptomatic by a meningiosis blastomatosa. By preoperative screening, a large tumor of the uterus was found. Final diagnosis was based on the histology of the curettage material, as well as on laparoscopy and on cytology of the peritoneal fluid. In the initially preterminal patient, chemotherapy led to a complete remission.

Aged↗
PubMed1988

[Ultrasonography in the primary diagnosis and follow up of ovarian tumors].

Preoperative sonographic data in 317 patients who underwent surgery at the University Women's Clinic Heidelberg for an ovarian tumour during a 6 years' observation period, were compared with the results of clinical examination. The prognostic value of both techniques was examined, by relating the findings (as to tumour size, demarcation from the uterus) to the postoperative histological or cytological diagnosis. In the 214 cases of benign and 103 of malignant ovarian tumours a correct diagnosis was provided by ultrasound in 88% and 74% respectively. Thus significantly more often than by clinical examination alone (p less than 0.001 for benign and p less than 0.01 for malignant tumours). The sonographic findings in 49 patients during follow-up after surgery for ovarian carcinoma and polychemotherapy were checked by a second look laparotomy. The detection rate of tumour progression, recurrence, residual tumour or remission was of 98%.

Antineoplastic Combined Chemotherapy Protocols↗