Argyrophilia in breast carcinomas is of uncertain significance. We tested a series of 20 cases of Grimelius-positive carcinomas with immunocytochemical markers of endocrine or exocrine differentiation. Fifty per cent of these tumors were positive, in a variable percentage of the neoplastic cells, with monoclonal antibodies against chromogranin, a specific marker of neuroendocrine differentiation. All cases were positive for neuron-specific enolase, but the significance and specificity of the reaction remain doubtful. The apparent positivity for alphalactalbumin, as found also by Clayton and coworkers (8), was found to be related to a contaminant, which is in fact also an endocrine marker. As with other types of breast carcinoma, all our cases were positive for epithelial membrane antigen, evidence that argyrophilic breast carcinomas, and specifically the chromogranin-positive subgroup, should be interpreted as endocrine neoplasms displaying multidirectional differentiation.
Journal Article Primary malignant lymphoma of the alimentary tract Get access J G Azzopardi, J G Azzopardi Departments of Pathology and Surgery, The Hammersmith Hospital and Postgraduate Medical School of London Search for other works by this author on: Oxford Academic Google Scholar T Menzies T Menzies Departments of Pathology and Surgery, The Hammersmith Hospital and Postgraduate Medical School of London Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 47, Issue 204, January 1960, Pages 358–366, https://doi.org/10.1002/bjs.18004720404 Published: 06 December 2005
A new variant of glomus tumour characterized by oncocytic change is reported. The light and electron microscopy and immunohistological findings are described. This is the first reported case of an oncocytoma of non‐epithelial origin.
In 1960 Williams and Azzopardi reported the first case of oat-cell carcinoma of the bronchus associated with the carcinoid syndrome and active production of 5-hydroxyindoles. No similar case has to our knowledge been recorded until recently when Gowenlock, Platt, Campbell, and Wormsley (1964) reported a patient with an oat-cell carcinoma of the bronchus; this secreted 5-hydroxytryptophan (5-HTP) in contrast to the conventional 5-hydroxytryptamine (5-HT) secreting carcinoid tumour. Though assay of the tumour for 5-hydroxyindoles was negative, these workers produced evidence that the oat-cell carcinoma in their patient was directly responsible for the endocrine secretion. We now report a third patient with oat-cell carcinoma and associated carcinoid syndrome: this report confirms and extends the original observations. In addition, the relation of oat-cell carcinoma to bronchial carcinoid is discussed.
Conventional histologic examination of Merkel cell tumors may result in misdiagnosis because of the close similarities these tumors bear to either malignant lymphomas or certain undifferentiated carcinomas. The authors have previously reported that neuron-specific enolase (NSE), a specific marker for neuroendocrine cells, is present in normal Merkel cells and can be used as a marker to identify this cell type. In this study, 11 Merkel cell tumors, identified employing electron microscopy, were studied using immunostaining of NSE by the peroxidase-antiperoxidase method. Varying intensities of NSE immunoreactivity were found in the cytoplasm of all the neoplastic cells in the different cases. The uniformly stained cytoplasm formed a small rim surrounding the large, unstained nucleus. Immunostaining of NSE thus provides a simple and reliable method for the differential diagnosis of Merkel cell tumors from other primary skin tumors which, with the exception of some malignant melanomas, have been shown not to contain NSE immunoreactivity.
Colonoscopy remains the gold standard for the investigation and management of bowel pathology. A 2009 National Bowel Cancer Screening Program Quality Working Group report revealed that small rural towns in inner regional Victoria, Australia, for example Echuca (Rural and Remote Metropolitan Areas [RRMA] 4), registered 10.5 colonoscopies per 1000 population versus 18.5 per 1000 in the state capital Melbourne. Reasons for this discrepancy include lack of skilled practitioners in rural communities and travel time for patients to attend larger centres when the required bowel preparation or mobility issues limit access. Ideally, services are high quality, safe and local. This study assessed the quality and safety of a rural GP colonoscopy service.The indications, findings, caecal intubation rates, complications and completion time were recorded for 3000 serial colonoscopies performed by one rural procedural GP from 1995 to 2011 in Victorian Echuca. Quality was assessed using caecal intubation rate, polyp and colorectal carcinoma detection rates, and completion time. Safety was determined by complication rates.The caecal intubation rate was 97% (excluding stenosing lesions), polypectomy detection rate was 39%, carcinoma detection rate was 2%, and the average time to completion was 17 min. Re-admission rates were 1.6/1000 for haemorrhage and 1.2/1000 for perforation. There were no deaths.The results from this study compare favourably with published international standards, validate Australian general practice procedural training standards, and validate the additional quality measure of 'colonoscopy completion time'. Rural GPs can provide a safe and high quality service. Extending this service model to similar settings could improve reduced access to colonoscopy for rural Australians.
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