Glomerulopathy associated with predominant fibronectin deposits: a newly recognized hereditary disease.

A newly recognized type of familial glomerulopathy observed in patients of both sexes in six families is reported. Proteinuria, often within the nephrotic range, microscopic hematuria, hypertension and a slowly decreasing renal function over several years were common. No underlying systemic diseases were identified.

[Medial necrosis of the pulmonary artery in ruptured aneurysm].

Fifty years ago the first author of this paper described the entity known as idiopathic medial necrosis of the aorta. The present report describes two cases of ruptured aneurysm of the main pulmonary artery. The histologic alterations of the arterial wall were the same as in the much more common aneurysms of the aorta, viz.

Immunosialadenitis (Sjögren's syndrome) and lymphoproliferation.

The association of primary salivary gland non-Hodgkin's lymphoma (NHL) and immunosialadenitis (myoepithelial sialadenitis, MESA) is well recognized. Within MESA the whole spectrum of lymphoproliferation starting with a prelymphoma transforming into an early lymphoma and later on into a manifest lymphoma can be observed. These lymphomas represent so-called low grade B-cell lymphomas of mucosa associated lymphoid tissue (MALT), an entity also including lymphoplasmocytoid immunocytoma according to the Kiel classification of NHL.

[Chronic pyelonephritis and its differential diagnosis. A disease changing with time].

Chronic pyelonephritis (c.p.) is by definition an infectious tubulo-interstitial nephritis.

Immunostaining in atypical fibroxanthoma of the skin.

We have studied 12 cases of cutaneous atypical fibroxanthoma using immunohistochemistry to demonstrate lysozyme, alpha-1-antitrypsin, S-100-protein, receptors for peanut agglutinin, and intermediate filaments. Results were compared with immunostaining in 24 cases of other so-called fibrohistiocytic tumours. In addition 2 cases of atypical fibroxanthoma and 6 cases of fibrohistiocytic tumours were stained by monoclonal antibodies specific for the monocyte cell lineage (Ki-M1, Ki-M2, Ki-M6, Ki-M7, Ki-M8, OKM-1 and Leu-M1) and double-stained by monocyte-markers and Ki-67.

[Sarcoidosis of the kidney].

Of 123 patients with sarcoidosis observed from 1971 to 1986, 4 had histologically proven renal involvement. Hypercalcemia was present in all of these 4 patients, hypercreatinemia in 3 and urolithiasis in one. Histologically renal interstitial nephritis or fibrosis was found in all 4 cases, and 3 cases showed sarcoid-like renale granulomas.

[Predictive value of additional immunohistochemical studies in histological diagnosis].

No exact information exists on the diagnostic value of immunohistochemistry applied to the routine material of an institute of surgical pathology. For this reason 390 cases additionally investigated by immunohistochemistry were analyzed retrospectively. This method was applied to 0.

[Renal involvement in Legionnaires' disease].

9 consecutive cases of Legionnaires' disease are presented, all of which involved either a pathological urinary sediment or acute renal insufficiency. Diabetic glomerular sclerosis and terminal septic shock in one patient accounted per se for the urinary findings and terminal oliguric renal failure. In the remaining 8 patients the renal abnormalities are interpreted as manifestations of Legionnaires' disease: these were acute renal insufficiency in 6, requiring dialysis treatment in 4, proteinuria in 7, hematuria in 5, leukocyturia in 5 and cylindruria in 3 patients.

[Early stomach carcinoma].

Geographical and epidemiologic investigations in recent years have thrown light on the determining factors in chronic atrophic gastritis and the intestinal type of gastric carcinoma. It is now proven that the majority of early gastric cancers have the exact symptoms of the ulcer type. Diagnosis is by endoscopy and biopsy.

[Rare stomach tumor--cystic leiomyoma in childhood].

We report about a rare gastric tumour of a child and discuss the important literature.

[Bronchial cancer from the viewpoint of 2 neighboring regional cancer registers].

From follow-up examinations on 460 male and 67 female patients with bronchial cancer during the years 1981 and 1982 in the cantons of St. Gallen and Appenzell/Switzerland, as well as from the region of Vorarlberg/Austria various morphological and clinically registered parameters of importance to oncology were comparatively analysed. These regional clinical cancer registers have existed for many years and are recognized legitimately and clinically as an important partial aspect in diagnostic, therapy and prophylaxis of malignant tumours.

[Malignant pericardial effusion--a sign of unfavorable prognosis?].

Malignant pericardial effusion (MPE) resulting in cardiac tamponade is a rare complication in neoplastic disease. From January 1975 to December 1984 the authors observed 22 patients with cytologically verified malignant pericardial effusion. The most frequent primary tumors were non-small cell lung cancer (6), breast cancer (5), non-Hodgkin lymphoma (4) and mesothelioma (4).

[Polar resection in double kidneys in childhood].

78 cases of double kidneys without vesico-uretero-renal reflux, in which a heminephrectomy was done, were histologically investigated. The histopathological results were compared with the clinic and the urogram. It could be demonstrated that the results did not correspond in some cases.

Colorectal cancer: the relationship of staging to survival. A cancer registry study of 800 cases in St. Gallen-Appenzell.

Proper classification of colorectal cancer has been critical in determining prognosis. Dukes' staging and its modifications have created considerable confusion. The TNM system has never been widely accepted because of its complexity.

The adenoma-carcinoma sequence of the colon and rectum.

Morphological and epidemiological arguments in favour of an adenoma-carcinoma concept of evolution in the development of colorectal cancers are presented. It is highly probable that most colorectal cancers arise in adenomas. Therefore detection and endoscopic removal of adenomas is a means of reducing the incidence of colorectal carcinomas.

Evidence of vascular differentiation in anaplastic tumours of the thyroid--an immunohistological study.

Sixteen cases of anaplastic carcinoma (ACA) and 4 cases of malignant haemangioendothelioma (HAE) of the thyroid were studied by light microscopy and immunohistochemistry. Seven cases of ACA and 3 cases of HAE were characterized by coexpression of immunohistological features of epithelial and vascular endothelial cells. Expression of vimentin was common to all tumours investigated.

[Significance of kidney papillae in the pathogenesis of pyelonephritis and reflux nephropathy].

The role of the renal papillae in the pathogenesis of pyelonephritis and reflux nephropathy was studied by endoscopy and histology in adult autopsy kidneys. Compound papillae with a concave area cribrosa of the "reflux type" were found in greater frequency in adults than in children. Acute purulent inflammation in the renal parenchyma or coarse pyelonephritic scars were seen almost always overlying "refluxing" papillae or overlying papillae altered by papillary necrosis, obstructive atrophy and other changes of papillary shape.

Identification of types and primary sites of malignant tumors by examination of exfoliated tumor cells in serous fluids. Comparison with the diagnostic accuracy on small histologic biopsies.

The accuracy of identification of tumor type and primary site of malignant tumors by examination of exfoliated tumor cells was cytologically studied in 448 malignant effusions from 366 patients for whom the primary tumor site had been confirmed by histology. Ninety-seven corresponding small biopsies from metastases were separately reviewed histopathologically. In four fluids, the cells were too scanty or too poorly preserved for tumor typing.

Epithelioid sarcoma.

Epithelioid sarcoma is a malignant soft tissue tumor characterized by its propensity to occur in the distal extremities as a nodular lesion and its slow and asymptomatic growth. Microscopically, the diagnosis is difficult. Therefore the interval between onset of symptoms and diagnosis averages one to three years.

Renal papillary morphology in adults.

Renal papillary morphology and distribution have been analysed endoscopically in 50 adult autopsy kidneys. Concave papillae of the refluxing type were found with greater frequency in the adult kidneys than had been reported by others in children. A further type of calyx lacking a true papilla, not previously described in children, was occasionally observed.

[Secondary malignancies after breast cancer surgery. Comparison of retro- and prospective findings].

Second malignancies (SM) represent one of the potential hazards of modern cancer treatment and especially of radio- and chemotherapy after surgery for breast cancer. For this reason, regional tumor registry data (1960-1975) on 1985 breast cancer patients were analyzed for SM in the retrospective part of our study. These data were compared with the prospective part of the study in which 241 patients were randomly assigned to either mastectomy or mastectomy and chemoimmunotherapy (CT + IT).