Claus-Peter Adler's research while affiliated with University of Freiburg and other places
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Publications (111)
Epithelioid and epithelial neoplasms of bone are rare. They include different epithelioid variants of vascular lesions, osteoblastoma, chondroblastoma and most importantly metastatic carcinoma. Up to now, only few cases of epithelioid osteosarcoma were described. In this case the authors report a 53-year-old patient presented with a medical history...
We describe in detail three cases of primary bone lymphoma (PBL), initially treated as osteomyelitis of unknown etiology. These cases show which difficulties can occur with diagnosing this entity and highlight the urgent need for rapid diagnostic results in the field of bone pathology. Case 1: A 22-year-old man with the very rare diagnosis of precu...
Chondrosarcoma is the third most frequent primary malignant tumor of bone, constituting up to 16% of the malignant osseous neoplasms. Up to date several genetic alterations and markers were described concerning the pathogenesis and the progression of the chondrosarcoma, which represents actually a heterogeneous group of different types including co...
Although primary malignant tumors of the spine and sacrum are described in all orthopedic textbooks, it is still remarkable how little attention is paid to differential diagnosis of persisting lower back pain and how to detect in special the underlying tumor disease. Chordoma, osteosarcoma, chondrosarcoma, plasmacytoma, lymphoma and Ewing's sarcoma...
Although primary malignant tumors of the spine and sacrum are described in all orthopedic textbooks, it is still remarkable how little attention is paid to differential diagnosis of persisting lower back pain and how to detect in special the underlying tumor disease. Chordoma, osteosarcoma, chondrosarcoma, plasmacytoma, lymphoma and Ewing's sarcoma...
We describe a 22 year-old man with the rare diagnosis of precursor b-lymphoblastic lymphoma involving only the proximal tibia without evidence of leukemia. He presented with right knee pain and swelling of approximately three months duration and nonspecific radiologic findings and was initially treated for osteomyelitis of unknown etiology. Followi...
Tumorähnliche Knochenläsionen sind nichttumoröse Knochenveränderungen, die radiologisch wie ein Tumor imponieren—ihr biologisches Verhalten zeigt jedoch kein autonomes Wachstum. Sie kommen solitär, in seltenen Fällen auch multipel im Skelettsystem vor.
In dieser Weiterbildungseinheit werden die wichtigen zystischen tumorähnlichen Knochenläsionen,...
To examine DNA parameters as prognostic factors for developing metastases.
Image cytometry was used to determine DNA content of 21 tumors and 28 metastases. DNA ploidy status, 2c deviation index (2cDI) and DNA malignancy grade (DNA-MG) (based on the variation of nuclear DNA content of tumor cells around the normal DNA [2c] peak) were examined for t...
Tricholemmal carcinoma is an extremely rare cutaneous adnexal tumor, not exceeding 1-2 cm in diameter in some reported cases. The few reports describe only a greater histologic malignancy. Some cases of recurrences have been reported, and metastasis of the soft tissue was described once by Amaral et al in 1984. In the current patient with tricholem...
Although benign tumors and tumor-like lesions of the spine are shown in every orthopedic teaching book, it is often surprising how little attention is paid to the differential diagnosis and diagnostic investigations, respectively, since surgical treatment and postoperative control depends on exact diagnosis. Clinically the importance of this fact c...
The clavicular type of manifestation of chronic recurrent multifocal osteomyelitis (CRMO) was found in 11 of 52 cases. In juvenile and adolescent CRMO it was present in 27 % and in adults in 14 % of our patients and documents the causal, non-bacterial primary chronical process of the disease. The clavicle was in 5 cases the first symptom, in 6 case...
CASE REPORT:
We report the case of a 9-year-old female patient with a moderate swelling of the right maxilla. A tumor was diagnosed by conventional X-ray within the region of tooth 17 in the right tuber maxillae. The histological diagnosis after biopsy of the lesion was "fibrous dysplasia Jaffe-Lichtenstein". One year later, the tumor was still gro...
Case report: We report the case of a 9-year-old female patient with a moderate swelling of the right maxilla. A tumor was diagnosed by conventional X-ray within the region of tooth 17 in the right tuber maxillae. The histological diagnosis after biopsy of the lesion was “fibrous dysplasia Jaffe-Lichtenstein”. One year later, the tumor was still gro...
One of the most frequent and incapacitating medical and social problems of our times is back pain. In most patients the cause of the symptoms remains unknown, although some relevant clues have been discovered over the last few years: mechanical, nutritional, chemical, social, psychological and genetic factors. Pathoanatomic conditions that are gene...
Osteoblastoma is a benign bone tumor with uncertain radiologic and typical histologic pattern that, in most cases, can be diagnosed without any problems. Usually, it is a solitary bone tumor. The case presented is a 9-year-old child with multiple osteoblastomas occurring in multiple bones of the right hand. The child had pain in his right hand for...
1,100 patients at University of Freiburg Medical Center and at the Institute of Pathology with newly diagnosed plasmacytoma between 1943 and 1989 were identified. Records for these patients were reviewed and the incidence, association with age and employment, distribution of the sexes, tumor stage and survival time and development of secondary tumo...
The frequency of secondary diseases in patients with multiple myeloma was examined by means of 164 post-mortem examinations and compared to those of patients without myeloma. In over 96% of the patients with multiple myeloma, the kidney was involved, and other organs also showed plasmacytoma- related changes more often than in the other group: hear...
Chondrosarcoma is the second most frequent primary malignant tumor of bone. Many of these tumors represent histopathologic borderline cases. In this study, DNA ploidy status, 2c deviation index (2cDI), and DNA malignancy grade (DNA-MG; based on the variation of nuclear DNA content of tumor cells around the normal DNA [2c] peak) were examined for th...
Various kinds of primary neoplasms and tumor-like lesions can develop in the joint capsule, mostly taking origin in the synovial membrane. On the one hand these may show a certain similarity to the morphological structure of the synovial membrane, or they may show no such similarity. Some of these joint tumors are only included in this group of neo...
From many different points of view the skeleton plays a central role in the life of every man and woman. It gives every living body its individual form, is responsible for its architectonics, and also determines its size. The form of the skeleton is both proportional and symmetrical, so that the size of each of its parts is directly related to that...
Just as in the case of any other living tissue, bone tissue can die, and this will result in the appearance of necrotic material; in other words, a bone necrosis. Such a condition may be due to: (1) impairment of the blood supply to the bone, (2) inflammation of the bone itself (osteomyelitis, p. 129), (3) radiation damage (radioosteonecrosis), (4)...
Whereas the osteoporoses (p. 65) are accompanied by a loss of bone tissue and produce translucency of the bone structure on the radiograph, with the osteoscleroses the exact opposite is the case. By osteosclerosis, we understand an increase in density of the structures within a bone brought about by an increased mineralization of the tissue, leadin...
The individual bones of the skeleton stand in close functional relationship to the surrounding soft tissues. Even from the descriptive point of view, both are differentiated from mesenchymal tissue, so that the influence of one upon the other is mutual, and, from the structural point of view, they are very similar tissues. Topographically the bones...
Disorders of metabolism, which are bound up with the storage of physiological substances, can also bring about changes in the skeleton. These substances are mostly stored in the cells of the reticulo-histiocytic system, which is significantly activated. For this reason the pathological storage foci in the bone are mostly found in the marrow cavity....
Fractures, in all their variety, are very frequent events. Diagnosis normally depends upon clinical examination and the radiological findings. In many cases, because of the treatment or because of some particular indication (a so-called “pathological” fracture, for instance), tissue is removed from the region of the injury for histological examinat...
From many points of view neoplasms of bone occupy a peculiar position among the tumors which afflict mankind. For one thing, they are comparatively rare, so that the physician often does not possess the experience which is necessary for diagnosing and treating this disease. The symptomatology is meagre and uncharacteristic, and very often only beco...
There are today an enormous number of special procedures available for examining the skeleton which can be specifically employed in difficult cases. In particular, they include techniques for carrying out radiological, pathological and anatomical investigations. In many cases of bone disease, pathologists must themselves obtain a direct impression...
As well as degenerative changes in the joint (see Chap. 12), those involving inflammation, i.e. the various forms of arthritis, present the most frequently found causes of joint damage. In this case the primary disorder is a change in the joint capsule, with the synovial membrane being the tissue in which the disease first develops. It is known tha...
Degenerative changes in the joints are so very frequently encountered that clinicians (orthopedists, surgeons, internists) as well as radiologists and pathologists are always coming across them. In the majority of cases these are the signs of wear and tear which greatly increase in old age. Primary damage to the articular cartilage appears in the m...
A variety of lesions can arise in any bone, or in different parts of the same bone, bringing about destruction or at least an alteration of the normal structure of the tissue. Depending upon their severity, these changes may be recognizable on a radiograph. The ability to assess a pathological lesion of bone naturally requires exact knowledge of th...
Granulomatous processes can develop in bone which frequently give rise to great clinical and radiological difficulties. All granulomatous lesions have in common the fact that they appear primarily in the marrow cavity. From there they extend into the cortex, bringing about an erosion of its endosteal side which can be recognized in the radiograph....
Bone inflammation develops primarily in the marrow cavity, from which it can secondarily attack the bone tissue itself. When the responsible pathogens reach the marrow and damage the local tissue, osteomyelitis arises. Many different pathogenic organisms — they are mostly bacteria — can cause osteomyelitis. Some of them can, as with inflammatory co...
Osteoporosis is an atrophy of bone tissue in which the cortex is narrowed, the number and thickness of the trabeculae in the spongiosa are reduced, and the proportion of bone substance to marrow cavity is altered in favor of the latter. Because of the reduction of calcified bone substance, there is radiologically an increase in the translucency and...
Developmental disorders of the skeleton appear in childhood and adolescence. They are sometimes hereditary, are often generalized and owe their immediate cause to an enzymatic defect or deficiency. Such disorders may also be acquired if important building materials (proteins, calcium, vitamin D) are absent, or not present in sufficient quantities,...
To investigate the prognostic significance of DNA image cytophotometric data.
Twenty-six osteosarcomas in patients without lung metastases were investigated for several cytophotometric data. In 24 cases, these data were correlated with the clinical course of the patients to assess the prognostic value of nuclear DNA content in osteosarcomas.
Of all...
Myocardial infarction is characterized by the loss of contractile cardiomyocytes. This results in an increased load on the spared myocardium. The aim of this article is to describe the response of the non-affected myocardium after infarction. Human hearts were investigated by microscopical, biochemical and cytophotometrical methods. The number of n...
Magnetic resonance imaging of amputated human knees was performed to determine optimal sequences for depicting articular cartilage. 24 knees were examined with eight different sequences in a 1.0 T imager. Each cartilage lesion was graded from 1 to 4 (Outerbridge staging system). The results of each sequence were compared with the macroscopic findin...
The aim of our study was to correlate MRI with histologic findings in normal and degenerative cartilage. Twenty-two human knees derived from patients undergoing amputation were examined with 1.0- and 1. 5-T MR imaging units. Firstly, we optimized two fat-suppressed 3D gradient-echo sequences. In this pilot study two knees were examined with fast im...
In the present study we examined light-microscopically the nuclei of 16 hearts (7 normal hearts, 7 hearts with hypertrophy and 2 hearts with atrophy) for the size, number and morphology of their nucleoli. The size of the nucleoli, defined as the total area of all nucleoli per nucleus, was an early and sensitive indication of a beginning hypertrophy...
Knochengeschwülste nehmen unter den menschlichen Tumoren in vieler Hinsicht eine Sonderstellung ein. Sie treten verhältnismäßig selten auf, so daß den handelnden Ärzten oft die nötigen Erfahrungen fehlen, die für die Diagnostik und Therapie dieser Erkrankungen notwendig sind. Die Symptomatologie ist dürftig und uncharakteristisch und weist häufig e...
Cardiac hypertrophy due to a prolonged functional activity is associated with an increase of cell size and polyploidization of the myocyte nuclei. Myocardial infarction is characterized by loss of myocytes. Increased load and as a consequence hypertrophic growth of the surviving myocardium has to be expected. The aim of this study was to investigat...
We examined and compared 22 human hearts (6 normal hearts, 4 with hypertrophic cardiomyopathy and 12 after acute ischaemia) for their DNA and collagen content and their cell number. A positive correlation between total heart weight and DNA content was demonstrated in all hearts. The relative DNA content decreased and the rate of polyploidy increase...
78 benign and malign, formalin-fixed bone or bone-associated tumors of different origin were prepared for image-cytophotometric measuring with a new method of preparing.
DNA content, ploidy level, cell size and nuclear number were investigated in 54 mammalian hearts from nine species. DNA content was determined biochemically and ploidy level of cells was studied by the means of Feulgen cytophotometry. Nuclear number was calculated by a new method, while cell size was determined by using ocular micrometry. In most m...
78 benign and malign, formalin-fixed bone or bone-associated tumors of different origin were prepared for image-cytophotometric measuring with a new method of preparing. The DNA-content of the tumors and the so resulting malignancy-grade were determined and compared with the corresponding measurements of unprepared fresh tumors respectively paraffi...
Using nuclear suspensions, the DNA-content of 7 bone-associated, paraffin-embedded liposarcomas and 3 lipomas were examined by means of flow cytometry (FCM) and was compared with the results of image cytophotometric measurements (ICM). Using ICM, 6 of 7 liposarcomas showed an aneuploid DNA content (86%), whereas FCM showed aneuploidy in 3 cases (43...
Traditionally, selection of cancer therapy is based on the assessment of the prognosis of the individual patient. The specific type of tumor and the stage of disease have been the most reliable indicators of prognosis.
Image cytometry to determine DNA content was used in conjunction with clinicopathologic parameters and patient survival to investig...
A patient is presented with solid aneurysmal bone cyst of the left proximal femur and a pathologic bone fracture in this region. The radiological and histological features of this lesion are described. While a conventional aneurysmal bone cyst is an expanding osteolytic lesion consisting of blood-filled spaces of variable size, separated by connect...
The diagnostic and prognostic analysis of bone tumors is usually extremely difficult and requires a great deal of experience. Clinicians, radiologists, and pathologists have to work together, interpretating the different symptoms and features in order to determine the correct diagnosis and plan appropriate therapy. DNA cytophotometry may be useful...
Using nuclear suspensions, the DNA content of 25 paraffin-embedded soft-tissue tumors of different types was examined retrospectively by means of flow cytometry (FCM) and a comparison was made with the results of image cytometric measurements (ICM). Compared were just the stem lines and the DNA-indices of the tumors. It is the aim of each method to...
The article describes a very severe case of hyperostosis of the frontal bone and discusses its possible differential diagnosis. What makes this case special is the fact that the osseous changes include all 3 layers of the bone. Macroscopically the lesion resembles an osteoma as described by Burkhardt (1970) and v. Eiselsberg (1906). The histologica...
A patient with mesenchymal chondrosarcoma involving both bone and soft tissues of the foot has been presented. The clinical and radiological criteria for this lesion have been described and the pathological features considered. It is noted that the pathological data in this case are markedly similar to the classical cases described in the literatur...
Detailed studies on neoplasms in prehistoric populations are rare. Each well-documented case can therefore add to our knowledge. In former times, palaeopathology could present only tentative diagnoses in the case of tumours. Today, modern diagnostic methods and a comparison with established cases make exact evaluations and their verification possib...
Quantitative computed tomography is an established method for the non-invasive assessment of bone mineral content. Scanning with two different X-ray energies allows material-selective image reconstruction and separation on the basis of differing atomic numbers. As proven by chemophysical analysis of 45 bone samples, dual-energy quantitative compute...
This case emphasized that the differential diagnosis of osteofibrous dysplasia and adamantinoma of the tibia can be difficult on roentgengrams as well as on histological studies. A radiological and histological diagnosis of osteofibrous dysplasia of the tibia in a young adult should always raise the consideration of the possibility of an adamantino...
Citations
... Aneurysmal bone cysts are characterized by the formation of multiple cavities, filled with blood, proliferating fibroblasts and giant cells and septated by bone trabeculae and fibrous connective tissue septa [6,7]. Almost half of them are meta-diaphyseal and the remainder predominantly metaphyseal occurring in the long bones (primarily in the lower extremities) [6,7]. ...
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... In the feline patient, mammary neoplasia is much more frequently associated with malignancy [75,76]. Eighty to ninety percent of mammary tumors are malignant in cats [76,86,87]. ...
Reference: Skin Nodules and Tumors
... [1] Knoeller reported a case of an ABC patient who underwent subtotal resection and exhibited recurrence after 3 months. [21] However, some authors could achieve total tumor resection and demonstrated no tumor recurrence after 1-to 17-year follow-up. [2,5,8,18,19] ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/11431281118770797-1675877293020_Q64/Stefan-Knoeller.jpg)
... 3 Al realizar el curetaje o legrado del hueso, es importante agregar un adyuvante para disminuir la probabilidad de recidiva local, pueden ser usados desde alcohol (96%), fenol (80%), peróxido de hidrógeno, nitrógeno líquido, óxido nitroso e incluso polimetilmetacrilato, este último cumple incluso una función de espaciador local temporal o definitivo. [7][8][9] La criocirugía es una técnica quirúrgica que emplea la congelación de los tejidos a temperaturas criogénicas (-30 o C), se inicia la formación de cristales de hielo intracelular, lo que ocasiona la lisis celular, siendo este proceso irreversible con la consecuente muerte celular en el rango de -40 a 70 o C. 10 ...
... Thus, following fracture of a bone, the pain associated with the fracture is partially relieved if the bone and periosteum are repositioned and stabilized in their normal orientation (Rubert et al., 2000). Bone pathologies such as osteoporosis (Claus-Peter, 2000d) and osteosarcomas (Claus-Peter, 2000b) are associated with extensive bone loss, whereas osteopetrosis (ClausPeter, 2000c) and prostatic metastases (Goltzman and Rabbani, 2000) are bone pathologies where bone forma-tion predominates over bone resorption, although the newly formed bone is mechanically weaker than normal bone (Claus-Peter, 2000a,d; Parsa and Murphy, 2000). With time, these pathologies result in the loss of mechanical strength and stability of mineralized bone so that normally innocuous mechanical stress now results in distortion of the periosteum and signi¢cant pain (Parsa and Murphy, 2000; Rubens, 2000). ...
... Bone formation and resorption is a common process throughout the age, unless and until the process is disturbed by an etiology like hormonal disturbances, developmental anomalies, genetic variations, and so on. [1][2][3] More often, ridge resorption is a common problem encountered with the elderly age group. This scenario is extremely challenging with prosthodontic view, as the available basal foundation is compromised to retain and support the prosthesis. ...
... It is usually a solitary lesion, rarely polyostotic. 3 In our case, there is involvement of the diaphysis of femur. ...
... Chondrosarcoma is the third most common malignant bone tumour arising from precursor cartilage forming cells, or secondary from a pre-existing benign osteochondromas and echondromas. [13,14] Chondrosarcomas account for 10% of all primary bone tumours, and have a 10% incidence in the spine. [15,16] They most commonly affect the thoracic spine, and clinical presentation is dependent on the tumour size, mass effect and involvement of adjacent neurovascular structures. ...
Reference: Tumours of the odontoid peg revisited
... However, it is becoming clear that benign tumors always have a diploid DNA distribution pattern, from our study as well as the literature (1,22). DNA aneuploidy has played a useful role in confirming a histological diagnosis, planning of therapy and assessing the prognosis of malignant tumors (9,(23)(24)(25). Many studies subdivided this rank of quantitative DNA measurement into different kinds of tumors (18,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). ...
Reference: Liposarcoma.
... It serves as a reservoir for calcium and phosphorus and maintains the body's mineral homeostasis (House et al. 1997). It occurs in two macroscopically distinct forms, as cortical and trabecular bone (Adler 2000). With its dense and mostly calcified matrix, cortical bone makes up to 80% of the bone mass. ...
