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The Azzopardi Phenomenon
Part A of the Figure demonstrates an outlined vessel containing red blood cells with a background of tumor cells and necrosis
Higher power reveals that the vascular deposition has a granular(Figure, B)and focally dense concentric appearance (Figure, C, oil immersion).
Azzopardi效应(小细胞癌HE切片上,血管壁嗜碱性物质沉积,为DNA)
The Azzopardi Phenomenon
图文见http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165(2003)127%3C1231%3ATAP%3E2.0.CO%3B2
Bobbi S. Pritt, MD; Kumarasen Cooper, MBChB, DPhil, FRCPath
The patient, a 73-year-old woman with stage II small cell
carcinoma of the cervix, had undergone whole pelvic
radiation and presented 4 years later with a right thyroid
mass. Biopsy showed metastatic small cell carcinoma, and
she underwent aggressive chemotherapy. Following treatment,
the mass resolved but recurred within 1 year and
occluded her right jugular vein. A right thyroid lobectomy
was performed. The resected specimen measured 4.5 3
2.2 3 2.0 cm and had a homogeneous tan-red cut surface.
A contiguous lymph node and a portion of jugular vein
occluded by tumor thrombus were also resected.
Microscopically, the thyroid and attached lymph node
specimen showed diffuse replacement by tumor. The malignant
cells had scant cytoplasm and coarsely granular nuclear
chromatin, and they demonstrated prominent nuclear
molding. There were large geographic areas of necrosis and
numerous atypical mitotic figures. Within the tumor and
concentrated within necrotic foci were numerous vessels
outlined by the deposition of basophilic debris. Part A of
the Figure demonstrates an outlined vessel containing red
blood cells with a background of tumor cells and necrosis
(hematoxylin-eosin, original magnification 320). Higher
power reveals that the vascular deposition has a granular
(Figure, B, hematoxylin-eosin, original magnification 340)
and focally dense concentric appearance (Figure, C, hematoxylin-
eosin, original magnification 3100, oil immersion).
This phenomenon is named the Azzopardi effect after
John G. Azzopardi, who correctly identified the basophilic
material as DNA in 1959.1 Prior to this publication, the
material was infrequently described in the literature and
was presumed to be caused by calcium deposition. Azzopardi1
examined 100 cases of oat cell (small cell) carcinoma
of the lung and identified coarsely granular basophilic
material encrusted within venules in 32 cases. He
noted a strong association of this vascular phenomenon
with tumor necrosis and showed it to be negative for calcium
with von Kossa’s and alizarin red methods. He also
demonstrated a positive Feulgen reaction in the vascular
deposition, suggesting that the basophilic substance was
DNA. Azzopardi1 subsequently confirmed this by nucleic
acid extraction and concluded that ‘‘this deposition of
DNA in the vessel wall is presumably the result of liberation
of nucleic acids in large amounts from degenerating
neoplastic tissue.’’ More than 42 years later, this phenomenon
continues to be referred to as the Azzopardi effect,
bearing the name of the pathologist who described and
interpreted this feature.
Reference
1. Azzopardi JG. Oat-cell carcinoma of the bronchus. J Pathol Bacteriol. 1959;
78:513–519.
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