Sullivan Nicolaides Pathology

Brisbane, Australia

Sullivan Nicolaides Pathology

Brisbane, Australia
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The International Association of HealthCare Professionals is pleased to welcome Dr. Daman Langguth, MBChB, FRACP, FRCPA, to their prestigious organization with his upcoming publication in The Leading Physicians of the World. He is a highly trained and qualified immunologist with a vast expertise in all facets of his work. Dr. Daman Langguth has been in practice for more than two decades and is currently serving patients at Sullivan Nicolaides Pathology in Bowen Hills, Queensland in Australia. He is also affiliated with the Wesley Hospital in Auchenflower, Queensland. Dr. Langguth gained his Medical Degree in 1996 from the University of Auckland Faculty of Medicine and Health Sciences in New Zealand. Thereafter, he completed his postgraduate training at Wanganui Hospital in New Zealand, and at Princess Alexandra Hospital in Queensland. Dr. Langguth is a distinguished member of the Australasian Society of Clinical Immunology and Allergy, the Australian Rheumatology Association, and the Royal Australasian College of Physicians. He attributes his success to his ability to simplify complex medical information for patients and other medical personnel. When he is not assisting his patients, Dr. Langguth dedicates his time to mountain biking and photography. Learn more about Dr. Daman Langguth here: and be sure to read his upcoming publication in The Leading Physicians of the World. is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics.  Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review. features each doctor’s full professional biography highlighting their achievements, experience, patient reviews and areas of expertise.  A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life.  For more information about FindaTopDoc, visit

Mitja O.,University of Barcelona | Mitja O.,Lihir Medical Center International | Lukehart S.A.,University of Washington | Pokowas G.,Lihir Medical Center International | And 9 more authors.
The Lancet Global Health | Year: 2014

Background: Skin infections with ulceration are a major health problem in countries of the south Pacific region. Yaws, caused by Treponema pallidum subspecies pertenue and diagnosed by the presence of skin ulcers and a reactive syphilis serology, is one major cause, but this infection can be confused clinically with ulcers due to other causative agents. We investigated T pallidum pertenue and another bacterium known to cause skin infections in the Pacific islands. Haemophilus ducreyi-as causes of skin ulceration in a yaws-endemic region. Additionally, we identified specific signs and symptoms associated with these causative agents of cutaneous ulcers and compared these findings with laboratory-based diagnoses. Methods: We did a prospective cohort study of five yaws-endemic villages (total population 3117 people) during a yaws elimination campaign in Papua New Guinea in April, 2013. We enrolled all consenting patients with chronic moist or exudative skin ulcers. We undertook a detailed dermatological assessment, syphilis serology, and PCR on lesional swabs to detect the presence of T pallidum pertenue and H ducreyi. Patients with PCR-confirmed bacterial infections were included in a comparative analysis of demographics and clinical features. Findings: Full outcome data were available for 90 people with skin ulcers. Of these patients, 17 (19%) had negative results in all molecular tests and were therefore excluded from the comparative analyses. A bacterial cause was identified in 73 (81%) participants-either H ducreyi (n=42), T pallidum pertenue (yaws; n=19), or coinfection with both organisms (dual infection; n=12). The demographic characteristics of the patients infected with yaws and with H ducreyi were similar. Skin lesions in patients with yaws and in those with dual infection were larger than those in patients infected with H ducreyi (p=0·071). The lesions in patients with yaws and dual infection were more circular in shape (79% and 67%) than in those infected with H ducreyi (21%; p<0·0001); more likely to have central granulating tissue (90% and 67% vs 14%; p<0·0001); and more likely to have indurated edges (74% and 83% vs 31%; p=0·0003). The prevalence of reactive combined serology (positive T pallidum haemagglutination test and rapid plasmin reagin titre of ≥1:8) was higher in cases of yaws (63%) and dual infections (92%) than in H ducreyi infections (29%; p<0·0001). Interpretation: In this yaws-endemic community, H ducreyi is an important and previously unrecognised cause of chronic skin ulceration. Reactive syphilis serology caused by latent yaws can occur in ulcers with the presence of H ducreyi alone. The introduction of PCR for ulcer surveillance could improve the accuracy of diagnosis in countries with yaws eradication campaigns. © 2014 Mitjà et al.

O'Brien B.H.,Royal Brisbane and Womens Hospital | McClymont K.,Sullivan Nicolaides Pathology | Brown I.,Royal Brisbane and Womens Hospital
American Journal of Surgical Pathology | Year: 2011

Collagenous ileitis (CI), characterized by subepithelial collagen deposition in the terminal ileum, is an uncommon condition. The few cases reported to date have been associated with collagenous colitis (CC) or lymphocytic colitis. Thirteen cases of CI retrieved over a 9-year period were retrospectively studied. There were 7 female and 6 male patients, with an age range of 39 to 72 years (mean, 64 y). Two groups were identified: (1) CI associated with collagenous or lymphocytic disease elsewhere in the gastrointestinal tract and (2) CI as an isolated process. Diarrhea was the presenting symptom in 11 cases. Most patients had no regular medication use. Subepithelial collagen thickness ranged from 15 to 100 μm (mean, 32 μm) and involved 5% to 80% of the subepithelial region of the submitted biopsies. Six cases had >25 intraepithelial lymphocytes (IELs)/100 epithelial cells, and villous blunting was observed in 11 cases. Chronic inflammation of the lamina propria was present in 9 cases, and focal neutrophil infiltration was identified in 3 cases. In biopsies taken from other sites, 7 of 13 colonic biopsies showed CC, 4 of 9 gastric biopsies showed collagenous gastritis, and 2 of 10 duodenal biopsies were abnormal with collagenous sprue (n=1) and partial villous atrophy and increased IELs (n=1) (both celiac disease related). Resolution of the subepithelial collagen deposition was found in the 1 case in which follow-up of terminal ileal biopsies were taken. There was partial or complete resolution of symptoms in 6 of 9 patients for whom follow-up information was available. Copyright © 2011 by Lippincott Williams & Wilkins.

Shield P.W.,Queensland University of Technology | Crous H.,Sullivan Nicolaides Pathology
Diagnostic Cytopathology | Year: 2014

This study reviewed the clinical presentation, cytologic findings, and the immunophenotype of 69 Merkel cell carcinoma (MCC) cases sampled by fine-needle aspiration (FNA). Demographic and clinical data, the cytology findings, and results of ancillary testing were reviewed. Median patient age was 78 years (372104) with a 1:1.8 female to male ratio. The most common FNA sites sampled included lymph nodes in the neck, the axillary region, the inguinal region and the parotid gland. Most patients had a history of MCC (68%) and/or non-MCC malignancy (70%). The common cytologic pattern was a cellular smear with malignant cells arranged in a dispersed pattern with variable numbers of disorganized groups of cells. Cytoplasm was scant or absent and nuclei showed mild to moderate anisokaryosis, stippled chromatin, inconspicuous nucleoli, and nuclear molding. Numerous apoptotic bodies were often present. Cell block samples (28 cases) were usually positive for cytokeratins in a perinuclear dot pattern, including 88% of cases with CK20 positivity. CD56 was the most sensitive (95%) neuroendocrine marker on cell blocks and was also positive with flow cytometry in nine cases tested. MCC is most commonly seen in FNA specimens from the head and neck of elderly patients, often with a history of previous skin lesions. Occasional cases present in younger patients and some may be mistaken for other round blue cell tumors, such as lymphoma. CD 56 may be a useful marker in cell block preparations and in flow cytometric analysis of MCC. © 2014 Wiley Periodicals, Inc.

Shield P.W.,Sullivan Nicolaides Pathology | Shield P.W.,Queensland University of Technology | Papadimos D.J.,Sullivan Nicolaides Pathology | Walsh M.D.,Sullivan Nicolaides Pathology
Cancer Cytopathology | Year: 2014

BACKGROUND: The usefulness of GATA3 (GATA-binding protein 3 to DNA sequence [A/T]GATA[A/G]) as a marker for metastatic breast carcinoma in serous effusion specimens was investigated. METHODS: Cell block sections from 74 serous effusion specimens (32 ascitic, 2 pericardial, and 40 pleural fluids) were stained with an anti-GATA3 murine monoclonal antibody. The specimens included 62 confirmed metastatic carcinomas from the breast (30 specimens), female genital tract (13 specimens), gastrointestinal tract (7 specimens), lung adenocarcinoma (9 specimens), pancreas (1 specimen), kidney (1 specimen), and bladder (1 specimen). The breast carcinoma cases included 15 ductal carcinomas and 8 lobular carcinomas; the histology subtype was not available for 7 specimens. Twelve cases containing florid reactive mesothelial cells were also stained. The breast carcinoma cases were also stained for mammaglobin and gross cystic disease fluid protein of 15 kilodaltons (GCDFP-15) to compare their sensitivity with GATA3. RESULTS: Positive nuclear staining for GATA3 was found to be present in 90% of metastatic breast carcinoma specimens (27 of 30 specimens). All nonbreast metastatic carcinomas tested were negative with the exception of the single case of metastatic urothelial carcinoma. No staining was observed in any of the benign reactive cases or in benign mesothelial cells present in the malignant cell block preparations. Two cases demonstrated weak positivity of benign lymphoid cells. Staining results were unambiguous because all positive cases demonstrated intense nuclear staining in>50% of tumor cells. Mammaglobin (57% staining; 17 of 30 cases) and GCDFP-15 (33% staining; 10 of 30 cases) were found to be less sensitive markers of breast carcinoma. If used in a panel, mammaglobin and GCFP-15 staining would have identified only 1 additional case compared with those stained with GATA3. CONCLUSIONS: GATA3 may be a useful addition to immunostaining panels for serous effusion specimens when metastatic breast carcinoma is a consideration. © 2014 American Cancer Society.

Dimeski G.,Princess Alexandra Hospital | Badrick T.,Sullivan Nicolaides Pathology | John A.S.,ARC Consulting
Clinica Chimica Acta | Year: 2010

Ion Selective Electrodes (ISEs) are used to measure some of the most critical analytes on clinical laboratory and point-of-care analysers. These analytes which include Na+, K+, Cl-, Ca2+, Mg2+ and Li+ are used for rapid patient care decisions. Although the electrodes are very selective, they are not free of interferences. It is important for laboratories to have an understanding of the type and extent of interferences in order to avoid incorrect clinical decisions and treatment. © 2009 Elsevier B.V. All rights reserved.

Stewart C.J.R.,King Edward Memorial Hospital | Leung Y.C.,University of Western Australia | Whitehouse A.,Sullivan Nicolaides Pathology
Histopathology | Year: 2012

Aims: To determine the frequency and distribution of Fallopian tube involvement in patients with ovarian metastases of non-gynaecological origin. Methods and results: All Fallopian tube tissue was processed for histological examination in a consecutive series of 31 patients with ovarian metastases of non-gynaecological origin. The most common primary sites were appendix (n=10) colon (n=7), stomach (n=6) and breast (n=4). Twenty cases (65%) showed at least one type of tubal spread. Mural involvement was most common (14 cases) but serosal, intra-vascular, intra-epithelial and intra-lumenal spread were also identified in 12, 9, 8 and 11 cases respectively. Intra-epithelial involvement was restricted to the fimbrial epithelium and mimicked tubal carcinoma in situ (CIS) architecturally. Pagetoid invasion was noted in two of the cases. Conclusions: The Fallopian tubes are commonly involved in patients who have neoplasms metastatic to the ovaries. Metastases may show a CIS-like pattern of intra-epithelial spread and therefore small serous CIS-type lesions may not represent proof of tubal tumour origin in patients who have high-stage pelvic serous carcinomas. The frequency of intra-lumenal tumour cells supports transtubal spread as a likely mechanism for mucosal involvement by metastatic tumours involving the lower genital tract. © 2012 Blackwell Publishing Ltd.

Henry R.,Sullivan Nicolaides Pathology | Glegg D.,Sullivan Nicolaides Pathology
Clinical Chemistry and Laboratory Medicine | Year: 2016

A 62-year-old diabetic man with prostate cancer first presented to our clinical laboratory in 2003 with a normal serum protein electrophoresis and immunofixation. In March 2009 he was diagnosed with an IgG κ myeloma. He underwent treatment and went into remission with the original paraprotein band being undetectable. Over the following 5 years, he developed oligoclonal bands and then eventually relapsed. Serum protein electrophoresis and immunofixation were inconclusive, however, isoelectrofocusing identified the oligoclonal pattern then the return of the original band, indicating relapse. This case illustrates the usefulness of an isoelectric focusing method to correctly determine clonality of small abnormal protein bands. It also highlights the need for appropriate commenting on reported results so that they are not confusing for clinicians. © 2016 by De Gruyter 2016.

Harrison M.,Sullivan Nicolaides Pathology
Australian Prescriber | Year: 2015

C-reactive protein is a better indicator of inflammation than the erythrocyte sedimentation rate. It is more sensitive and responds more quickly to changes in the clinical situation. False negative and false positive results are more common when measuring the erythrocyte sedimentation rate. Renal disease, female sex and older age increase the erythrocyte sedimentation rate. The erythrocyte sedimentation rate has value in detecting low-grade bone infection, and in monitoring some patients with systemic lupus erythematosus. © 2015, Australian Government Publishing Service. All rights reserved.

Bygott J.M.,Sullivan Nicolaides Pathology | Robson J.M.,Sullivan Nicolaides Pathology
Sexually Transmitted Infections | Year: 2013

Objectives Infection with Trichomonas vaginalis has declined dramatically in urban Australia but remains endemic in some predominantly indigenous rural regions. The objective was to determine T vaginalis positivity rates in clinical specimens by PCR detection, from a large community-based private pathology laboratory servicing rural and urban Australian populations. Methods Retrospective analysis of data from 44 464 specimens referred for T vaginalis PCR testing over 8 years from 2004 to 2011. Results 44 464 consecutive specimens (37 137 female, 7242 male, 85 sex-unspecified) were analysed: T vaginalis was detected in 633 specimens. The overall community T vaginalis positivity rate was 1.4% (95% CI 1.3% to 1.5%). Overall rates were 2.1-fold higher in women than in men (1.5% vs 0.7%). Positivity rates were highest in the 10-14 year age group (p0.0001). Referrals from urban areas of South-East Queensland accounted for 52% of specimens (23 121): the T vaginalis positivity rate in this urban cohort was 0.7% (95% CI 0.6% to 0.8%). Referrals identified to be from indigenous patients accounted for 48% of positive cases (304/633), and came from predominantly rural and regional areas of northern Queensland. Where follow-up testing was available 21% of patients (14/66) remained T vaginalis PCR positive when tested again within 3 months and 25% (26/101) within 6 months of the initial diagnosis. Conclusions This study confirms that T vaginalis is rare in the urban non-indigenous Australian setting. Guidelines need to be developed to allow targeted testing. Follow-up testing 3 months after treatment should be considered.

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