Biomedical subjects
Heike Varnholt
Publications and source records attributed to Heike Varnholt.
Images in HIV/AIDS. AIDS-associated intestinal cryptosporidiosis.
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Giant cell arteritis.
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Liver biopsy in advanced autoimmune hepatitis.
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Fallopian tube prolapse mimicking aggressive angiomyxoma.
A 68-year-old woman presented with a 4-cm polypoid bleeding mass protruding from the vaginal apex 30 years after vaginal hysterectomy. Laparotomy did not confirm the clinical suspicion of bowel prolapse and led to resection of the mass. Microscopic examination revealed a hypocellular edematous lesion with glandular areas resembling fallopian tube epithelium. Condensation of eosinophilic fibrils around medium sized vessels was marked. This case of fallopian tube prolapse shows an unusual resemblance of aggressive angiomyxoma and thus poses a diagnostic pitfall.
Re: Influence of body weight on plasma homocysteine in preeclampsia.
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Pulmonary capillary hemangiomatosis arising in hereditary hemorrhagic telangiectasia.
Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is an autosomal dominant inherited disease characterized by epistaxis, telangiectases, and visceral arteriovenous malformations that can lead to hemorrhage and other complications. We report the case of a 56-year-old female patient with HHT and pulmonary hypertension who died with intractable pulmonary and gastrointestinal bleeding. Autopsy revealed vascular malformations in the lungs, gastrointestinal tract, liver, spleen, and brain. Capillary proliferations in the pulmonary alveolar walls, characteristic of pulmonary capillary hemangiomatosis, were identified, as was evidence of pulmonary hypertensive arteriopathy. To our knowledge, this is the first report of pulmonary capillary hemangiomatosis arising in HHT. The histopathologic findings of HHT and pulmonary capillary hemangiomatosis are reviewed, and a possible role for diminished capillary expression of endothelial nitric oxide synthase is discussed.
Gene expression profiles of human breast cancer progression.
Although distinct pathological stages of breast cancer have been described, the molecular differences among these stages are largely unknown. Here, through the combined use of laser capture microdissection and DNA microarrays, we have generated in situ gene expression profiles of the premalignant, preinvasive, and invasive stages of human breast cancer. Our data reveal extensive similarities at the transcriptome level among the distinct stages of progression and suggest that gene expression alterations conferring the potential for invasive growth are already present in the preinvasive stages. In contrast to tumor stage, different tumor grades are associated with distinct gene expression signatures. Furthermore, a subset of genes associated with high tumor grade is quantitatively correlated with the transition from preinvasive to invasive growth.
Biliary adenofibroma: a rare neoplasm of bile duct origin with an indolent behavior.
We report a case of biliary adenofibroma in a 47-year-old woman, who presented with right upper quadrant pain for several months. Abdominal imaging revealed a 16-cm solid and cystic mass in the left hepatic lobe. Histologically, the tumor showed two distinct components: 1) cystic and tubular structures lined by low columnar to cuboidal biliary-type epithelium, and 2) a dense fibrous stroma composed of spindle-shaped cells with only mild nuclear pleomorphism and inconspicuous nucleoli. Mitoses and stromal invasion were absent. The glandular epithelium stained positively for keratin AE.3/Cam 5.2, cytokeratin 7, cytokeratin 19, carcinoembryonic antigen, and epithelial membrane antigen and had a low Ki-67 proliferative index. In addition, the epithelium was positive for D10 but did not stain for 1F6 or acid mucin with alcian blue stain. This staining pattern, similar to bile duct hamartoma (von Meyenburg complex) with which this tumor shares morphologic similarity, suggests that biliary adenofibroma originates from interlobular or larger bile ducts. Three years after a subtotal resection no metastasis or significant tumor growth was noted. However, given the marked nuclear p53 immunoreactivity and tetraploidy status observed in this tumor, we cannot exclude that biliary adenofibroma may represent a premalignant process that warrants complete resection and thorough histopathologic examination.
Intrahepatic cholangiocarcinoma.
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Glucagon-like peptide 2 is an endogenous mediator of postresection intestinal adaptation.
BACKGROUND: After massive small bowel resection, the remnant intestine undergoes compensatory adaptation. We tested the hypothesis that glucagon-like peptide-2 (GLP-2) is an endogenous mediator of postresection intestinal adaptation. METHODS: Rats were allocated to 1 of 4 groups: groups 1 and 2 rats underwent mid-small bowel transection and reanastomosis; groups 3 and 4 rats underwent 75% mid-small bowel resection and reanastomosis. Groups 2 and 4 rats were administered 1.8 mg of antirat GLP-2 antibody twice daily beginning immediately after the surgical procedure; groups 1 and 3 rats were administered rabbit serum (control). Ileal specimens were harvested on postoperative day 7. RESULTS: Ileal mucosa from group 3 animals displayed morphologic and proliferative indices of adaptation. Each of these indices of adaptation was inhibited by GLP-2 immunoneutralization (group 4). Morphologic and proliferative parameters in the ileum from animals that had undergone transection with reanastomosis were unaffected by GLP-2 immunoneutralization. CONCLUSIONS: These results suggest that GLP-2 is an endogenous mediator of postresection intestinal adaptation.
C-met and hepatocyte growth factor expression in combined hepatocellular and cholangiocarcinoma.
The membranous tyrosine kinase receptor c-met and its natural ligand hepatocyte growth factor are prominent mitogens, motogens and morphogens for hepatocytes and many other cell types in vitro as well as in vivo. To clarify the significance of the c-met/hepatocyte growth factor system in the development and spread of combined hepatocellular and cholangiocarcinoma, surgical specimen from 30 patients, consisting of 4 double cancers, 20 combined types and 6 mixed types, were examined immunohistochemically. Immunoreactivity for HGF was significantly correlated with the differentiation degree of cholangiocellular components, being highest in well and moderately differentiated and lowest in poorly differentiated components (p=0.0119). No significant association was observed between expression of c-met or HGF and the presence of liver cirrhosis, vascular invasion, perineural invasion, lymphatic permeation, intrahepatic metastasis or lymph node metastasis. HGF may have an important impact on the differentiation of certain cHCC-CC. Other clinicopathologic factors related to tumor development and spread may not be influenced by c-met or HGF, at least not on the protein level.