Islet hyperplasia in adults: challenge to preoperatively diagnose non-insulinoma pancreatogenic hypoglycemia syndrome.

Background: Pancreatic hyperfunctional islet hyperplasia in adults has been more and more frequently described in the literature. Postprandial neuroglycopenia, a negative normal fasting test, negative pancreatic imaging results, and positive intra-arterial calcium stimulation of serum insulin are characteristic. In affected patients the term non-insulinoma pancreatogenic hypoglycemia syndrome (NIPHS) was proposed.

Malignant metastatic insulinoma-postoperative treatment and follow-up.

The rarity of malignant insulinoma limits reports on therapeutic strategies and outcome. The treatment and follow-up of 10 patients, all presenting an insulinoma with metastatic disease of the liver and newly diagnosed between 1992 and 2002, is reported. Pancreatic surgery with successful removal of the primary tumor preferentially located in the tail was performed in 7 women and 3 men, median age 55 years (range 36-82 years).

[Primary sarcomatoid carcinoma of the ureter].

Introduction: We present a case of unusually rapid tumor progression in a patient with primary sarcomatoid carcinoma of the ureter.

Case Report: An 82-year-old female patient underwent total nephroureterectomy for a ureteral tumor that turned out to be a primary sarcomatoid carcinoma of the ureter. After a normal postoperative course, the patient developed a metastatic symptomatic that seemed to have appeared "like an explosion" on the 33rd p.

Immunohistochemical reclassification of anaplastic carcinoma reveals small and giant cell lymphoma.

Thirty-one cases of thyroid malignancies which were originally classified as anaplastic carcinoma were reexamined immunohistochemically using PAP methods (peroxidase:antiperoxidase) for IgM, IgG, IgA, cytokeratin, calcitonin, lysozyme and alpha-1-antitrypsin. The reclassification results were compared with patient data such as clinical symptoms, treatment modalities, and clinical outcome. Postoperative radiotherapy was carried out in more than 80% of cases, chemotherapy in none.

Quantification and classification of echographic findings in the thyroid gland by computerized B-mode texture analysis.

Computerized B-mode image analysis was investigated in a pilot study to establish quantitative criteria for thyroid echography and to demonstrate the diagnostic accuracy of the procedure in thyroid disease. The ten per cent percentile of grey level distribution and entropy proved to be the most efficient statistical parameters. Computerized ultrasound detected all nodular lesions with an overall accuracy of about 85%.

[The familial carcinoma burden and indications for subcutaneous mastectomy].

Histological examination of the surgical specimen was undertaken in 182 women (aged between 20 and 58 years, mean 44 years) after a subcutaneous mastectomy, which had been performed largely because the diagnosis of the breast lesion had been problematic. Among 46 patients, operated on exclusively because of either palpatory or radiological diagnostic problems, histological examination revealed occult carcinoma or precancerous lesion in two, while among 58 patients with combined palpatory and radiological diagnostic problems there were twelve with invasive or noninvasive carcinoma, and among seven with at least four preoperative biopsies there was none. Four of 41 patients who had previously had a modified radical mastectomy of the other breast for invasive breast cancer had invasive or noninvasive carcinoma, as well as 18 of 30 patients with biopsy-confirmed proliferative breast lesion.

Multicentric primaries and residual tumor masses following wide excision in breast cancer: a basis for irradiation.

In the Department of Gynecology and Obstetrics 131 modified radical mastectomies were carried out in patients with invasive breast cancer eligible for breast conserving therapy between 1978 and 1981. The technique of plastination was used for the first time in a complete histological investigation of the breast specimens. In all cases segmental resections with a rim of crossly normal tissue around the primary of at least 2 cm were simulated.

[Capillary hemangioma of the umbilical cord as a cause of polyhydramnios].

The authors report on an encapsulated, fibrous capillary hemangioma, 4 cm in diameter, located at the insertion of the umbilical cord, which caused a polyhydramnion in the 26th week of gestation. The diagnosis of capillary hemangioma was confirmed by multiple sonographic examinations. In the 27th week of gestation, 700 ml of amniotic fluid were drained by a single transabdominal amniocentesis.

[Subcutaneous mastectomy: surgical indications and pathologico-anatomic findings in the mastectomy specimen].

This is a report on the histological findings in subcutaneous mastectomy (scM) specimens of 250 patients, who underwent surgery at the Gynaecological Department of the University Hospital Heidelberg between 1978 and 1987. These operations were indicated either because of diagnostic problems (n = 111), a carcinoma of the contralateral breast (n = 41), a histologically proven mastopathy with epithelial atypia (n = 30), non-invasive lobular carcinoma (n = 28) or non-invasive ductal carcinoma (n = 40). In the group of patients with diagnostic problems, a large number of occult carcinoma and precancerous lesions (36%) could only be found where the glandular tissue could be evaluated neither clinically nor radiologically.

Neuron-specific enolase in medullary thyroid carcinoma: immunohistochemical demonstration, but no significance as serum tumor marker.

Neuron-specific enolase (NSE) is an enzyme detectable in nervous and neuroendocrine tissue. Increased serum levels of NSE are found in small cell lung cancer and in patients with neuroblastoma, in whom NSE is used as a serum tumor marker. We have investigated 32 patients with histologically proven medullary thyroid carcinoma, a tumor of neuroendocrine origin, in which the classical tumor marker calcitonin (CT) was pathologically elevated.

[5MHz realtime sonography of the breast. 2. Examination technic and diagnostic value].

The diagnostic value of mamma-sonography using realtime technique was evaluated in a prospective study based on the experience of 452 pathomorphologically confirmed sonographic results. Large cysts (greater than 1 cm) were correctly classified as 97%, while small cysts (less than or equal to 1 cm) were recognized in 84%. Eighty-six percent of the fibroadenomas were visualized; 50% of these lesions were classified as "benign" and 34% as "equivocal--probably benign".

The proliferative index (PI) of human breast cancer as obtained by flow cytometry.

As known from previous reports, the DNA synthesis fraction of mammary carcinoma cells is correlated with the course of the disease and response to adjuvant therapy. Quantitative parameters of the proliferative activity can be determined by the classic 3HTdR-labelling technique as well as by the more rapid flow cytometric (FCM) DNA analysis. The values of DNA-cytometric S-phase fractions in breast cancers reported up to now were consistently higher than those obtained by the 3HTdR labelling index (LI).

[Subcutaneous mastectomy: the importance of the histopathological assessment technic].

Subcutaneous mastectomy was performed in 300 patients between 1974 and 1981 for various indications. Precancerosis or non-invasive carcinomas were established by previous biopsy in 106 patients. The comparison of pathologic anatomy data of conventional and serial assessment of specimens showed an increase of clinically occult non-invasive carcinomas from 5.

Morphological feedback effect on neurons of the nucl. arcuatus (sive infundibularis) and nucl. subventricularis hypothalami due to gonadal atrophy.

We have correlated the light-microscopic features in the unmyelinated hypothalamus with gonadal atrophy in 15 women of 30-111 years of age and in 7 men between 29 and 82 years. In the postmenstrual cases there is a distinct concordance of gonadal atrophy and the manifestation of nucleolar changes (augmentation, multiplication and vacuolization) in many nerve cells of the arcuate and subventricular nuclei. In younger, still fertile women this nucleolar finding was seen only rarely and sporadically, was limited to the arcuate nucleus and was absent in the subventricular nucleus.

Cytology of a mammary carcinoma metastasis at the angle of the mandible: a case report.

Cytologic findings in a fine needle aspiration biopsy specimen of a tumor of the right angle of the mandible provided the first clues to the presence of a poorly differentiated carcinoma. Patient history, clinical course and histology suggested a metastasis of an established mammary carcinoma as the most probable diagnosis.

Granulomatous hepatitis in systemic lupus erythematosus. Report of a case.

Liver disease is rarely present in systemic lupus erythematosus (SLE). Nevertheless, a recent retrospective study has found a broad spectrum of hepatic pathology in patients with SLE. It is, however, open to question whether this association is fortuitous, or whether any particular form of liver disease represents a manifestation of SLE.

[Early recognition of C-cell carcinoma by family screening (author's transl)].

All available family members of five patients with C-cell carcinoma (medullary carcinoma of the thyroid) were tested for their basal serum-calcitonin level and after pentagastrin stimulation. In two females, aged 12 and 25 years, from two different families, serum-calcitonin was elevated, but only after repeated tests or after pentagastrin stimulation, to definitely abnormal levels. Neither had palpable thyroid nodules, lymph-adenopathy or diarrhoea.