Benign chondroid syringoma (mixed tumor of skin) on the flank with satellites: case report and literature review.

BACKGROUND: Mixed tumor of skin (chondroid syringoma) is a rare skin tumor. METHODS: We report on the rare occasion of an atypical mixed tumor of skin (chondroid syringoma) in a 71-year old Caucasian male patient. RESULTS: The tumor presented as a firm subcutaneous nodule on his flank. Histopathologic investigations revealed a focally increased proliferative activity and satellites in the adipose tissue. This is in accordance with the diagnosis of an atypical chondroid syringoma. The differential diagnosis to malignant chondroid syringoma is discussed. The tumor was removed by delayed Mohs surgery. CONCLUSIONS: Atypical chondroid syringoma is a very rare subtype of mixed tumor of skin. It is an important differential diagnosis to malignant chondroid syringoma of skin.

[Primary carcinoid of the testis]. / Primäres Karzinoid des Hodens.

A primary carcinoid tumour of the testicle without carcinoid syndrome was recorded from a patient aged 48 years. The tumour was made up of solid and acinar structures which exhibited strongly pronounced argyrophilia. Teratogenic structures were not established. Neuron-specific enolase (NSE) and chromogranin were immunohistologically recorded from tumour cells. The carcinoid had not spread metastases. Semi-castration was chosen as therapeutic approach. Orchidectomy was not followed by complications.

[Immunocytochemical studies of epithelial markers in pleural and peritoneal effusions as an adjunct to cytologic diagnosis]. / Immunzytologischer Epithelmarkernachweis in Pleura- und Aszitespunktaten als Ergänzung zur Zytodiagnostik.

Monoclonal antibodies were used in an indirect immunoperoxidase assay to investigate 83 smears of pleural or peritoneal effusions for expression of the epithelial markers MAM-6, MAM-3, and carcinoembryonic antigen (CEA). All but one smears containing tumor cells according to the evaluation of H&E preparations were positive for one, two or all three markers, the exception being a malignant melanoma. Three of 5 cases, suspicious by routine cytology, exhibited marker expression in a different number of cells and thus confirmed the cytological diagnosis. Five of 63 cytologically negative smears exhibited single cells or small cell clusters positive for up to three markers. Four of these patients were found to suffer from metastatic cancer, as established by clinical follow-up and subsequent biopsy or autopsy, respectively. Felty's syndrome and concomitant serositis were diagnosed and confirmed by autopsy in one of the MAM-6 positive cases with negative cytology. The comparatively strong MAM-6 expression in some mesothelial cells of this patient might have been induced by abnormal stimulation due to the rheumatic disease. The results of this study encourage wider use of immunocytochemistry as an adjunct to cytological diagnosis in effusions.

[Single-fiber electromyography, examination technic and findings]. / Die Einzelfasermyographie, Untersuchungstechnik und Befunde.

Single-fibre electromyography has become much easier because of the advantages offered by modern computerised EMG equipment. Fibre density, jitter and the frequency of blockings can thus be examined with relative reliability. The technique allows a sensitive diagnosis of disturbances of neuromuscular stimulus transmission. Furthermore, different pathological results obtained in patients suffering from neuropathies or myopathies (12 controls, 65 patients) proved the diagnostic value of single-fibre EMG. The method is a valuable addition to conventional EMG. The examination technique is described and illustrated by various examples.

[Somatosensory evoked potentials following tactile skin stimulation]. / Somatosensorisch evozierte Potentiale nach taktilen Hautreizen.

Somatosensory evoked potentials were recorded for tactile stimuli applied to the fingers II and V as well as paravertebrally. The advantage of the painless mechanical stimuli is their specificity and the well defined stimulus localization. The question was therefore if the evoked responses are clearly demarcated. Nack potentials (N22: 22.5 and 22.3 ms) as well as cortical SEP's (P1: 33.2 and 32.8 ms) were easily to derive. It was also possible to get SEP's for segmental paravertebral tactile stimuli. For the finger stimulation an Erb's potential could not be recorded reliably.

[Demonstration and possible prognostic value of the nucleolar organizer region (NOR), the microtubule-associated proteins 1A/1B (MAP) and the intermediate filaments vimentin and cytokeratin 19 in invasive ductal breast carcinoma]. / Darstellung und mögliche prognostische Bedeutung der Nukleolus-organisierenden Regionen (NOR), des Mikrotubuli-assoziierten Proteins 1A/1B (MAP) sowie der Intermediärfilamente Vimentin und Cytokeratin 19 bei invasiven duktalen Mammakarzinomen.

We examined the expression of the nucleolar organizer region, the microtubule-associated protein and the intermediate filaments vimentin and cytokeratin 19 and their possible value for prognosis in 51 infiltrating ductal breast carcinomas. We registered the highest NOR counts in pT2/3-tumors, in poorly differentiated breast carcinomas, in tumors with a strong MAP- and vimentin expression (this holds true for vimentin only in pT2/3-tumors). There was a relationship between areas of NOR and the differentiation degree on the one hand and the MAP- and vimentin expression on the other hand. The area of nucleolus increased with the decrease of differentiation and with the increase of vimentin expression, respectively. The expression of cytokeratin 19 showed no homogeneous relations to the traditional prognostic factors as well as to the parameters of the NOR. The area of nucleus had no prognostic value in our study. The value of the NOR is limited by its high variation. The NORs are suitable only as an adjuvant factor for the prognosis. Further studies into MAP and vimentin and their role in the prognosis of infiltrating ductal breast carcinomas appear to be important.

[Somatosensory evoked potentials following stimulation of the lateral femoral cutaneous nerve in normal persons and in patients with meralgia paraesthetica]. / Somatosensibel evozierte Potentiale nach Stimulation des N. cutaneus femoris lateralis bei Normalpersonen und Patienten mit Meralgia paraesthetica.

Cortical somatosensory potentials evoked by stimulation of the N. cutaneus femoris lateralis at two different places (proximal and distal) were investigated in normal persons and patients with sensory disorders of this nerve. A relatively constant early peak (P 32 and P 37 respectively) proved to be a useful diagnostic parameter for normal and delayed nerve conduction. Abnormalities were found in two thirds of cases on the side clinically affected. Peripheral sensory nerve potentials, evoked by orthodromic or antidromic nerve stimulation, have been found to be of limited value because frequently they could not be recorded in normals and also because lesions of the nerve may be localized proximally from the section that is accessible with peripheral electroneurography.

[Suprascapular nerve entrapment syndrome]. / Läsionssyndrome des N. suprascapularis.

Nineteen patients with isolated suprascapular entrapment neuropathy were seen between 1980 and 1986. A neurogenic cause and absence of other deficits were confirmed by electromyography. Electroneurographic tests were performed in 13 and demonstrated delayed conduction time and (or) reduction in stimulus response amplitude. In 16 patients there was an acute or chronic mechanical cause (direct pressure on the suprascapular nerve, forced dislocation of the shoulder blade). Two types of paralysis could be distinguished, an upper one affecting both the infra- and the supraspinatus muscles (12 patients), and a lower one involving only the infraspinatus muscle (4 patients). In two patients an inflammatory cause was considered likely, while in one the cause remained unclear. Restricting movement brought about an improvement in most patients, while in one the neurophysiological parameters improved after neurosurgical intervention, without complete clinical restoration.

[Immunohistochemical detection of thyroglobulin]. / Immunhistochemischer Nachweis von Thyreoglobulin.

An antiserum against human thyroglobulin isolated by gelfiltration from the human thyroid gland was raised in rabbits. The specificity of the antiserum to detect human thyroglobulin was determined by an immunoperoxidase technique on formalin-fixed and paraffin-embedded tissue sections of 17 primary thyroid carcinomas and 80 carcinomas of other origins, such as pancreas, colon, breast, bladder, ovary, testis, and larynx. Positive reactions to immunological staining were recorded only from differentiated thyroid carcinomas, while no reactions were exhibited by the other malignant tumours tested in this study.

Immunohistological detection of tissue factor in normal and abnormal human mammary glands using monoclonal antibodies.

Tissue factor (TF) is the primary cell-bound initiator of the coagulation protease cascade. The cytological distribution of TF in various tissues may be described on the basis of immunohistochemistry with epitope-defined monoclonal antibodies and the extravascular distribution of TF apparently represents a haemostatic envelope ready to activate coagulation when vascular integrity is disrupted. The present study localized TF in human breast cancer tissues when compared with normal breast gland tissues and benign disorders of the mammary gland. By use of a cocktail of three epitope-defined monoclonal antibodies, TF was detected only in the myoepithelia of the resting breast gland. In proliferating disorders like fibrocystic disease or in fibroadenomas, both myoepithelia and luminal epithelia showed TF expression. Of 115 breast cancers 93 reacted with anti-TF, in an inhomogeneous manner in terms of intensity and number of positive cells. There was a tendency for more positive and intensely stained cells to be found in well-differentiated structures such as tubules. Invasive ductal carcinomas exhibiting more positive and more strongly stained cells were less commonly metastatic to lymph nodes when compared with the tumours with no detectable or very low TF immunostaining. A semi-quantitatively recorded score of TF immunostaining correlated with the procoagulatory activity measured (7 fibroadenomas and 24 carcinomas). The results of this study suggest that proliferation and differentiation of the mammary gland is associated with enhanced TF expression in the epithelia which are negative for TF staining in the resting gland. Malignant growth is characterized by randomly expressed epithelial TF, which expression is enhanced and more frequent in well-differentiated tumour cells.

Induction of thyroid neoplasms in the rat. A histochemical, immunohistochemical, autoradiographic and ultrastructural study.

Papillary carcinomas of the thyroid gland induced in rats by combined methylthiouracil (MTU)/nitrosomethylurea treatment were studied electron microscopically and histochemically for their acid phosphatase activity, radioactive iodine uptake and for their thyroglobulin synthesis. The papillary carcinomas accumulated radioactive iodine, synthesized thyroglobulin and showed a perinuclear localization of acid phosphatase activity in the cytoplasm. After omitting the reactive thyrotropic effect (cessation of MTU administration) a decrease of both iodine organification and acid phosphatase activity was observed. The synthesis of thyroglobulin was also reduced. The changes in the ultrastructure of tumour cells corresponded to the respective functional activities. The results suggest that the papillary carcinomas may have a functional dependence on thyroid-stimulating hormone.