Convexity meningioma associated with empty sella presenting as primary amenorrhea.

A case of a 30-year-old female seen for a convexity meningioma is presented. History and investigations revealed an empty sella turcica associated with primary amenorrhea. The removal of the convexity meningioma resulted in the disappearance of the amenorrhea and in the rise of plasma gonadotropins. The importance of the consideration of intracranial causes in patients who have a delayed puberty or the absence of a menstrual history is briefly emphasized in the light of literature.

Subarachnoid haemorrhage with acute cauda symptom due to spinal tumour.

Massive spontaneous subarachnoid haemorrhage causing compression of the cauda equina is reported. The origin of haemorrhage is concluded to have been an intradural angioblastic meningioma of the filum terminale at the L 3/4. Our paper describes the course of this patient in respect of diagnostic problems and reviews 6 cases of spontaneous spinal subarachnoid haematoma due to SAH from a spinal tumour with acute compression of the adjoining nervous structures. The necessity of early diagnosis and proper operative treatment is stressed.

[Invasive amebiasis with detection of Entamoeba histolytica in rectal biopsies and liver abscesses]. / Invasive Amöbiasis mit Nachweis von Entamoeba histolytica in Rektumbiopsien und Leberabszessen.

A 45-years old man after having returned from Thailand was admitted to the hospital with a severe ulcerative, pyogenic colitis and multiple liver abscesses. In the endoscopically taken rectal biopsies as well as in the liver abscess aspirate gained by fine needle puncture Throphozoites of E. histolytica could be demonstrated. On the other hand stool specimens and serology were negative. The various diagnostic facilities in invasive Amebiasis are discussed. Because of the problems, which may arise from the examination of fresh stool specimens, the advantage of endoscopically gained biopsies in suspected amebic colitis is emphasized.

Benign fibrous histiocytoma of bone. Light- and electron-microscopic observations.

Case report of a patient with an unusual, rapidly growing bone tumor in the third and fourth cervical vertebrae. Histological and electron-microscopic investigations reveal a tumor composed of histiocytic cells, xanthomatous cells, giant cells of Touton type, and fibroblastic cells. No cellular features of malignancy are observed. From its cytologic appearance the tumor has to be classified as a benign fibrous histiocytoma. Regarding its ultrastructural features, the tumor may not be distinguished from non-ossifying fibroma of bone, but its clinical pattern shows obvious differences of localization and growth potential. the term "benign fibrous histiocytoma of bone" is proposed for these tumors which must be differentiated from non-ossifying fibroma.

[Kaposi's sarcoma (author's transl)]. / Beitrag zum idiopatischen multiplen Pigmentsarkom der Haut (Kaposi-Sarkom).

Pathological epidemiological and clinical aspects of Kaposi's Sarcoma are demonstrated. The prevalence of this disease in African countries and the appearance similar to the Burkitt-Lymphoma indicate a probability of viral origin. The histo-pathologic differential diagnosis also includes other vascular tumours. The disease shows a characteristic variable mixture of spindle cells and vascular components. In case of multifocal appearance surgery should be omitted, its aim can be only to ensure the diagnosis. A combined cytostatic and/or radiation therapy is recommended.

Ultrastructure of telangiectatic osteosarcoma.

Recent investigations have shown that telangiectatic osteosarcoma has a poorer prognosis than other osteosarcomas. To elucidate the histogenesis of TOS two cases were investigated on the electron microscopic level. The results show that besides anaplastic, osteoblast-like, and fibroblast-like tumor cells angiosarcomatous components can be observed in this malignant bone tumor, which are characterized by endothelial cells with pinocytotic vesicles, tight intercellular junctions, fine fibrils, and so-called Weibel-Palade bodies in their cytoplasm. From these results, it is concluded that telangiectatic osteosarcoma is derived from multipotent mesenchymal cells with potential differentiation into various directions, such as osteoblast-like cells, and fibroblast-like cells.

Malignant fibrous histiocytoma of bone and osteosarcoma. A comparative light and electron microscopic study.

Malignant fibrous histiocytomas are well-described tumors of the soft tissues. Recent investigations have shown that malignant histiocytoma may also occur as a primary bone tumor. However, difficulties may arise to distinguish malignant histiocytoma of bone from other malignant bone tumors, such as osteosarcoma. In the present study, the ultrastructure of five cases of malignant fibrous histiocytoma of bone is compared with that of osteosarcoma. The results show that malignant fibrous histiocytoma is composed mainly of histiocytic cells and fibroblastic cells. In addition, xanthomatous cells, undifferentiated cells, and giant cells may be observed. By contrast, the predominant cell type in osteosarcoma is the neoplastic osteoblast, characterized by abundant rough endoplasmic reticulum. Signs of matrix calcification in the intercellular matrix between the collagen fibrils are regularly observed in osteosarcoma, but not in malignant histiocytoma. From these results it is concluded that the ultrastructure of malignant fibrous histiocytoma arising in bone is morphologically identical with the soft tissue counterpart of this tumor. The components of the tumor are derived from neoplastic histiocytes. This cytogenesis differs from that of osteosarcoma, which is derived from neoplastic osteoblasts. Therefore, from the ultrastructural point of view, malignant fibrous histiocytoma of bone should be accepted as a distinct histologic entity among bone tumors.

Animal experimental studies on chronic granulomatous inflammation and T-lymphocyte-system.

The presence of lymphocytes in chronic granulomatous inflammations is frequently thought to indicate that thymus-dependent cellular immune mechanisms are involved in the pathogenesis of such processes. Therefore, in the present studies, a model of a granulomatous heaptitis (induced by heat-inactivated group A streptococci) was used to determine whether liver granulomata, consisting of macrophages and lymphocytes, could also be evoked in neonatally thymectomized or in congenitally thymus-deficient nude mice. The morphological (light and electron microscopical, immunohistological) investigations were supplemented with selective determination of T- and B-lymphocyte function. The thymus-deficient mice, after injection of streptococci, developed liver granulomata that did differ neither quanlitatively nor quantitatively from those of control animals with thymus. Lymphocytes were found within the granulomata in both animal groups. There was no evidence for functional disorder of the RES in thymus-deficient mice; on the contrary, RES-activity seemed to be increased. Phagocytosis of streptococci, their intracellular breakdown and streptococcal antigen-degradation occurred as fast or faster in such animals. PHA- and LPS-stimulation of spleen lymphocytes indicated a considerable depletion of T-cells in neonatally thymectomized mice and a complete absence of T-cells in congenitally thymus-deficient nude mice. However, radioimmunological determination of antibodies to group A streptococcal carbohydrate revealed that both groups of experimental animals possessed functionally active B-cells. Therefore, the granulomatous hepatitis described here can be defined as a focal reaction of the liver RES with "B-lymphocyte trapping". Cellular immune mechanisms are not involved in the pathogenesis of these lesions.