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Brisbane, Australia

Gaskin B.J.,Royal Brisbane and Womens Hospital | Fernando B.S.,Royal Brisbane and Womens Hospital | Sullivan C.A.,Royal Brisbane and Womens Hospital | Whitehead K.,Sullivan and Nicolaides Pathology | And 2 more authors.
British Journal of Ophthalmology | Year: 2011

Objective: The aims of this study were to determine the significance of expression of DNA mismatch repair proteins in detecting systemic malignancies in a series of patients with periocular sebaceous cell carcinoma and to determine the clinical characteristics and frequency of Muir-Torre syndrome in this cohort. Design: The study was a retrospective non-comparative interventional case series. Participants: 31 patients with histologically proven sebaceous cell carcinoma of the eyelid participated in the study. Methods: The authors made use of retrospective chart review and immunohistochemical staining of specimens. Main outcome measures: The main outcome measures are as follows: location, tumour size, sites of origin, growth patterns, management, histopathological and immunohistochemical findings, metastasis, other visceral malignancies and mortality. Results: The median age of presentation of the 31 patients in this study was 71 years (range 35-92 years). There was a near-equal gender distribution (M:F-14:17). The average follow-up was 72 months. Seventeen patients had tumours arising from the upper lid, 13 from the lower lid and 1 from the caruncle. Nine patients had clinical Muir-Torre syndrome. Four patients were positive for microsatellite instability complexes and four were negative. Histologically, 14 patients had a high-grade tumour, 13 were intermediate grade and 4 were low grade. Based on the in situ pattern, six patients had a bowenoid pattern, five had both bowenoid and pagetoid patterns and two had a pagetoid pattern. Eighteen patients had no in situ disease detected. Twenty-one patients were alive without disease, and two were alive with disease. Six patients had died, five from other causes and one from the disease. Conclusions: Visceral malignancies are common in patients with periocular sebaceous cell carcinoma. Approximately one in eight demonstrated a heritable risk for further visceral malignancy through failure to express DNA mismatch repair proteins. Diagnosis of periocular sebaceous cell carcinoma should prompt physicians to search for other associated malignancies. Immunohistochemical characterisation of these sebaceous lesions is useful in identifying increased risk in affected patients and family members.

Solares C.A.,Georgia Regents University | Boyle G.M.,Queensland Institute of Medical Research | Brown I.,Sullivan and Nicolaides Pathology | Parsons P.G.,Queensland Institute of Medical Research | Panizza B.,Princess Alexandra Hospital Skull Base Unit
Otolaryngology - Head and Neck Surgery | Year: 2010

Objective: Perineural invasion (PNI) in cutaneous squamous cell carcinoma of the head and neck (CSCCHN) carries poor prognosis. Tumor markers associated with neurotropism in CSCCHN have not been identified. Our objective was to study the expression of αB-crystallin in CSCCHN with neurotropism. Study Design: Cross-sectional review of pathologic specimens. Setting: Tertiary care center. Subjects and Methods: Tissue from patients with CSCCHN with clinical PNI who underwent surgery between 1998 and 2005 was immunostained for αB-crystallin. In addition, non-PNI CSCCHN and normal nerve sections were also stained. Staining intensity was calculated by the histologic, or H, score (product of the intensity and proportion of tumor cells stained). The H-score ranged from 0.0 to 3.0, with 0 indicating negative staining in all cells and 3.0 indicating strong staining in 100 percent of cells. Results: Tissue was available in 15 clinical PNI CSCCHN patients. The analysis was also carried out in 14 non-PNI patients matched by stage and four normal greater auricular nerve (GAN) sections. The mean H-score was 0.56 for CSCCHN with PNI, 1.06 for non-PNI CSCCHN, and 3.0 for normal nerves. The difference in H-score between PNI and non-PNI CSCCHN was statistically significant (P = 0.04). Conclusion: CSCCHN with clinical PNI has decreased staining for αB-crystallin. This finding further demonstrates the differences between clinical PNI and non-PNI CSCCHN tumors. Additional studies are required to identify cell surface markers expressed by CSCCHN that confer neurotropism capabilities. © 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation.

Piliouras P.,Royal Brisbane and Womens Hospital | Piliouras P.,University of Queensland | Allison S.,University of Queensland | Rosendahl C.,University of Queensland | And 2 more authors.
Australasian Journal of Dermatology | Year: 2011

Background/Objectives: Tinea nigra is a relatively uncommon dematiaceous fungal infection of the palms and soles, which clinically may mimic a melanocytic lesion. We sought to ascertain how frequently misdiagnosis of this infection occurred and whether the use of dermoscopy helped in its diagnosis. Methods: Fifty consecutive cases of tinea nigra diagnosed at a dermatopathology laboratory were examined with regard to the clinical diagnosis, use of dermoscopy and the mode of management. Results: Of the 50 cases, 21 (42.0%) were treated by shave or surgical excision. The clinical diagnosis of tinea nigra was made in five cases (10.0%) and suggested along with other diagnoses in a further two cases (4.0%). The dermatologists (n = 9) gave the correct diagnosis in four patients (44.4%), the general practitioners (n = 38) gave the correct diagnosis in one patient (2.6%) and the three surgeons involved did not give the correct diagnosis. When dermoscopy was used, in seven of 13 (53.8%) cases tinea nigra was suggested as a probable diagnosis but when dermoscopy was not used (n = 37) tinea nigra was not clinically diagnosed (P < 0.001). Conclusions: The diagnosis of tinea nigra is significantly improved by dermoscopy, the disease should be considered as a cause of palmar or plantar pigmentation. © 2011 The Authors; Australasian Journal of Dermatology © 2011 The Australasian College of Dermatologists.

Biggar M.A.,Wesley Breast Clinic | Kerr K.M.,Sullivan and Nicolaides Pathology | Erzetich L.M.,Wesley Breast Clinic | Bennett I.C.,Wesley Breast Clinic
Breast Journal | Year: 2012

Columnar cell change with atypia (CCCA) is a relatively recently recognized pathologic breast entity considered to be a risk factor for subsequent development of breast carcinoma. The aim of this study was to investigate the significance of finding CCCA on breast core biopsy, by establishing the frequency of other breast pathology on subsequently performed surgical excision specimens. All cases with CCCA as the most advanced lesion on core biopsy were reviewed. After excision, another advanced proliferative lesion was identified in 17 (33%) patients, including three patients (6%) with in situ or invasive carcinoma. An additional five patients (10%) were concurrently diagnosed with primary breast carcinoma at other sites. These findings indicate that when CCCA is found on core biopsy, open surgical biopsy of the relevant area should be performed and that workup of both breasts should be undertaken to exclude coexistent breast carcinoma at alternative sites. © 2012 Wiley Periodicals, Inc.

A Helicobacter pylori-negative young Japanese man with dyspeptic symptoms suffered from a diffuse erosive gastroduodenitis and multiple superficial ulcerations. Histology and electron microscopic examinations on the biopsy specimens revealed the presence of multiple unidentified intralesional and intracellular coccoid microorganisms in the pathological gastroduodenal mucosa. Microaerophilic and anaerobic Gram-negative coccoid and filamentobacillary bacteria were cultured from the gastric aspirate. The triple therapy containing tetracycline for 14 days followed by 4 months treatment with omeprazole resulted in the resolution of the gastroduodenal pathology. The question, therefore, was raised regarding a possible role for the cultured coccoid bacteria in the pathogenesis. 16S rRNA gene sequence analysis of the isolated Gram-negative coccoid bacteria revealed a close relationship with Haemophilus haemolyticus. The unidentified coccoid microorganisms and cultured X and V factors independent coccoid bacteria, however, shared similar phenotypic, microbiological and pathological characteristics to the novel Gram-negative Streptococcaceae: Okadaella gastrococcus.©2014 BMJ Publishing Group. All rights reserved.

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