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PubMed1976

Carcinoma and dysplastic lesions of the prostate. A histomorphological analysis of 50 total prostatectomies by step-section technique.

50 prostate carcinomas which were totally prostatectomized together with removal of the seminal vesicles in all cases and pelvic lymphadenectomy in 38 cases were studied histologically. The material was cut by step-section technique in 5 mm thick slices and "large area slides" were made. 4 of the 50 carcinomas were morphologically circumscribed (stage I), 6 tumors were limited to the organ (stage II) and 40 prostate carcinomas had already penetrated the capsule, i.e. fascia of Denonvillier (stage III). In 12 cases the seminal vesicles were involved, regional lymph node metastases were seen 8 times. The carcinomas were mainly localized in the peripheral part of the organ (28 X in the periphery, 21 X both peripherally and centrally and only 1 X in the centre). Multifocal tumor growth was found in 30 cases (60%). The main mass of tumor was mostly situated in the middle (25 X) and caudal (15 X) zone of the prostate. During the course of tumor growth the expansion was directed centrally but then mainly longitudinal and parallel to the urethra. By progressing tumor volume there was a noticeable increase in capsular penetration as well as infiltration of the seminal vesicles and lymph node metastases. Histologically 10 carcinomas showed a uniform pattern, a unique solid and/or cribriform tumor architecture was never observed. 90% of the pluriform carcinomas consisted of the morphological stage III.

Adenocarcinoma↗

PubMed1977

Age changes of the human optic nerve head. A neurohistologic study.

Eleven human optic nerves from subjects in different decades ranging from the fifth to the ninth were investigated with the silver carbonate method to establish the pattern and frequency of age changes within the optic nerve head and their relationship with the glaucomatous excavation. It has been found that despite the occurrence of age degeneration at the same level of the cribriform lamina, there are definite anatomical differences as compared with glaucoma changes, especially regarding the distribution of axonal damage.

Age Factors↗

PubMed1979

The trabecular meshwork of a non-glaucomatous eye with the exfoliation syndrome. Electronmicroscopic study.

The trabecular meshwork of a non-glaucomatous eye with the exfoliation syndrome was investigated. The exfoliation material was found mainly in massive deposits in the subendothelial region of the outer and inner wall of Schlemm's canal, in the cribriform area and the uveal meshwork. The other alterations of the trabeculum corneosclerale corresponded to the age of the patient. The concept that the accumulation of exfoliation material is an important pathogenetic factor in the development of glaucoma was not confirmed by this study.

Aged↗

PubMed1979

Histopathology of 30 non-operated acoustic schwannomas.

Thirty of 1720 temporal bones from the Wittmaack's Collection contain nonoperated acoustic neuromas, 22 of them large tumors. Histologically, each tumor has to be considered as an individual. Most of the tumors show a mixture of Antoni type A and B. Tumor vascularization is pronounced in half the cases. Vessels of the internal acoustic meatus are found in all cases. Protein contents of the perilymphatic spaces is medium to pronounced in 23 of 30 cases in comparison to the small protein contents of the healthy side. Ganglion geniculi is invaded in 11 cases (9 von Recklinghausen's disease), Ganglion Scarpae in 26 cases (9 von Recklinghausen's disease), and Ganglion spirale in 9 cases (7 von Recklinghausen's disease). Cochlear and vestibular nerve fibers within the internal auditory meatus were affected by the tumor in 28 of 30 cases, the facial nerve only in 11 cases, among them 9 cases of von Recklinghausen's disease. Twenty-six of 30 schwannomas have a portion within the cribriform area of the cochlea fundus, which explains the limitation to radical tumor surgery without damage of the cochlear nerve. These histological findings explain the site of damage of hearing to expand between the cochlea to the auditory brain stem nuclei, and support the audiological experience that a correlation of "acoustic neuroma" and "retrocochlear lesion" is often not correct.

Adolescent↗

PubMed1975

Cryptophthalmos syndrome with basal encephaloceles.

A 2,144-g white girl was born with absence of the right ear and eye, cleft lip and palate, two basal encephaloceles, tricuspid atresia, ventricualr and atrial septal defects, detransposition of the great vessels, right aortic arch, and aberrant right subclavian artery. Through an oval defect in the center of the sphenoid bone, soft tissue protruded into the right nasopharynx. The medial portions of the roof of both orbits and the cribriform plate were absent and soft tissue protruded through this bony defect. Basal tomography was required to demonstrate the encephaloceles, which should be suspected in any child with a median cleft syndrome, a flat broad nasal root, and hypertelorism.

Abnormalities, Multiple↗

PubMed1978

Facial duplication -- the unique case of Antonio.

A case of facial duplication with its surgical correction in childhood and the consequences on facial growth is reported. It is a unique case in the duration of observation. The following structures were fully duplicated: the nose, the premaxilla, the cribriform plate, the crista galli. In addition there was an enormous facial cleft including lip, alveolus and palate. Additionally there were two rudimentary eye sockets, eyes, and two supplementary eyebrows. The monstrous hypertelorism with the facial duplication was corrected at the age of ten. The surgical procedure is described and the postoperative complications are discussed. Gross lack of growth of the middle third of the facial skeleton was observed. This was probably the consequence of the initial corrective surgery. Overgrowth of the mandible created a gorilla-like appearance by the end of the growth period. This was corrected in one operation by advancement of the middle third in three sections and repositioning of the mandible as a whole together with the mandibular anterior alveolar segment. Finally all parts of the lower half of the nose had to be enlarged, both soft tissues as well as the cartilaginous framework. A pharyngoplasty in addition to the correction of the intermaxillary abnormalities did much to improve the speech quality of the patient. A large secondary cranial defect was successfully reconstructed with the use of 14 halved ribs. In spite of the removal of four ribs from one side and three ribs from the other, there were no postoperative respiratory problems. Spontaneous rib regeneration was found where ribs had been removed one year earlier.

Adolescent↗

PubMed1978

[Tomographic findings in C.S.F. fistulae (author's transl)].

The majority of C.S.F. fistulae are of traumatic origin and in order to avoid the threat of meningitis, they require operative closure. For the demonstration of the fronto-basal defects, multi-dimensional tomograms in various planes have proved very valuable. In 28 patients examined in the Radiological University Clinic (Münster), defects were most common in the cribriform plate. In addition to a break in its contour, one can find displacement of fragments, step formation, opacification of the adjacent nose or sinuses or intracranial air. 88% of defects could be localised in this way. The tomograms were not helpful in two very small fronto-basal fractures.

Adolescent↗

PubMed1978

Proliferative serous tumors of the ovary. Histologic features and prognosis.

In reviewing all proliferative serous tumors of the ovary seen at Barnes Hospital from 1950 to 1974, we quantitated histologic characteristics and defined criteria for diagnosis in 55 borderline tumors, 13 well-differentiated cystadenocarcinomas, and 15 cystadenomas with unusual proliferative areas. This last type with focal proliferation behaved in a benign fashion and should be considered a variant of a simple cystadenoma. Stromal invasion was the only histologic feature which consistently distinguished carcinomas from the borderline tumors. The presence in some borderline tumors of severe cellular atypia, marked epithelial disorganization, frequent mitoses, and cribriform glands in the stroma neither signified carcinoma nor indicated poor prognosis. No patient with a Stage I borderline lesion died of tumor. Although the mortality of patients with Stage IIb or Stage III borderline tumors is high, tumor-related deaths rarely occurred before 5 years, and three patients lived more than 10 years. Borderline serous tumors are low-grade malignant neoplasms which differ from overt carcinomas in the excellent prognosis of Stage I lesions and in long survival even with widespread abdominal disease.

Cystadenocarcinoma↗

PubMed1979

Cerebrospinal fluid rhinorrhea following nasogastric intubation.

This report describes a normal individual who sustained injury to the cribriform plate during nasogastric intubation. Cerebrospinal fluid rhinorrhea, a potentially fatal complication, resulted and persisted for 5 months until it was surgically corrected. The relevant anatomy is reviewed and the importance of proper technique of nasal cannulation, with minimal or no use of force, or other instruments, is emphasized. The leading end of the tube should not be directed cephalad.

Cerebrospinal Fluid Rhinorrhea↗

PubMed1975

A qualitative and quantitative electronmicroscopic study of the structure of the adenoid cystic carcinoma of human minor salivary glands.

The fine structural characteristics of five adenoid cystic carcinomas of human minor salivary galnds and a quantitative assessment of the relative volumes occupied by morphologically defined cell types in these tumors are reported. We observed that the cyst-like spaces which give the characteristic cribriform pattern to the adenoid cystic carcinoma contain replicated basement membrane-like materail. Material comprisimg aggregates of fine tubules having a median diameter of 270 A, and rounded, electron dense bodies were noted within duct-like lumena of one tumor. In addition, dilatation of the intercellular spaces and squamous metaplasia were noted. From 500 electronmicrographs obtained by standardized techniques and used for the morphological part of the study, 175 were selected by a random sampling method and analyzed by the stereological technique of point counting. This method demonstrated that duct type cells occupied 75% by volume of the tumor in these glands; myoepithelial cells occupied 3%, acinar cells occupied 2%, and other tissues occupied 22% of the tumors. These proportions differ significantly (P less than 0.001) from our previously published figures for normal specimens of these glands.

Basement Membrane↗

PubMed1978

Optic disc cupping and prematurity. Large cups as a possible low birth weight sequel.

In a previous ophthalmic study of ex-prematures around the age of 10 years it was accidentally found that cupping of the optic disc was significantly more pronounced in children of a low birth weight (less than 2000 g) than in full-term controls (Fledelius 1976). This was true for cup size (cup/disc diameter ratio) as well as depth (as indicated by a visible cribriform plate). The present analyses make up an extension of the above study, with additional calculations based on some of its data. Within the ex-prematures (n = 268) the cup size did not seem to be related to birth weight, sex, or visual acuity. Eyes with myopia of prematurity were not especially 'loaded' with large cups. For the whole sample (including the 187 full-term control there was a weak association between cup size and refraction (and axial eye length). Larger cups occurred relatively more often in myopic eyes. Possible mechanisms behind early changes in disc are discussed (astroglial hypothesis--distension of disc--loss of retinal nerve fibers). It is felt that this new observation--large disc cupping as a possible low birth weight sequel--has to be substantiated by further clinical evidence, as statistical type 1 error (mass significance) cannot be ruled out.

Child↗

PubMed1975

Adenoid cystic carcinoma of the breast: prevalence, diagnostic criteria, and histogenesis.

Three cases of adenoid cystic carcinoma have been identified in a 10-year review of 2686 cases of breast carcinoma. The criteria necessary for diagnosis have been reviewed with particular reference to cribriform intraduct carcinoma and adenocarcinoma of the breast with small, dark, 'basaloid'-cell pattern. The most important single diagnostic criterion of adenoid cystic carcinoma is a biphasic cellular pattern which may be aded by the demonstration of two types of mucin stromal acid mucopolysaccharide and ductal neutral mucopolysaccharide. This tumour most frequently presents as a painful or tender mass near the areola, and it carries a uniquely favourable prognosis when compared with similar tumours elsewhere in the body. Actomyosin has been demonstrated in all three tumours by an immunofluorescent method, and this supports a predominantly myoepithelial origin.

Actomyosin↗

PubMed1979

Extracranial meningioma presenting as a nasal polyp.

The extracranial occurrence of meningiomas is summarized. A patient suffering from repeated episodes of epistaxis presented with a lobulated nasal polyp which was found to be a meningioma. At subsequent radical removal, the extracranial location in the nose, ethmoidal region and cribriform area was verified.

Diagnosis, Differential↗

PubMedDate not supplied

Esthesioneuroblastoma: diagnosis and treatment.

Esthesioneuroblastoma is a nasal tumor which arises from cells of neural crest origin. It is a difficult tumor to diagnose clinically and histopathologically. First described in 1924, approximately 160 cases have been reported with over 125 of these in the last 15 years. This reflects an increased awareness of the tumor by physicians rather than an icreased incidence. In the past 17 years, 12 cases of esthesioneuroblastoma have been treated at the Department of Otolaryngology and Maxillofacial Surgery of the University of Virginia Medical Center. Reviewing these cases and the literature leads us to make the following recommendations for diagnosis and treatment: The diagnosis of esthesioneuroblastoma can be made by 1) the clinician who suspects it in any patient with a nasal mass causing unilateral obstruction; 2) the finding of plexiform intercellular fibrils by light microscopy (rosettes and pseudorosettes are not as common as reported); 3) the finding of secretory granules and neurites by electron microscopy of the highly undifferentiated tumors; and 4) formaldehyde-fume-induced fluorescence. Combined therapy with preoperative irradiation followed by craniofacial resection of the tumor to include the cribriform plate is recommended. This treatment should result in a five-year survival in excess of 50% of patients.

Adult↗

PubMedDate not supplied

Cholesteatoma of the frontal and ethmoid areas.

Cholesteatomas of the frontoethmoid region must always be considered in the differential diagnosis of a mass in the frontoethmoid region. A painless, slow-growing mass, often accompanied by proptosis and diplopia, but without history of trauma or infection, should make one suspect of this pathologic entity. Although histologically a benign lesion, the keratinizing squamous epithelial lining will continue to desquamate and expand, leading to erosion of surrounding structures which could be life-threatening. In order to prevent recurrence, complete removal of the cyst lining is mandatory. Cosmetic reconstruction, often requiring obliteration of the surgical cavity, should be delayed for one year to insure against recurrence of the covering of active squamous tissue adjacent to dura, cribriform plate or ocular structures.

Adult↗

PubMed1978

Traumatic cerebrospinal fluid fistula simulating tears. Case report.

A young child developed delayed cerebrospinal fluid (CSF) rhinorrhea and CSF leak from the eye presenting as tears. The "tears" were CSF which had tracked from the cribriform plate through the ethmoidal air sinuses to the medial aspect of the left orbit. There was marked chemosis and it was considered likely that the tears had leaked through damaged conjunctiva.

Accidents, Traffic↗

PubMed1979

Studies on cell surface conformation following injury. II. Scanning and transmission electron microscopy of cell surface changes following anoxic injury in Ehrlich ascites tumor cells.

Exposure of Ehrlich ascites tumor cells to anoxia resulted in rapid and characteristic conformational changes of cell surface topography. Combined scanning and transmission E/M studies revealed rapid alterations including simplification of the cell surface configuration with disappearance of microvilli which were replaced with formation of blebs and recesses at the cell periphery. These surface changes were accompanied by characteristic organelle alterations inside the cells which in this and other cellular systems have been shown to be reversible. Later, the cell surface topography became smoother and monotonic with small blebs and cribriform invaginations in addition to larger eruptions of the cell periphery. Combined transmission E/M studies revealed fragmentation of cellular membrane systems and lysis of organelles indicating the irreversible phase of anoxic injury. The rapid conformational surface changes encountered in Ehrlich ascites tumor cells following anoxia suggest the important role of the plasma membrane and its unfolding as a virtually instantaneous response of the cells to this injury.

Animals↗

PubMed1979

[Electronmicroscopic studies of the trabecular meshwork in corticosteroid glaucoma].

The tissue specimen of a 41-year-old patient with cortisonglaucoma, obtained by trabeculectomy, was examined by electronmicroscope. There are massive depositions of band-like and linear arranged structures in the cribriform area and adjacent lamellae of the trabeculum corneosclerale. The pathways for aqueous humor of this region are almost completely obstructed by this material. That is the reason for an increased outflow resistance. The cells of this area show signs of degeneration and are reduced in their numbers. -- The cortisonglaucoma differs from all the other forms of glaucoma especially from glaucoma simplex by these characteristic deposits.

Adult↗