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Susanne Holck

Publications and source records attributed to Susanne Holck.

7 recordsLinked to original sources
PubMed2006

[Serrated, hyperplastic and hyperplasia-like colorectal polyps].

The colorectal hyperplastic polyp has generally been considered a finding of no clinical significance. Recent research has, however, called attention to the existence of some variants of hyperplastic polyp which are potentially malignant. The term "advanced serrated polyp" has been coined for such cases, which comprise mixed hyperplastic/adenomatous tissue, serrated adenoma, and sessile serrated polyp, in contrast to the traditional hyperplastic polyp. Since epithelial dysplasia is an integrated component of mixed hyperplastic/adenomatous polyp and of the serrated adenoma, such a diagnosis would dictate control colonoscopy comparable to the guidelines for subjects with conventional adenomas. The cytology of the sessile serrated polyp is, however, closer to that of the traditional hyperplastic polyp, whereas the architecture mimics that of the serrated adenoma. For this reason, a consensus regarding the optimal management of such patients has not been obtained, but if the polyp is sizeable and located in the right colon, control should be considered. The small, usually left-sided traditional polyp as a rule needs no follow-up, but the context in which such a lesion is found and its morphology may influence the clinical decision. Future large-scale investigations of serrated colorectal polyps, including interobserver studies, will be required to identify histological details of clinical utility which can be adopted in daily routine practice.

Adenoma↗
PubMed2006

[Hyperplastic colorectal polyposis].

Two cases of hyperplastic polyposis are presented, a 59-year-old female with >50 colorectal serrated polyps in a pancolic distribution and a 69-year-old female with four mucinous colorectal carcinomas and seven serrated polyps, three of which >10 mm. The pathological tissue of the latter patient was confined to the right colon and the neoplastic areas displayed loss of MLH1 expression. Three first degree relatives of this patient had carcinoma of the large bowel, breast and ovary, respectively. A first degree relative of the former patient succumbed to a colorectal carcinoma.

Adenoma↗
PubMed2006

Occurrence of thymosin beta4 in human breast cancer cells and in other cell types of the tumor microenvironment.

Previous studies have shown that the G-actin sequestering polypeptide thymosin beta4 frequently is overexpressed in cancers and that such overexpression correlates to malignant progression. However, the localization of thymosin beta4 in human cancers has not been determined. We now demonstrate that there is a considerable heterogeneity in the cellular distribution of thymosin beta4 in breast cancer. In most tumors examined, cancer cells showed low or intermediate reactivity for thymosin beta4, whereas leukocytes and macrophages showed intense reactivity. In addition, endothelial cells showed variable reactivity to thymosin beta4, whereas myofibroblasts were negative. There was no correlation between the intensity of tumor cell staining and histological grade, whereas there was a tendency toward a correlation between endothelial cell staining and grade. These results demonstrate that multiple cell types within the tumor microenvironment produce thymosin beta4 and that such expression varies from tumor to tumor. Such heterogeneity of expression should be taken into account when the role of thymosin beta4 in tumor biology is assessed.

Breast Neoplasms↗
PubMed2006

Endobiliary brush biopsy: Intra- and interobserver variation in cytological evaluation of brushings from bile duct strictures.

OBJECTIVE: Obtaining cytological specimens by wire-guided endobiliary brushing at the time of endoscopic retrograde cholangiopancreatography (ERCP) is a convenient way to reach a diagnosis. Sensitivity for malignant disease is generally around 50% and specificity around 100%. The present study was designed to assess the reproducibility of the cytological examination. MATERIAL AND METHODS: Samples were obtained from 55 consecutive patients with biliary duct strictures that eventually turned out to be caused by malignant disease in 41 patients (73%). The cytology specimens were evaluated twice in different random order with an interval of at least 4 months by two pathologists blinded to the final diagnoses. Suitability for diagnosis (suitable, suboptimal or unsuitable) and cytologic diagnosis (benign, atypical, suspicious for malignancy and malignant cells) were registered. Kappa analysis was applied. RESULTS: Regarding suitability for diagnosis, the two observers reproduced their findings in 84% (kappa 0.76) and 87% (0.59) (p>0.05), while the interobserver variations on the two occasions were 76% and 78% (kappa 0.49 and 0.58, respectively) (p>0.05). Five percent of samples were rated as inadequate for diagnosis in at least one reading; 18% were suboptimal and 62-82% were suitable. The observers reproduced their cytological diagnosis in 77% and 71% (weighted kappa 0.83 and 0.75) (p>0.05), and agreed on the cytological diagnosis in 65% and 73% (weighted kappa 0.65 and 0.75) (p>0.05). CONCLUSIONS: The intra- and interobserver agreement in cytological evaluation of endobiliary brushings from bile duct strictures is generally good. The rates of inadequate and suboptimal samples can probably be reduced by modifications of the brush design.

Bile Duct Neoplasms↗
PubMed2005

Gastric inflammatory markers and interleukins in patients with functional dyspepsia, with and without Helicobacter pylori infection.

Helicobacter pylori is the most important cause of gastritis, peptic ulcers and the development of gastric cancer. The chronic active inflammation is dominated by neutrophils, macrophages, lymphocytes and plasma cells. Several interleukins (IL-8, IL-10 and IFN-gamma) are involved in the inflammatory process in the gastric mucosa. The aim of this study was to investigate the gastric inflammation in patients with functional dyspepsia. Fifty-three consecutive patients were included and antral biopsies were obtained for histology, culture and immunohistochemistry. The sections were examined for the interleukins IL-4, IL-6, IL-8, IL-10 and IFN-gamma as well as for the cell markers CD4, CD8, CD14, Cd19, CD25 and CD30. Only CD4 and CD19 were significantly increased in patients with increased gastric inflammation and increased density of H. pylori. However, several of the examined markers (IFN-gamma, IL-8, IL-10 and CD14) showed a non-significant trend to be increased in patients with extensive gastric inflammation and high density of H. pylori. Therefore, an arbitrary index (IM11) for all the 11 immunological markers was made as an average value for each of the four morphological groups. For the four morphologically different groups of patients the values were 0.49, 0.77, 0.86 and 1.25, respectively. Significant increases in the index from none to moderate antral inflammation as well as the density of H. pylori were found (p<0.001). By using an index of inflammatory markers trends can be summarized and thereby significant which may be of importance when gastric inflammation is investigated in children and patients with functional dyspepsia.

Adult↗
PubMedDate not supplied

Endoscopic ultrasonography-guided fine needle aspiration biopsy for staging malignant melanoma of the esophagus. A case report.

BACKGROUND: Malignant melanoma (MM) rarely involves the esophagus. The outlook is dismal unless lesional tissue is limited to the esophageal wall. Hence, staging prior to extensive surgical intervention is desirable. CASE: A 54-year-old male presented with fatigue and melena. A diagnosis of MM primary in the esophagus was rendered on a biopsy of an esophageal polyp. The stage, determined by endoscopic ultrasonography-guided fine needle aspiration biopsy, was advanced. On the basis of this information, it was decided to spare the patient mutilating surgery. CONCLUSION: This report confirms the utility of endoscopic ultrasonography-guided fine needle aspiration biopsy in documenting the extent of lesions at sites difficult to access. Thus, management can be improved.

Biopsy, Needle↗