Comparative histological, histochemical, immunohistochemical and biochemical studies on oestrogen receptors, lectin receptors, and Barr bodies in human breast cancer.

The present study performed on a total of 567 cases of human female breast cancer compares the results of the biochemical assay (dextran-coated charcoal assay = DCC) for oestrogen receptor (ER) with those of several morphological methods developed for the detection of the ER or for the prediction of prognosis by use of other systems (FSA = fluorescent ligand binding assay, ER-ICA = monoclonal antibody assay for ER, LRA = lectin receptor assay using peanut agglutinin, and Barr body estimation). Whereas no correlation at all was observed among the results of the DCC and those of the FSA and Barr body estimation, the ER-ICA and the LRA showed an unanimous tendency towards higher values of ER with increasing intensity of the staining product. The results of the ER-ICA may be expressed by an immuno-reactive score (IRS) calculated from the staining intensity (SI) and the percentage of positive cells (PP). The morphological methods are evaluated with special regard to their correlation with the DCC, their theoretical basis, and their practical application. In summary, the ER-ICA appears to be the sole method directly visualizing the ER protein and--in contrast to the DCC--is therefore completely independent of the content of endogenous or exogenous oestrogens in the tumor tissue. The LRA provides valuable additional information concerning tumour differentiation and possible response to endocrine therapy, whereas the FSA and Barr body estimation should be considered as obsolete and should therefore be abandoned.

[Dermatofibrosarcoma protuberans: transition to fibrosarcoma]. / Dermatofibrosarcoma protuberans: Ubergang in ein Fibrosarkom.

We report on two patients suffering from dermatofibrosarcoma protuberans showing areas of fascicular fibrosarcoma. Whereas the mitotic rate was very low in the classic storiform parts of the tumor, the dedifferentiated areas presented an increased mitotic rate up to 10 to 15 mitoses/10 HPF. Metastases did not occur. Clinically, such a tumor may be treated like typical dermatofibrosarcoma protuberans as long as the sarcomatous component is small and not prevalent.

Mycobacterium ulcerans in Liberia: a clinicopathologic study of 6 patients with Buruli ulcer.

Two patients with Buruli ulcer (infection by Mycobacterium ulcerans) in the Foya region of Liberia have recently been reported. We describe three more patients which together with the two original patients establish the Mayor River basin as an endemic area of Buruli ulcer. We also describe a patient from the St. Paul River basin. This disease, unrecognized in Liberia before 1978, now seems to be widespread in Liberia and has been reported in neighboring Sierra Leone and observed in Ivory Coast as well. The possibility of Buruli ulcer appearing in other regions of West Africa should be anticipated. Diagnosis involves finding acid-fast bacilli in smears of the exudate from typical lesions or by finding in biopsy specimens the characteristic zone of coagulation necrosis containing acid-fast bacilli. The bacillus, Mycobacterium ulcerans, stains readily with the Ziehl-Neelsen (ZN) and Fite-Faraco (FF) procedures. Treatment is excision when the lesion is small and by debridement and grafting, combined with heat and chemotherapeutic agents when the lesion is large.

Kidney damage by ionizing radiation.

The report describes a case of radiation damage to a kidney due to radiotherapy of a sarcoma of the muscles of the back. The characteristic clinical, pathological and histological findings and the results of X-ray investigation are presented in detail.

Histological findings in testes with varicocele during childhood and their therapeutic consequences.

Contrary to widespread opinion, varicocele is a common disorder in children and can be seen in 10-year-old boys. The peak incidence of varicocele is reached at 15 years. Usually the disorder remains asymptomatic and is overlooked. Over 5 years we observed 22 boys with varicocele. Testicular biopsy carried out in 10 of them demonstrated essentially the same changes of tubules, interstitium and blood vessels seen in adults, though in a less severe form. Surgical removal of varicocele should therefore be carried out during childhood as soon after diagnosis as possible, regardless of degree of severity and the presence or absence of symptoms. This averts the danger of progressive and irreversible damage to the testes. The argument that infertility does not necessarily result in each case of varicocele is probably not relevant due to the uncertainty involved in an individual case. The high risk of later infertility should be compared with the low risk of surgery during childhood.

[Germ cell tumours in gonadal dysgenesis (author's transl)]. / Zur Klinik der Keimzelltumoren bei Gonadendysgenesie

In a 17-year-old patient gonadal dysgenesis with a XY-karyotype was diagnosed by laparoscopy and chromosomal analysis. Two years later, the patient came again to the hospital because of a large tumour which proved to be a dysgerminoma. Except dysgerminomas, other germ cell tumours are also found in gonadal dysgenesis, for example gonadoblastomas, which consist of germinal cells, Sertoli-granulosa-cells and interstitial cells. In most cases of gonadal dysgenesis with a germ cell tumour a Y-chromosome is present. The risk of a gonadal tumour in such cases is estimated to be 25%. In gonadal dysgenesis with a Y-chromosome a prophylactic extirpation of the gonads is necessary, which should be combined with a hysterectomy.

[Spermatological and histological findings in patients with varicocele (author's transl)]. / Spermatologische und histologische Befunde bei Patienten mit Varicocele

In 31 patients with unilateral idiopathic varicocele it was sought to correlate spermiogram and morphology of testis, particularly germinative epithelium, interstitial connective tissue and blood vessels. In both testes of all of 12 patients with pathological sperm striking morphological changes were found, from depletion of germinative cells to Sertoli-cell-only syndrome and including fibrosis of the interstitial tissue, reduction and occasionally diffuse or nodular hyperplasia of the Leydig cells as well as typical vascular changes. Due to alterations to the vascular walls the germinative epithelium had degenerated, this accounting for sub- and infertility, In the prophylaxis of fertility disturbances, the findings indicate that the same aspects apply to both varicocele and undecended testis.