0000000000021642
AUTHOR
H. J. Rumpelt
Human chromophobe cell renal carcinoma
Twelve renal cell carcinomas composed of "chromophobe" cells are described. This is the first report of renal chromophobe cell tumors in humans neoplasms of this cell type having been described previously only in experimentally induced adenomas in animals. By light microscopy chromophobe cells have slightly opaque or finely reticular cytoplasm when stained with haematoxylin and eosin. They may be distinguished from the clear cells of hypernephroid renal cell carcinomas by the strongly positive reaction of their cytoplasm with Hale's (1946) colloidal iron method and the weaker positive reaction with alcian blue. Vesicular structures, often containing internal vesicles, and possibly derived f…
Experimental Evaluation of a New Electromagnetic Shock Wave Source
Clinical application of new shock wave sources always warrants prior experimental evaluation of the stone disintegration capabilities and characterization of the shock wave impulses. The least possible tissue traumatization is necessary for successful clinical introduction. After the spark-gap generation of shock waves with semi-ellipsoid focussing had been introduced to the urological armamentarium for extracorporeal destruction of renal and ureteral stones in 1980 (Chaussy 1982), new modes of shock wave generation have been developed. In cooperation with the Siemens Company of Erlangen, Germany, a new electromagnetic shock wave source was evaluated by in vitro and in vivo animal experimen…
The obsolescent renal glomerulus ? Collapse, sclerosis, hyalinosis, fibrosis
By light and electron microscopical examination it is shown that four structural components can contribute to obsolescent glomeruli: capillary basement membranes, enriched mesangium matrix, “vascular” hyalin and collagen fibers. Each of these components can bring about glomerular damage alone. One non-reactive form — a glomerular collapse with only basement membrane remnants — can be separated from three reactive forms: the accumulation of mesangium matrix (sclerosis or matrix-sclerosis), deposition of vascular hyalin (hyalinosis in the narrow sense), and fiber development within the former urinary space (fibrosis or fibro-sclerosis). The use of the term “fibrinoid” in place of the descript…
Structure and closure mechanism of the human umbilical artery
The structure of the fully-patent umbilical artery and rearrangement of its structural elements with postnatal closure were examined in 10 centimeter long umbilical cord segments which were double-clamped at different time intervals after delivery. The fully-patent umbilical artery consists of two main layers: an outer layer of circularly arranged smooth muscle cells and an inner layer which shows rather irregularly and loosely arranged cells embedded in abundant metachromatic ground substance. No predominantly longitudinal arrangements of cells and fibers reported by earlier investigators could be identified in the inner layer. Closure of the umbilical arteries is initiated by numerous loc…
Epitheloid Hemangioendothelioma of the Scalp
A case of an epitheloid hemangioendothelioma of the skin and subcutaneous tissue of the scalp is described. Clinically and histologically a (metastatic) carcinoma had been considered in differential diagnosis. Of great help in recognition of the endothelial nature of this tumor was the immunohistochemical reaction with Factor-VIII associated antigen and Ulex europaeus antigen. Not only tumor cells in solid areas, but also intracytoplasmic vacuoles revealed positive staining. Thereby it could be shown, that this paranuclear vacuoles are actually compatible with developing capillary lumina. Only few tumor cells showed positive reaction with alpha-1-antichymotrypsin, pointing to a possible sma…
Ultrastructure of alcoholic hyalin and fate of the affected hepatocytes
In liver biopsy specimens, foci of satellitosis, i.e., foci of alcoholic hyalin containing hepatocytes surrounded by accumulated leukocytes, were studied by means of electron-microscopic investigation. Within satellitosis hepatocytes, the same morphologic variants of alcoholic hyalin were observed as formerly described in nonsatellitosis liver cells: (1) clusters of randomly oriented smooth filaments of homogenous electron density, (2) bundles of filaments aligned in parallel arrays and exhibiting irregular densities and indistinct boundaries, and (3) masses of a strongly osmiophilic amorphous material, presumably lipidic in nature. The individual hyalin body was composed of one, two, or al…
Histaminkonzentration in Nebenschilddrüsentumoren und Plasma mit Untersuchungen zur Mastzelldichte beim primären und sekundären Hyperparathyreoidismus
Aus in vitro-Untersuchungen von menschlichen Epithelkorperchentumoren ist bekannt, das diese uber Histaminreceptoren verfugen. An Einzelzellsuspensionen stimuliert Histamin die Freisetzung von Parathormonen (PTH), wahrend die H1- bzw. H2-Receptorantagonisten Promethazin und Cimetidin die basale und histaminstimulierte PTH-Sekretion konzentrationsabhangig supprimieren (2, 4). Da die bisherigen Therapieversuche mit Cimetidin beim Hyperparathyreoidismus (HPT) zu widerspruchlichen Ergebnissen fuhrten (5), ist es umstritten, ob diesen in vitro-Befunden eine pathogenetische Bedeutung bei der Nebenschilddrusenuberfunktion zukommt.
Angioma-Like Pseudometamorphosis in Wilms' Tumors Subjected to Preoperative Radio- and Chemotherapy
Six Wilms' tumors (stage III-V), which had undergone preoperative irradiation and chemotherapy, were examined histologically. While mesenchymal and differentiated epithelial tumor elements were preserved to a large extent, blastemic tumor structures were almost completely lacking. Instead, pseudoangioma-like structures similar to cavernous hemangioma prevailed. As demonstrated by transitional pictures, the pseudoangioma-like pattern is a result of the fact that blastemic tumor elements are replaced by blood after therapy-induced necrosis and lysis. The clinical advantages of preoperative treatment are briefly discussed, especially for patients with advanced tumors.
Assoziation einer arteriellen Verschlußkrankheit mit Ciclosporin-Therapie nach Nierentransplantation
Renal transplantation followed by immunosuppression with cyclosporine (whole-blood levels 200-300 micrograms/l) and methylprednisolone (4 mg daily) was performed in a 54-year-old man with chronic glomerulonephritis. Three years later rapidly progressive arterial obstructive disease (peripheral type) developed. Parenteral treatment with prostaglandins, calcium antagonists and nitrates, as well as a lumbar sympathectomy, was unsuccessful so that, in rapid succession, several amputations on upper and lower limbs became necessary. The disease progression was arrested only when azathioprine replaced cyclosporine. Raynaud's phenomenon, present at the time, also disappeared and analgesics were no …
Sekundäre Achalasie bei niedrigmalignem Non-Hodgkin-Lymphom und Leiomyomatose der Kardia
A 28-year-old man had been dysphagic for 9 months with a weight loss of 4 kg. A preliminary diagnosis of primary achalasia was made on the basis of typical radiological and manometric findings. Despite balloon dilatation of the cardia the symptoms did not improve and further diagnostic tests were performed. Ultrasound demonstrated a 4 cm tumour below the cardia. But its type and possible malignancy remained uncertain even at laparotomy. But as a malignant tumour was suspected a gastrectomy and omentectomy with removal of the local and regional lymph nodes were performed. After this the symptoms regressed and postoperative food intake was without problem. Histological examination of the surg…
Autosomal dominant polycystic kidney disease—in vitro culture of cyst-lining epithelial cells
The major form of autosomal dominant polycystic kidney disease (ADPKD) in humans is linked to the PKD1 gene on chromosome 16p. The identity of the gene and the underlying pathogenetic mechanisms are not yet defined. Cyst-lining epithelial cells derived from a polycystic kidney were successfully grown in culture and designated MZ-PKD-1 cells. By linkage analysis, the related pedigree of the nephrectomized patient could be linked to the PKD1 gene on chromosome 16p. Thus, these cells exhibit the genotype of a mutated PKD1 gene and represent an in vitro culture model for ADPKD involving chromosome 16p. The antigenic phenotype was characterized immunohistologically by epithelial differentiation …
Malignant Rhabdoid Tumor in the Gastric Wall of an Aged Orangutan (Pongo pygmaeus)
A 34-year-old female orangutan ( Pongo pygmaeus) developed renal failure and became uremic. At necropsy, large gastric masses were present around the cardia and in the corpus. Abdominal metastases occurred in the liver, pancreas, and right ovary. Light microscopic examination of the tumor revealed polygonal cells with vesicular nuclei and prominent nucleoli. The growth pattern was predominantly solid. Focal areas contained excentric cytoplasmic intermediate filament inclusions, as identified by immunohistochemistry and electron microscopy. Immunohisiochemical procedures demonstrated mainly the vimentin type of intermediate filaments. Except for occasional cytokeratin, other intermediate fil…
Histopathology and Classification of Renal Cell Tumors (Adenomas, Oncocytomas and Carcinomas)
The term renal cell tumors (adenomas and carcinomas) subsumes the tumors deriving from the uriniferous tubule epithelium of the kidney. Precise analysis shows that the renal cell tumors display different cell types which build up the individual tumor alone or in combination with each other. Three categories of basic elements are distinguished in the characterization of renal cell tumors: Cytological elements = tumor cell types: Clear, chromophobe, chromophilic (basophilic, eosinophilic), oncocytic, spindle-shaped/pleomorphic. Histological elements = growth patterns: Compact, acinar (nest-like), tubulopapillary (tubular, papillary), cystic. Cytological grading of malignancy: G I, G II, G III…
Acute human pyelonephritis: Leukocytic infiltration of tubules and localization of bacteria
The fine structural details of how leukocytes appear in the lumen of tubules and the localization of bacteria in the tubulo-interstitial space were studied by light and electronmicroscopy in renal cortical biopsy specimens from three patients with acute pyelonephritis. The cells of interstitial infiltrates infiltrated and sometimes disrupted the cortical collecting tubules preferentially, while inflammatory infiltration of the proximal and distal convoluted tubules occurred more rarely. Since the emigration of tubular wall-localized individual leukocytes into the lumen was not observed even in long series of thin sections, focal inflammatory disruption of the uriniferous ducts was considere…
Chromophobe cell renal carcinoma and its variants--a report on 32 cases.
This paper reports on 32 chromophobe cell renal carcinomas observed in 697 renal cell cancers (RCC) of adults (peak in the sixth decade of life). The chromophobe cell-type differs from other types of RCC macroscopically, the cut-surface being predominantly of grey-beige colour. Histologically, there are two variants: one is the typical (light) variant (n = 22) and the other is eosinophilic (n = 10). Both variants have in common (a) reaction of the cytoplasm with Hale's acid iron colloid; (b) electron microscopic detection of cytoplasmic microvesicles (150-300 nm), frequently with 'inner vesicles', and (c) low glycogen content in comparison with the clear cell carcinoma. Immunocytochemical i…