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Biomedical subjects

W Wöckel

Publications and source records attributed to W Wöckel.

At least 19 recordsLinked to original sources
PubMed1992

Giant cell granuloma of the lung.

In a 50-year-old man without bronchopulmonary symptoms a round mass lesion close to the hilum of the right lung was detected in a routine chest x-ray and confirmed by computed tomography. Histological examination of two biopsy specimens did not result in a definitive diagnosis. Therefore thoracotomy with enucleation of the focus was performed. The histological picture of the lesion is characterized by connective tissue proliferation, multinucleated giant cells, ossification, localised hemorrhage, deposits of hemosiderin and foci of foam cells. The findings are interpreted as a giant cell granuloma of the lung.

Granuloma, Giant Cell↗
PubMed1992

[Thoracic actinomycosis versus bronchial cancer].

We report on 4 thoracic actinomycoses; in three of these four cases a bronchial carcinoma was suspected, and in case No. 2 this carcinoma had been considered to be in a very advanced and inoperable stage. A man of 51 years of age was in a generally run-down condition. He also noticed that his sputum was tinged with blood. The x-ray film showed a large space-occupying growth at the right lung hilus. Repeated perbronchial biopsies of the focus did not yield any diagnosis. Actinomycosis was identified histologically only in the tissue samples obtained via thoracotomy. After a three-month penicillin course the hilar shadow receded. A 61-year old male patient was transferred to our Pneumological Hospital, being strongly suspected of suffering from an extensive bronchial carcinoma, and having multiple intrathoracic space-occupying growths as well as pleural effusions, a pericardial effusion, and an infiltration of the left thoracic wall with fistula formation; however, histological examination of skin biopsies revealed that he was suffering from actinomycosis. Antibiotic therapy cured him completely in a six-month course. In a man of 32 years of age who had been indulging for many years in a severe abuse of nicotin, we suspected a central bronchial carcinoma on the basis of his x-ray, but histology of the tissue taken from the space-occupying growth via diagnostic thoracotomy revealed that this patient, too, suffered from actinomycosis. Complete recession occurred after several months of antibiotic treatment. A woman of 82 years had been an inpatient for several months in another hospital because of relapsing pleuropneumonias on the right side. She was transferred to us as an outpatient after a renewed relapse. We conducted a transcutaneous fine-needle biopsy of the right indurating pleural effusion. A few actinomyces filaments were seen on histological examination of the purulent exudate. Hence, actinomycosis was confirmed. After antibiotic therapy the finding receded completely.

Actinomycosis↗
PubMed1991

[The morphology and clinical picture of epithelioid hemangioendothelioma of the lung].

A 36-year-old woman presented with multiple shadows, up to 1 cm in diameter, in both lungs revealed by routine chest radiography. Right thoracotomy showed numerous firm nodules in the middle and lower lobes. Histological examination of the wedge biopsy disclosed an epithelioid haemangioendothelioma of the lung (positive immunohistochemical reaction for factor VIII-associated antigen). Eight years later the patient remains symptom-free without treatment and the radiological picture is almost unaltered. Another woman, 22 years old, had a skin nodule near the right external malleolus. It was removed and found to be a semi-malignant haemangioendothelioma. Five years later a chest radiograph showed finely nodular shadowing in both lungs which roused suspicion of sarcoidosis. She had steroid therapy for one year, but the radiological findings remained unchanged. After a further 10 years a round lesion, some 3 cm in diameter with partial calcification, was found in the right lower lobe. Histological examination revealed an epithelioid haemangioendothelioma with a positive immunohistochemical reaction for factor VIII-associated antigen. She subsequently complained of severe pain in the left shoulder (with histologically demonstrated bone involvement by the neoplasm) together with rapidly increasing dyspnoea. Seventeen years after the original diagnosis she died of rapidly progressive diffuse lymphangiomatosis carcinomatosa. Post mortem secondary deposits were found in the liver as well.

Adult↗
PubMed1991

Pulmonary myofibroblastic nodules with "amianthoid features".

Two consecutive publications appeared 1989 in the same number of a medical journal, which reported peculiar spindle-cell tumors with dense collagen or hyaline nodules, exclusively in inguinal lymph nodes of adults. The first series of 22 cases bore the title "Palisaded myofibroblastoma, a benign mesenchymal tumor of lymph node", the second with 6 identical cases "Intranodal hemorrhagic spindle-cell tumor with "amianthoid" fibers". The following case report deals with a similar tumorous lesion, with multiple small pulmonary nodules, without recognizable lymph node constituents.

Biopsy↗
PubMed1991

[Contribution to graphite dust lungs].

This is a report on a male patient of 71 years of age who had been a graphite mill worker for about 14 years. Despite respiratory insufficiency he was rejected in 1985 as an applicant for being recognised as a victim of a professional disease, because the radiologically visible changes in the lung were only discrete. Perbronchial lung biopsy was performed in January 1990 as his dyspnoea increased. Histological examination revealed graphite dust disease of the lung. Asteroid bodies in multinucleated giant cells were an unusual finding. Energy-dispersing x-ray microanalysis proved that the so-called graphite dust disease lung was actually a type of mixed dust pneumoconiosis.

Aged↗
PubMed1990

[Morphology and clinical picture of thymus carcinoid].

A large mediastinal tumour was discovered radiologically in a 50-year-old man, with at times blood-tinged sputum and dyspnoea. Parasternal needle biopsy revealed a thymic carcinoid. After surgical excision of the tumour, which had argyrophilic foci (total weight of tumour 1,605 g), histochemical analysis demonstrated neuron-specific enolase, synaptophysin and chromogranin, as well as calcitonin (as the only hormone). For the first time in a thymic carcinoid, radioimmunoassay demonstrated growth-hormone-releasing hormone (2 micrograms/g tumour tissue). Post-operative radiotherapy (total dosage 50.5 Gy) was instituted because histological examination had shown invasion of the capsule and blood vessels. There has been no local recurrence or metastases after three years.

Biopsy, Needle↗
PubMed1990

Tuberous sclerosis with pulmonary involvement.

Pulmonary involvement in tuberous sclerosis (pTS) is very rare and seems to be associated with a more benign course, compared to tuberous sclerosis without pulmonary manifestation (TS). Furthermore, pTS seems to be related to lymphangiomyomatosis (LAM). We present the case of a 33-year-old woman in whom the overlap of TS, pTS and LAM is demonstrated. Treatment with medroxyprogesterone was initiated, but without success.

Adult↗
PubMed1990

[Hermansky-Pudlak syndrome in 2 brothers with lung fibrosis].

This is a report on two brothers with the Hermansky-Pudlak syndrome who developed pulmonary fibrosis. In the first, a gradual course lasting 13 years was observed, the patient finally died of long-standing colitis. His brother died of progressive respiratory failure 15 months after the subjective onset of the disease. Immunosuppressive therapy proved ineffective.

Adult↗
PubMed1990

[Clinical aspects, morphology and long-term follow-up--retrospective study of 23 thymoma patients].

Twenty-three patients with a thymoma diagnosed in the period between 1967 and 1987, were investigated retrospectively. In all the patients, the major therapeutic procedure performed had been surgery. The most important factor for the prognosis proved to be the tumour stage established at surgery. In locally non-invasive thymomas, the long-term prognosis is unimpaired. In cases showing invasion of the capsule or surrounding tissue, the prognosis deteriorates markedly, in particular in thymomas in which radical surgery is not possible. For this reason, in all stages with microscopically or macroscopically recognisable invasion, local postoperative radiation treatment is recommended. The histological classification in accordance with various proposals made in the literature has no apparent prognostic value.

Follow-Up Studies↗
PubMed1989

[Bronchocentric granulomatosis].

We describe the case of a 53-year-old woman patient with recurrent attacks of fever, in whom, both roentgenologically and computer-tomographically, a shadow was found in the anterior upper lobe segment of the right lung, and a presumptive diagnosis of a tumour in underlying retention pneumonia was established. For this reason, this segment was resected. The histologic work-up of the surgical specimen revealed bronchocentric granulomatosis. The clinical and morphological findings, together with differential diagnostic considerations of this relatively rare disease, are discussed.

Biopsy↗
PubMed1988

Primary spinal medulloblastomas?

Two cases with spinal medulloblastoma are presented in which even modern neuroradiological methods (computed tomography - CT - and nuclear magnetic resonance imaging - NMR -) did not demonstrate intracranial lesions. These cases should be considered to be primary spinal medulloblastomas, even if until now the existence of real primary spinal medulloblastomas has been doubted.

Adolescent↗
PubMed1987

[Bronchocentric granulomatosis as a manifestation of allergic bronchopulmonary aspergillosis without bronchial asthma].

A 17-year-old girl developed fever, cough and hemoptysis, as well as bouts of septic fever, dyspnea on exertion, cyanosis and weight loss. Opacification in the left lower lung was a persistent feature. Complement-fixation reaction to Aspergillus fumigatus was 1:80, and there were four precipitation lines against this fungus on immunoelectrophoresis. Aspergilli were also demonstrated in sputum and bronchial aspirate. Because the patient's condition deteriorated an atypical lingula resection was performed and cortisone treatment begun postoperatively. Subsequently all abnormal findings disappeared and the patient was cured. Two subsequent exposures to Aspergillum on the parental farm produced high fever, cough, dyspnea and thoracic pain. Histological examination of the lingular specimen revealed bronchocentric granulomatosis. In this case it was the rarely occurring morphological manifestation of an allergic bronchopulmonary aspergillosis without bronchial asthma.

Adolescent↗
PubMed1986

[Congenital unilobar pulmonary lymphangiectasis].

A left upper lobectomy was performed on a 27-day-old male infant with clinically suspected congenital lobar emphysema. At operation a cranial pericardial hiatus was also noted. The infant died ten days postoperatively of a septicaemia of extrapulmonary origin. An autopsy was not performed. Histologic examination of the left upper lobe revealed the changes to be pulmonary lymphangiectasis, which is only rarely unilateral or unilobar. In this infant alveolar rupture is thought to have provided air entry into the primarily ectatic lymphatic vessels with further spread of air. The clinical symptoms were due to this complication. This interpretation is supported by the finding of numerous foreign-body giant cells in the lymph vessels, an extraordinary finding in congenital pulmonary lymphangiectasis.

Diagnosis, Differential↗
PubMed1986

Excessive epithelioid cell granulomatous reaction associated with a lymphoepithelial carcinoma (Schmincke-Regaud).

We report on a 56-year-old man in whom histologic examination of "granulation tissue" from the right lower meatus of the nose revealed the presence of an undifferentiated nasopharyngeal carcinoma of the lymphoepithelial type (Schmincke-Regaud). The diagnosis was supported by serologic detection of antibodies against the Epstein-Barr virus. Approximately 3 weeks after the first excision, biopsy material was taken from the epipharynx. Histologically a marked epithelioid cell granulomatous reaction was found. As an unusual feature, granulomas were not located between tumor cell complexes, but rather contained tumor remnants in their center. At tissue site all transitions from well preserved to completely necrotic tumor cells were discernible. This unusual reaction probably represents a strong, favorable immunologic response against the neoplasm.

Carcinoma, Squamous Cell↗
PubMed1979

[Metastasising squamous-cell carcinoma of the skin in a ten-year-old girl].

Because of recurrent paronychia of the right thumb "granulation" tissue was removed from the nail-bed of a ten-year-old girl. Histological examination revealed a cornified squamous-cell carcinoma. About five months later a lymph-node metastasis was found in the right axilla. After radical dissection of the axillary region further lymph-node metastases were found, as well as a lymphangitic carcinosis with tumour infiltration in the veins. Despite telecobalt radiation there were recurrent retastases which could no longer be removed by operation. Two years after the diagnosis the girl died. Necrospy revealed diffuse tumour infiltration of the soft tissue of the axilla, upper arm, shoulder, neck and thoracic wall on the right, including the breast tissue, with thoracic para-aortic-abdominal and left-sided axillary lymph-node metastases, and lung and pleural metastases bilaterally.

Age Factors↗