Subcutaneous abscess due to gallstones lost during laparoscopic cholecystectomy.

No complications caused by gallstones lost during laparoscopic cholecystectomy have yet been described in the literature. In one animal study in rats, it has been shown that pigment calculi, but not cholesterol stones, lead to severe local inflammation of the abdominal cavity. We present a case of a chronic subcutaneous and subfascial abscess in the lower abdomen, which included multiple pigment calculi, six months after laparoscopic cholecystectomy.

Fine needle aspiration cytodiagnosis of subacute (de Quervain's) thyroiditis in an endemic goitre area.

Between 1977 and 1989 252 fine needle aspirates (FNAs) of the thyroid from patients with a clinical suspicion of subacute granulomatous (de Quervain's) thyroiditis were examined in the Department of Pathology of the University of Innsbruck, Austria. In the same period 31 cases with preoperative FNA were diagnosed histologically as subacute thyroiditis. Only in three of these cases were the cytological features of de Quervain's thyroiditis found in the preoperative FNA.

Immunohistochemical comparison of chromogranins A and B and secretogranin II with calcitonin and calcitonin gene-related peptide expression in normal, hyperplastic and neoplastic C-cells of the human thyroid.

Normal and hyperplastic thyroid C-cells and 14 cases of medullary thyroid carcinoma were investigated immunohistochemically with antibodies against chromogranins A and B, secretogranin II, calcitonin and calcitonin gene-related peptide (CGRP). Normal and hyperplastic C-cells showed strong calcitonin and chromogranin A immunoreactivity whereas CGRP, chromogranin B and secretogranin II expression was less intense. Strong calcitonin and chromogranin A immunoreactivity was also found in the majority of tumour cells in medullary thyroid carcinoma.

CA 19-9 expression in subacute (de Quervain's) thyroiditis: an immunohistochemical study.

Carcinoma antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) expression was immunohistochemically investigated in 48 cases of subacute granulomatous (de Quervain's) thyroiditis, two of focal lymphocytic thyroiditis, three of Hashimoto's thyroiditis, two of Graves' disease, and seven follicular adenomas, 27 follicular carcinomas, and eight papillary carcinomas of the thyroid. CA 19-9 expression was found in all cases of subacute thyroiditis, lymphocytic thyroiditis, and papillary carcinomas examined and in approximately 50% of follicular adenomas and carcinomas. The strongest CA 19-9 staining was demonstrated in late stage subacute thyroiditis and in papillary carcinomas with marked sclerosis.

Metastatic tumors in fine needle aspiration biopsy of the thyroid.

A series of almost 25,000 thyroids examined by fine needle aspiration (FNA) biopsy was reviewed to ascertain the incidence and presentation of metastatic cancers in thyroid FNA samples. Metastatic cancers in FNA samples from the thyroid were identified in 25 cases (0.1%); the primary tumors were carcinomas of the kidney (8 cases), lung (7 cases), breast (5 cases), cervix uteri (1 case) and colon (1 case) and 1 case each of malignant melanoma, malignant pleural mesothelioma and rhabdomyosarcoma.

Chromogranin A and B in parathyroid tissue of cases of primary hyperparathyroidism: an immunohistochemical study.

Routinely processed parathyroid tissues from 26 cases with primary hyperparathyroidism (19 adenomas, 7 multiglandular hyperplasia) and 8 normal human parathyroid glands were investigated with antibodies against chromogranin A and B and parathyroid hormone (PTH). Normal parathyroids were immunohistochemically positive for PTH and chromogranin A but negative for chromogranin B. Hyperplastic glands showed a focal staining for PTH and chromogranin A without correlation of the staining pattern on serial sections.

[Tumor recurrence at the neck in papillary thyroid gland cancer. A statistical analysis of the recurrence probability after radical surgery].

308 cases of papillary thyroid carcinoma (82.6% of our patients operated on between 1952 and 1987) who had undergone potentially curative surgery were analysed postoperatively. The follow-up ranges from 1 month to 29.

Surgical aspects of diseases of the thyroid gland in childhood.

The treatment of juvenile struma is the domain of the pediatrician, and operations are rarely necessary, even in struma-endemic regions. An absolute indication for surgery is diagnosed or suspected struma maligna: relative indications are hyperthyroidism and euthyroid goiter. The operative procedure in benign thyroid diseases is based on the pathogenesis: a tissue-saving technique is mandatory to prevent postoperative hypothyroidism.

[The thyroid gland scintigram. A decision aid for the surgical approach in thyroid gland diseases?].

For the operative proceeding thyroid scintiscan seems widely dispensable in many routine cases as it leads neither to a different operative strategy nor to an improvement of surgical results. In a few selected cases, however, operative proceeding is determined by scintigraphic results. Thus the question of the importance of scintigraphic methods for thyroid diagnostics and therapy as well as for the selection of patients for surgery cannot be answered and must be subject of a separate examination.

[Malignant hemangioendothelioma of the thyroid gland. Pathology, clinical aspects and prognosis].

Malignant hemangioendothelioma (MHE) of the thyroid still constitutes a relatively important part of our surgical material, with 23 MHE (2.0%) among 1153 primary thyroid tumors diagnosed between 1952 and 1987 (biopsy material of the Innsbruck Pathology Institute). 18 of these cases were investigated immunohistochemically; in 14 cases the data on clinical findings and follow-up were complete.

Malignant hemangioendothelioma of the thyroid. Its immunohistochemical discrimination from undifferentiated thyroid carcinoma.

Eighteen cases of malignant hemangioendothelioma (MHE) of the thyroid and 16 cases of undifferentiated thyroid carcinoma were investigated immunohistochemically with antibodies against endothelial cell specific markers (factor VIII-related antigen, BMA 120, blood group isoantigens, Ulex europaeus agglutinin I), thyroglobulin, and the intermediate filament proteins vimentin and cytokeratin. All MHE were positive for factor VIII-related antigen and vimentin, in 14 of 18 cases for BMA 120, and in 9 of 18 cases for U. europaeus.

Fine needle aspiration cytodiagnosis of anaplastic carcinoma and malignant haemangioendothelioma of the thyroid in an endemic goitre area.

Between 1970 and 1987, 20,028 fine needle aspirates (FNA) of the thyroid have been examined in the Department of Pathology of the University of Innsbruck, Austria. During this period 92 cases of anaplastic carcinoma and 16 cases of malignant haemangioendothelioma (MHE) of the thyroid were diagnosed. Forty-three out of these 108 highly malignant tumours of the thyroid underwent FNA pre-operatively (39.

Frequency of medullary thyroid carcinoma in an endemic goiter area.

A series of 41 poorly differentiated follicular carcinomas of the thyroid gland without histopathological features of medullary or papillary carcinoma and 9 cases of undifferentiated thyroid carcinoma of the small cell type (diagnosed between 1967 and 1983) were investigated immunohistochemically. Two poorly differentiated follicular carcinomas showed a considerable number of calcitonin-positive cells in addition to the weakly thyroglobulin-positive tumor cells. One of these cases revealed several areas with calcitonin-positive tumor cells with additional squamous metaplasia with keratinization.

Clinicopathologic management of tumors of the thyroid gland in an endemic goiter area. Combined use of preoperative fine needle aspiration biopsy and intraoperative frozen section.

In total, 15,325 fine needle aspiration (FNA) biopsies of the thyroid were examined in the Department of Pathology of the University of Innsbruck, Austria, between 1976 and 1985, with the cytologic results histologically verified in 3,112 cases. Since (1) it is frequently impossible to distinguish benign from malignant encapsulated follicular thyroid tumors by cytologic criteria and (2) there is a high level of follicular thyroid carcinoma in our endemic goiter area, we have adopted a diagnostic strategy that accepts a high percentage of false-positive cytologic results in order not to miss highly differentiated follicular carcinoma. To avoid unnecessarily extensive surgical treatment, 1,079 intraoperative frozen section examinations of the thyroid were performed in the same time period in (1) patients with preoperative suspicious or positive FNA cytologic findings, (2) cases with suspicious clinical and anamnestic data and (3) tumors with a suspicious macroscopic appearance without preoperative FNA or with negative or unsatisfactory cytologic findings.

Papillary carcinoma of the thyroid gland. Analysis of 94 cases with preoperative fine needle aspiration cytologic examination.

From 1979 to 1983, 94 papillary carcinomas of the thyroid gland were examined histologically in our institute after a preoperative cytologic examination. Material for cytologic examination was obtained using fine needle aspiration (FNA) biopsy. Eighty-five (90.

Small cell carcinoma of the thyroid. A reclassification of cases originally diagnosed as small cell carcinomas of the thyroid.

99 cases of undifferentiated carcinomas of the thyroid and nine cases of primary malignant Non-Hodgkin lymphomas of the thyroid were examined from 1967 to 1983 in our institute. Among the undifferentiated carcinomas nine cases were classified as small cell subtype. Over the years, the histopathological handling in regard to small cell subtype of undifferentiated carcinoma and primary malignant Non-Hodgkin lymphoma has changed.

A fourteen year practice with the fine needle aspiration biopsy of the thyroid in an endemic area.

In our institute from 1970 to 1983 12,829 fine needle aspiration biopsies (FNB) of the thyroid were cytologically examined. Cytologically unsatisfactory specimens were found in 17.7%.

[Differentiated thyroid carcinoma in an endemic area. Clinical aspects, prognosis, therapeutic considerations].

A retrospective analysis was undertaken of 179 cases of differentiated thyroid carcinoma (89 follicular and 90 papillary; first operations 1952-1977). At the time of the diagnosis there was no significant difference between the two types of malignancy as to age, sex, stage of tumour and degree of local radical operation. Nor was there any difference as to clinical course, but for papillary carcinoma the recurrence rate was higher and the survival time significantly shorter.

[Follicular thyroid cancer. A multivariate analysis].

The prognosis of malignant tumors is determined by a number of factors and their interaction. These factors may be assessed statistically by means of regression models for the hazard rates, which are assumed to be proportional. 89 follicular thyroid cancers from 1952 to 1975 were analysed according to clinical, macropathological and special histological criteria.

[Papillary thyroid cancer--prognosis and prognostic factors].

90 papillary thyroid carcinomas (operated on between 1952 and 1977) were retrospectively analysed. The median follow-up is 5.29 years (range 0.