Evolution of VHL tumourigenesis in nerve root tissue

A. O. Vortmeyer, M. G.B. Tran, W. Zeng, S. Gläsker, C. Riley, M. Tsokos, B. Ikejiri, M. J. Merrill, M. Raffeld, Z. Zhuang, R. R. Lonser, P. H. Maxwell, E. H. Oldfield

Research output: Contribution to journalArticle

30 Scopus citations


Haemangioblastomas are the key central nervous system manifestation of von Hippel-Lindau (VHL) disease, which is caused by germline mutation of the VHL gene. We have recently shown that 'tumour-free' spinal cord from patients with VHL disease contains microscopic, poorly differentiated cellular aggregates in nerve root tissue, which we descriptively designated 'mesenchymal tumourlets'. Here we have investigated spinal cord tissue affected by multiple tumours. We show that a small subset of mesenchymal tumourlets of extends beyond the nerve root to form proliferative VHL-deficient mesenchyme and frank haemangioblastoma. We thus demonstrate that tumourlets present potential, but true precursor material for haemangioblastoma. We further show that intraradicular tumourlets consist of scattered VHL-deficient cells with activation of HIF-2α and HIF-dependent target proteins including CAIX and VEGF, and are associated with an extensive angiogenic response. In contrast, activation of HIF-1α was only observed in the later stages of tumour progression. In addition, ultrastructural examination reveals gradual transition from poorly differentiated VHL-deficient cells into vacuolated cells with a 'stromal' cell phenotype. The evolution of frank haemangioblastoma seems to involve multiple steps from a large pool of precursor lesions.

Original languageEnglish (US)
Pages (from-to)374-382
Number of pages9
JournalJournal of Pathology
Issue number3
StatePublished - Nov 1 2006
Externally publishedYes


  • Haemangioblastoma
  • Hypoxia-inducible factor
  • Nerve root
  • VEGF
  • VHL disease

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Fingerprint Dive into the research topics of 'Evolution of VHL tumourigenesis in nerve root tissue'. Together they form a unique fingerprint.

  • Cite this

    Vortmeyer, A. O., Tran, M. G. B., Zeng, W., Gläsker, S., Riley, C., Tsokos, M., Ikejiri, B., Merrill, M. J., Raffeld, M., Zhuang, Z., Lonser, R. R., Maxwell, P. H., & Oldfield, E. H. (2006). Evolution of VHL tumourigenesis in nerve root tissue. Journal of Pathology, 210(3), 374-382. https://doi.org/10.1002/path.2062