Aims-To examine neuroendocrine differentiation, as shown by chromogranin A (CGA) expression, in cervical carcinomas. Methods-Sixty seven cervical carcinomas were studied and were classified as adenocarcinomas, adenosquamous carcinomas or squamous cell carcinomas based on the assessment of haematoxylin and eosin staining and stains for mucin. Where features of glandular differentiation were identified, sections were also stained for evidence of intestinal type mucin. CGA immunostaminig was done and the results were graded on a three point scale: 0, + (1-5% of cells positive) and + + (>5% of cells positive). These findings were then analysed with respect to lymph node status, tumour differentiation and clinical outcome. Results-There were 32 adenocarcinomas, 18 adenosquamous carcinomas and 17 squamous cell carcinomas. Positive staining was seen in 14 (20X9%) cases, of which four were strongly positive. All but one case were either adenocarcinomas or adenosquamous carcinomas. There was a trend for CGA positivity to be related to intestinal differentiation but this failed to reach statistical significance. No correlation could be demonstrated between CGA staining and lymph node status, tumour differentiation and clinical outcome. Conclusions-Neuroendocrine differentiation is common in cervical carcinomas where there is evidence of glandular differentiation. Whilst the numbers in this study are relatively small, the presence of neuroendocrine cells in otherwise typical carcinomas does not seem to have any association with clinical behaviour. Neuroendocrine differentiation in carcinomas of the cervix is unusual, but is well recognised. It is seen in neoplasms ranging from well differentiated carcinoid tumours to poorly differentiated small cell carcinomas. These tumours morphologically resemble their counterparts at other sites ofthe body-for example, in the gastrointestinal tract and lung. Isolated neuroendocrine cells are, however, also present in the common types of cervical carcinoma, but are not evident on routine haematoxylin and eosin preparations.'Sixty seven cases of cervical carcinoma were studied to elucidate: (1) the prevalence of Cases showing features of glandular differentiation were also stained with PB/KOH/PAS to identify the presence ofintestinal type mucin.3Immunostaining was performed using a standard avidin biotin complex (Dako, High Wycombe, UK) alkaline phosphatase technique. A rabbit antihuman monoclonal antibody to chromogranin A (Dako) was supplied at a concentration of 3 g/l in a solvent of 0O1 NaCl and 15 mM NaNz and was used at a dilution of 1 in 50 in Tris buffered saline.Incubation was performed for 50 minutes at room temperature. Positive and negative controls were used throughout.The presence of diffuse cytoplasmic staining was assessed. Positivity was graded on a three point scale: 0, + and + + for no positivity, positivity in 1-5% cells and positivity in >5% of cells, respectively. The presence or absence of cytoplasmic staining in the adjacent normal endocervical columnar an...

Before a diagnosis of DIP is made, cytokeratin markers should be used.

Results show that intraoperative, surgical specimen (ex vivo) US control of resection margins in patients undergoing PN is feasible and efficient. It represents a promising tool to ensure margin negativity during PN.

Objectives• To evaluate the accuracy of reporting of the Leibovich score (LS) by general pathologists at our centre by comparing the LS in their initial reports with the LS in subsequent review reports by our specialist urological pathologists.• We also assessed whether a revision in the LS subsequently altered the risk group. Patients and Methods• In all, 54 consecutive patients had had their initial histology after nephrectomy reported by a general pathologist between August 2008 and March 2012.• The histological slides were subsequently re-reviewed by the two specialist urological pathologists and revised LS were given if appropriate. The cases were then discussed at the Uro-oncology Multi disciplinary meeting (MDT) and the reason for the revised LS was discussed with the participating panel and reviewed by the uropathologist. Results• The general pathologists allocated the 54 patients into low-(13 patients), intermediate- (25) and high-risk (16) categories.• After a review of the slides by the specialist urological pathologists and discussion at the MDT meeting the LS was revised in 23 patients (42.6%).• The 23 patients who had their LS revised were divided into two groups for the purpose of the present study. On revision of the LS a total of eight patients (14.8%) changed their prognostic group. • The change in the prognostic group in the eight patients was increased from intermediate-to high-risk in four patients.• There was a reduction in the LS in four patients, which was from high-to intermediate-risk category in one patient and intermediate-to low-risk in three patients. Conclusion• In the present study, histopathology review by a specialist urological pathologist led to a change in LS in 42.6% of cases leading a change in risk grouping in 14.8% of cases. This level of discrepancy is not insignificant. However, the few cases evaluated in the present study does limit robust conclusions and further studies are needed to investigate this issue, so that recommendations can be made to enhance diagnostic accuracy and reproducibility.

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