[Renin-secreting renal tumor. Apropos of a case with an ultrastructural and immunohistochemical study]. / Tumeur rénale à sécrétion de rénine. A propos d'un cas avec étude ultrastructurale et immunohistochimique.

A case of renin-secreting tumor of the left kidney in a 36 year-old man with hypertension of five years duration is reported. The antihypertensive therapy was unsuccessful. Following nephrectomy, blood pressure returned to normal values and is still normal, seven years later. There is no evidence of metastasis. The tumor was studied by electron microscopy and by immunohistochemistry. It is composed of two cellular structures normally encountered in the kidney: renin-secreting cells and cells similar to those of the cortical collecting ducts. This benign lesion might be hamartomatous.

[Clinical aspect and noninvasive diagnosis of cardiac myxomas]. / Klinik und nichtinvasive Diagnostik von kardialen Myxomen.

The alteration of cardiac function in the presence of intracardiac tumors varies considerably according to their localization, size, and mode of insertion. Various cardiovascular diseases can be mimicked, e.g., primary valve dysfunction, cardiomyopathy, intracardiac shunts. Embolic events are frequent secondary symptoms. However, subtle noninvasive techniques such as M-mode and sector echocardiography, pulsed Doppler echocardiography, digital video subtraction angiography (DVSA), and computed tomography permit a thorough diagnosis of intracardiac tumorous masses without heart catheterization and catheter angiography. In this paper, myxomas within the left atrium (LA) and the right ventricle (RV) are described. Leading symptoms were systemic embolism and mitral stenosis (LA localization), low cardiac output and right to left shunt (RV localization). First suspicion of intracardiac tumor was raised by M-mode and sector echocardiography, whereas the diagnosis of LA myxoma was in one case missed by computed tomography and the RV myxoma was missed by right ventricular catheterization. In that case, only the four-chamber subxiphoidal sector echogram substantiated the diagnosis and explained the hemodynamic constellation of very low pulmonary pressures combined with right to left shunt. By the new technique of DVSA, all three tumors were plainly visualized. Nevertheless, echocardiography proved to be the most reliable technique of detecting intracardiac tumors.

Giant-cell reaction in the small tubular bones. A light- and electron-microscopic study.

Light- and electron-microscopic investigations were performed in a case of cystic soap-bubble-like expansion of the shaft region of the second metatarsal bone. Morphologically, strongly cellular tissue with a closely packed net of osteoid trabeculae containing osteoblasts and a whorl-shaped spindle cell stroma with fibroblasts, fibrocytes, and irregularly scattered multinucleated giant cells of the osteoclast type were observed. After clinical and morphological exclusion of osteosarcoma, enchondroma, non-ossifying fibroma, osteoblastoma, osteoclastoma, and bone cysts the final diagnosis was giant-cell reaction of small tubular bone with unusual marked osteoid formation. As recurrences are possible, block resection appears more appropriate than curettage.

[Morphology of cavernous transformation of the portal vein (author's transl)]. / Morphologisches bild der kavernösen transformation der pfortader.

Morphology of cavernous transformation of the portal vein is discussed on the basis of 5 case reports. On histological examination it can be shown, that in these cases a combination is present of chronic recanalized portal vein thrombosis and formation of paraportal hepatopetal collaterals. Formation of collaterals starts with new growth of primitive sinusoidal vessels originating from the portal vein and protruding into the paraportal tissue. Later on these vessels exhibit increasing venous differentiation up to the point of formation of varices very late in the development. The meaning of the veins of Sappey is discussed in regard to collateral circulation and to the formation of the new vessels mentioned.

Premalignant lesions of the stomach.

The histopathogenesis of the three major types of gastric carcinoma--intestinal, diffuse and indeterminate--is reviewed, considering normal and abnormal cell kinetics of the gastric mucosa. Intestinalization is a precursor of intestinal-type carcinoma and is related to environmental factors. Diffuse gastric carcinoma originates from dysplasia of the neck of the gland and is of nonenvironmental, probably genetic, origin.

[Concomitant infarction of the right ventricle in patients with acute transmural myocardial infarction (author's transl)]. / Mitbeteiligung des rechten Ventrikels beim akuten Myokardinfarkt.

In 56 patients with acute transmural myocardial infarction hemodynamic parameters were studied. 21 patients proved to suffer from anterior infarction and 35 patients an inferior infarction. By clinical as well as by hemodynamic findings 10 patients out of the group of the 35 patients with inferior infarction were suspect of having a concomitant infarction of the right ventricle. As it is known from literature and documented by the present results this is not a rarity. Failure of the right ventricle is the main cause of death in these patients.

[Aggressive emperipolesis in chronic hepatitis (author's transl)]. / Aggressive Emperipolese bei chronischen Hepatitiden

The penetration and destruction of hepatocytes by lymphocytes (aggressive emperipolesis) has been described and examined quantitatively in biopsy specimens of chronic hepatitis. In 48 cases of chronic persistent hepatitis, the aggressive emperipolesis was rare and, obviously, not of great importance: sometimes there was no emperipolesis at all. In 36 cases of chronic aggressive hepatitis, however, emperioplesis was always evident, usually even to a very high extent.

[Morphological changes of the liver after chronic vinyl chloride intoxication (author's transl)]. / Das morphologische Bild der Leberschädigung nach chronischer Vinylchlorid-Exposition

The monomer vinyl chloride in its gaseous form is used as basic product for industrial synthesis of polyvinyl chloride; it does cause lesions of the liver depending on the dose and the time of exposure. Lesions found on histological examination are: 1. degenerative alterations of liver parenchyma; 2. focal adaptive changes in the cytoplasma of hepatocytes; 3. enlargement of liver cells and polymorphy of cell nuclei; 4. slowly progressive fibrotic and to a lesser degree cirrhotic changes of liver parenchyma, localized in part around the sinus, in part in the septal-periportal areas; 5. activation and proliferation of sinusoidal cells. Sarcoma of the liver due to a probable oncogenic effect of vinyl chloride could be diagnosed in three patients exposed to the toxic agent.