96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...

Conclusions. In primary imaging a glomus tumor was number one diagnosis
as most frequent entity of tumors in region of bifurcation of carotid
artery. During operation we found a close relationship to vagus nerve
which was confirmed in histology. For differential diagnosis there has
to be considered a hemangioma, myoepithelioma, peripheral paragangliomas
(f. e. M. von Recklinghausen), schwannoma, clotted aneurysms
of carotid artery interne/externe or tumors out of the members with
multiple endocrine neoplasias. Because most of these tumors are found
accidentally by blood pressure disorders, dizziness attacks or syncopes
a fast imaging is being done which detects the majority of these tumors.
Most authors in literature recommend a surgical resection to salve clinical
symptoms and to exclude a malignant tumor. It should be made
clear, that a apparent clear imaging not always can be confirmed in a
histological examination so a definite diagnosis should always be forced.
FR-P-117
Antibody-mediated rejection is associated with microvasculopathy
after heart transplantation
N .E . Hiemann1 , E . Wellnhofer1 , S . Kretschmer1 , C . Christan1 , H . Lehmkuhl1 ,
C . Knosalla1 , R . Hetzer1 , R . Meyer1 1Deutsches Herzzentrum Berlin, Berlin
Aims. Antibody-mediated rejection (AMR) and microvasculopathy are
associated with poor survival after heart transplantation (HTx). Following
the new guidelines of the ISHLT we tested the effect of AMR on the
development of microvasculopathy (MVP) in biopsy.
Methods. We prospectively studied 134 pts (117 men, mean age 50 yrs)
who underwent endomyocardial biopsy at 4 weeks (n=134), 1 yr (n=107)
and 3 yrs (n=61) after HTx. Acute cellular rejection (ACR; ISHLT), MVP
(ratio of luminal radius to diameter of vessel wall) and endothelial swelling
were evaluated in H&E stainings. AMR was assessed by immunohistochemistry
(CD31-positive capillaries to CD68, IgG, IgA, IgM, C1q
and C3c; all x200).
Results. At 4 weeks, 1 yr and 3 yrs, MVP affected 36%, 48% and 43% of
pts, and AMR was present in 37%, 8% and 10% of pts, respectively. Pts
with AMR more frequently presented with MVP at 4 weeks (47% vs. 22%;
p=0.010), 1 yr (74% vs. 46%; p=0.006) and 3 yrs after HTx (81% vs. 45%;
p=0.013). AMR was significantly correlated to ACR, e.g. at 4 weeks 43%
(p