[Leydig cell tumor with pronounced virilization]. / Leydigzell-Tumor mit ausgeprägter Virilisierung.

A report is given on the rare case of a hormonactive Leydig cell-tumor in a 52-year-old patient. In spite of virilization symptoms of many years' standing, it was only because of multiple troubles with a great uterus myomatosus that she was admitted to the hospital. An ovarian tumor existing at the same time, turned out to be histologically a mere hilus cell-tumor with a strong nucleus polymorphy. In consideration of the danger of a malignant degeneration (borderline case), the patient was included in our tumor follow-up control programme.

[Image analysis study of squamous epithelial cells in cytological smears of the uterine cervix]. / Bildanalytische Untersuchungen an Plattenepithelzellen in zytologischen Abstrichen von der Cervix uteri.

The automated image analysis is a method, which may model essential effects of the cytologist's perception, combined with an increase of objectivity. We studied 9136 epithelial cells from 105 suspension smears of the cervix by means of image analysis. The results show that the process of maturation of squamous cells can be represented by image analysis parameters. Such a model enables an opposition of processes of differentiation and dedifferentiation. Furthermore subvisual changes in visual inconspicuous intermediate cells can be proved, too which appear in different degree correlated with the grade of dedifferentiation. At present a study is designed to investigate cases without any atypical cells, but having been classified as "positive cases" by the evaluation of intermediate cells in a long term follow-up.

Frequency and diagnostic reliability of subvisual morphologic markers for malignancy in the cervical epithelium.

Nowadays the existence of malignancy associated changes in the epithelium of the cervix uteri is commonly accepted. There are some differences in the view about the nature of these changes. Some hints were given by previous studies for the epithelial changes to exhibit possibly early preneoplastic aspects. In this study subvisually morphologic changes were detected in intermediate cells of the cervical smears by means of image analysis (ZYPAB-3-system). Our investigations on 117 patients suffering from cervical neoplasias as well as healthy controls have shown that the malignancy associated changes are not only limited to about two third of patients with cervical neoplasias but also existent in close to a fourth of healthy women. Those healthy people are considered to be at higher risk for developing a cervical neoplasia than other healthy women.

[Prospective immunohistologic search for metastases using monoclonal anti-cytokeratin antibodies in gynecologic malignancies]. / Prospektive immunohistologische Metastasensuche mittels monoklonalem Antizytokeratin-Antikörper bei gynäkologischen Malignomen.

A higher prevalence of positive lymph node metastases can be found with immunohistological methods in comparison with conventional technique. We examined the lymph nodes from 20 patients with gynecological malignant tumors. We found in 304 lymph nodes with conventional technique 3.3% metastases. With immunohistological methods we showed in 9.9% of the lymph nodes metastases.

[Retrospective immunohistologic search for metastases using monoclonal anti-cytokeratin antibodies in lymph nodes of patients with stage Ib-IIb cervix cancer dying within 5 years]. / Retrospektive immunohistologische Metastasensuche mittels monoklonalem Anti-Zytokeratin-Antikörper an Lymphknoten von Zervixkarzinompatientinnen der Stadien Ib-IIb, die innerhalb von 5 Jahren verstarben.

With immunohistological methods using monoclonal antibodies more metastases were detected in carcinomas today. We examined 10 women, where the carcinoma of the cervix was removed today in healthy and where the lymph nodes were free of metastases. With use of the monoclonal cytokeratin-antibody lu-5 it was not possible to improve the diagnostic. In a histomorphological differentiation of grade 2 or 3 a radiation should be considered.

Application of malignancy-associated changes of the cervical epithelium in a hierarchic classification concept.

For almost 10 years malignancy-associated changes (MAC) have been consistently found by means of high resolution image analysis of apparently normal uterine cervical cells. This study was performed on Feulgen-stained monolayer specimens from 55 healthy women and 19 patients suffering from various stages of cervical neoplasia. About 200 epithelial cells and 30 trout red blood cells in each case were measured by image cytometry at a spatial resolution of 0.27 micron. The philosophy of classification is based on the hierarchic stepwise definition of 'truly normal' specimens by removal of all suspicious specimens, characterized by the presence of atypical cells or subvisually altered cell populations. The suitability of MAC-sensitive classifiers, in combination with classifiers for the recognition of atypical cells, was demonstrated. The demands of automated prescreening were met by several decision tree procedures (95-100% sensitivity, 85-95% specificity). By focussing on the MAC evidence a new risk group from seemingly healthy women may be defined.

[The histologically evaluated accuracy of lymphography in operative therapy of invasive cervix cancer stages Ib-IIb]. / Die histologisch überprüfte Treffsicherheit der Lymphographie bei der operativen Therapie invasiver Zervixkarzinome der Stadien Ib-IIb.

118 of 129 pre-operative patients with invasive cervical carcinoma of stage Ib to IIb from 1974 to 1978 were examined lymphographically. Abdominal radical hysterectomy according to Wertheim with obligatory lymphonodectomy followed in all cases. Results of the histologic examination of lymphnodes have been compared with the findings from lymphography, whereby a coincidence could be proved in 84 per cent of all cases. The correlation for the lumbar and iliac lymphonodi was listed separately in 75 per cent of the cases. Lymphography gives significantly better results within the lumbar region with an accuracy rate of 92 per cent, a sensitivity of 100 per cent and a specificity of 98.5 per cent. It may be concluded that a lumbar lymphonodectomy is not necessary in the event of a negative lymphography.