Australasian Division of the
International Academy of Pathology Limited


Newsletters - 2001

Number Two

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Australian Pathologist Honoured in Thailand

Tony Leong, a former President of the Australasian Division of the I.A.P., and now based in Newcastle, N.S.W. was admitted as an Honorary Fellow of the Royal College of Pathologists of Thailand on March 28, 2001. He is the first foreigner to receive this award. The award was made in recognition of Tony's contributions to Thai Pathology over the past 15 years. Tony has visited Thailand almost every year during this period, sometimes more than once in a year to conduct lectures and tutorials. In 1998 he was Visiting Professor at the Chulalongkorn Hospital for three months. During this time he spearheaded the establishment of a multidisciplinary breast cancer team at the hospital.

The photograph shows Tony with his wife Wendy, on his right and three of his former Fellows at the ceremony in Bangkok. Dr Pongsak Wannakrairot from Chulalongkorn University, Dr Cheepsumon Suthipintawong from Rajavithi Hospital and Dr Songkhun Vinyuvat from the Institute of Pathology. They presented him with a portrait of himself. Tony also initiated and directed a programme of advanced tutorials for Indonesian pathologists for the past 8 years in which 4 Australain pathologists under the sponsorship of the Australasian Division of the IAP went to Indonesia on a yearly basis to teach. The programme is currently in suspension because of the political and financial instability in Indonesia.

In 1993, Tony was also honoured with a honorary fellowshhip of the College of Pathologists of Hong Kong. Tony is continuing his efforts to extend Australian contacts in Asia. Currently he has two Research Fellows in his department - one from Samsung University in Seoul, Korea, and the other from PLA301 Hospital, Beijing, China.




Report on the Meeting of the United States and Canadian Academy of Pathology.

Atlanta, Georgia.
March 3-9, 2001.
Atlanta Marriott Marquis Hotel.

By Robin Cooke.

The Entrance to the Administrative Block of CDC, Atlanta. The peach blossoms are in bloom.



I arrived at the hotel at midnight on Friday March 2nd. There was a message waiting for me with an invitation to attend a thirty delegate conference for users of the Systematised Nomenclature of Medicine, starting with breakfast at 7.00a.m. I accepted the invitation and had a most interesting morning and luncheon. SNOMED is owned and was developed by the College of American Pathologists. This is a very big organisation with an annual budget of many millions of dollars.
I met at this meeting the Editor of their monthly news bulletin called CAP Today which is a very slick publication. He receives over three million dollars annually in advertising for this journal. I sat at lunch with the Director of Continuing Education in Anatomical Pathology for the College of American Pathologists. The CAP is doing, on a much larger scale, what the Royal College of Pathologists of Australasia has been doing since about 1975.

Sunday March 4th I attended the Executive Meeting of the International Academy of Pathology which is the International parent body of which the USCAP is one Division, albeit the largest. I reported on my activities as Editor of the News Bulletin of the International Academy of Pathology. This has a distribution of about 17,000 to pathologists in virtually every country in the world. It is now in full colour. I also reported on the development of the Home Page for the I.A.P. As Chief Organiser of the International Congress of the I.A.P. to be held in Brisbane in October, 2004, I reported on the activities of the Organising Committee to date. During the following week I contacted numerous pathologists from all around the world to advertise the meeting in Brisbane and to encourage them to attend.

An organiser hears what he wants to hear, but the feedback that I got and that other Australians attending the meeting got, was that there was a great deal of interest in attending the meeting in Australia. Andrew Ostor, a member of the Executive of the International Association of Gynaecological Pathologists, played an active role in two meetings. He publicised Congress 2004 at these meetings. Ted Mills was an active speaker in the Electron Microscopy session. He also publicised Congress 2004. The other Australian and New Zealand delegates led by Kon Muller, Regional Vice President also publicised the meeting. The conference began on Saturday with companion meetings of the College of American Pathologists. This was a new initiative. It was successful and will be repeated. Sunday is also occupied with companion meetings.

The CDC is affiliated with the main university in Atlanta - Emory University. The Conference Center Hotel for the University is directly opposite the CDC building.

Some of the high security laboratories at the CDC. The one in the centre foreground is an older laboratory. The one behind is almost completed. All of the laboratories have positive pressure airconditioning. The chimneys in the new laboratory are highly sophisticated filters which filter the air leaving the laboratories.


I attended the afternoon companion meeting of the Paleopathology Club and the History of Pathology Society. This year I am the President of the History of Pathology Society and I was responsible for choosing the topic for discussion. I chose to talk about Q Fever. I presented the finding of Q Fever by Dr Ted Derrick, the first forensic pathologist in Brisbane. I based my talk on his hand written laboratory notes which I found amongst the papers which he had packed away before his retirement. No-one except he and I would have read these papers before. His investigations in 1935 - 1937 demonstrated the uniqueness of a new fever entity which had been noted by three Brisbane physicians during the previous two years. It soon became apparent that Q Fever was a worldwide disease. The method of transmission was found by American workers, particularly Bob Heubner and Ed Linnette. American workers at the Rocky Mountain Fever Laboratory in Montana (on the Eastern foothills of the Rocky Mountains), also identified a new fever which they called Nine Mile Fever because it occurred nine miles from their laboratory. In 1939 it was shown that Nine Mile Fever and Q Fever were identical and were caused by the same organism which was labelled Coxiella burnettii. Professor Herb Thompson, formerly Professor of Microbiology at Morgantown, West Virginia has recently been appointed Head of a Q Fever Laboratory which is a new division within the Centers for Disease Control in Atlanta. Professor Thompson shared the podium with me and he presented the contribution of the American group to the elucidation of Q Fever.

There was quite a big attendance at this meeting and because there were so many real experts in the audience, we specially reduced our speaking time to allow plenty of time for discussion. The discussion was indeed extremely interesting. I thought one of the most interesting comments came from an elderly pathologist who moved slowly to the microphone and told us that he was the doctor on a troop ship bringing back American soldiers from the South of Italy. In the week before they embarked they were housed in large farm buildings. During the voyage to America about half the shipÕs company came down with Q Fever. They had almost certainly acquired this from the dust in the farm buildings which would have been contaminated previously by placentas of cattle, sheep or goats whose placentas would have carried vast numbers of Q Fever organisms. This allowed me to mention the epidemic of Q Fever which occurred in the Balkan Peninsula and Greece during the earlier part of the Second World War. It was called the Balkan Grippe and it affected large numbers of the young, non-immune German soldiers and then later, large numbers of the young, non-immune American soldiers. The disease was so endemic in the local population that most people were immune. The cause of this epidemic was determined by a young Greek biologist called Caminopetros. After the War he took broth cultures of the organism in his pocket with him on a three month journey to America where the organism was confirmed by the scientists in the National Institutes of Health in Washington.

A group of visitors at CDC on the Tuesday of the USCAP Meeting. Robin Cooke (Royal Brisbane Hospital, Australia), Herb Thompson (Chief of the Q Fever Lab, CDC), Michel Huerre (Pathologist, Pasteur Institute, Paris), David Walker (Head of the Infectious Diseases Center, University of Texax, Galveston), Francis Jaubert (Head of the Pathology Department, Children's Hospital, Paris & Consultant in Genetics to the Pasteur Institute, Paris), Chris Paddock (Pathologist & Entomologist, CDC), Jamie Childs (Chief of Division, CDC), Greg Dasch (Chief of the Rickettsial Division, CDC).


As you know, Q Fever is a common disease in the abattoirs around Australia. It is receiving a considerable amount of notice now because of the litigation involved. They say there is very little Q Fever in the U.S.A. but this may change when the Q Fever Laboratory at the C.D.C. gets going and they start testing the herds. On Sunday evening I was invited to attend a dinner party at the Carlton Rex Hotel for 15 guests. This was hosted by the American Registry of Pathology. At my table of five there was Paul Bachner who I met some years ago when he was a guest speaker at the RCPA Conference in Adelaide. He is now the President of the College of American Pathologists. The Conference proper got underway on Monday morning. There were about 3000 delegates at the meeting. The vast majority were from the U.S.A. and Canada but there were pathologists from many other countries. The meeting is specifically designed for updating and consolidating the knowledge and expertise of Anatomical pathologists.

A large number of concurrent sessions are run during the five days of the Conference. They start at 8 .00a.m. and continue with an evening session beginning at 7.30p.m. and finishing about 10.00p.m. The meeting is run very efficiently and the subject matter is well covered by extremely competent speakers. It is not by accident that the meeting is so well attended. During the daytime I spent most of my time attending to administrative matters related to the I.A.P. News Bulletin and the Congress in 2004. I attended the special lectures, and one specialty conference each evening. On Wednesday I went with Professor Herb Thompson to visit the Centers for Disease Control. This is a Government -funded laboratory which is the reference centre for the U.S.A. and the whole world for infectious diseases. Pathologists send unknown organisms to the Laboratory for identification as well as sending serum from patients with undiagnosed fever to be tested against a battery of tests available in the C.D.C. This institution is undoubtedly the most important medical venue in Atlanta. It is associated with the Emory University Medical School which is the main medical faculty in Atlanta. I was accompanied by my good friend Francis Jaubert who is Head of Pathology in the world famous ChildrenÕs Hospital in Paris, and an adviser to the Pasteur Institute. After lunch we were joined by three other infectious diseases delegates attending the Conference.

There was a very interesting exchange of information between these experts and a few of the senior staff from the Rickettsial Section of the C.D.C. The laboratories at C.D.C. are divided into varying categories of security. Here they are testing live viruses such as Small Pox, Ebola, Lassa Fever, Q Fever and many other organisms. The laboratories are kept under very tight security as you would expect and hope. They all have positive pressure air conditioning and the exit vents are all protected by very sophisticated filter systems. The personnel who work in the laboratories don spacesuit type gear before entering. For most of the week the weather was cold and overcast but on one day the sun was shining. I took this opportunity to visit some of the tourist sites of Atlanta.


View of the Olympic Park which commemorates the 1986 Olympic Games. On the left is the headquarters of the television company CNN and behind is the Convention Centre. (Photograph taken from the highest point in Atlanta - the revolving restaurant on the 74th floor of the Westin Hotel).




The Martin Luther King Church and Memorial. It is situated close to downtown Atlanta and opposite the old Ebeneza Baptist Church. Martin Luther KingÕs father was Pastor at this church and he, himself, preached there during the campaigns against racial discrimination.




Looking west from the restaurant towards the low hills around Atlanta. In the time of the Civil War, Atlanta was an important railway centre. It still is. The Battle for Atlanta formed a major part of the famous book Gone with the Wind. The author, Margaret Mitchell, lived in Atlanta and her house is preserved as a museum.




Atlanta is also a major centre on the interstate highway system.




These included the house where Margaret Mitchell, the author of "Gone with the Wind" lived. This is now a museum. The city tour later included a visit to a Cyclorama where they had a beautiful painting embellished by small figures which showed the Battle for Atlanta during the Civil War. Atlanta was, and still is, an important communication hub in the south east of America. In those days it was a railroad crossing. The railways are still important. An interstate highway passes through the city, and it is a very large hub for aircraft. The attractively designed Martin Luther King Jnr Memorial is on the tourist beat. Two of the major industries in Atlanta are the headquarters of Coca Cola and the headquarters of CNN. The latter television and communications company is owned by Ted Turner, the sponsor of the Goodwill Games which will be held in Brisbane August 29 to September 9 this year.

It was interesting to see the studios in which they prepare their programs and to see their newsreaders sitting in the middle of a busy newsroom. With modern technology they are able to blot out the noise in the newsroom but maintain the background behind the newsreader which gives the impression of immediacy and reality. They have just launched a Spanish language channel which so far has been extremely successful. This caters for a very large and increasing segment of the population of the U.S. and also a large part of the population of South America. Some of the venues from the 1996 Olympics have been kept and there is a rather nice Olympic Park in the centre of the city in front of the CNN building. In the week following the meeting I went to Augusta to visit the headquarters of the U.S./ Canadian Academy of Pathology. I wanted to see their organisation, to speak with their staff and to look at the previous editions of the I.A.P. News Bulletin which began in 1906. Dr Fred Silva and his wife Jean very kindly offered to accommodate me during the visit. I was treated to the traditional Southern hospitality and had a fairly intense education in the matters which I wanted to see in Augusta.

I gave two lectures in the Pathology Department in the Medical College of Georgia and then was invited again by the Chairman of the Department of Medicine to repeat one of the lectures for his Department. The U.S. Masters Golf Championship will be staged on the Augusta National Golf Course in the first week in April. The annual golf fever is beginning to take hold of the citizens in Augusta and people are starting to wear their green jackets for the occasion. The golf course itself is hidden behind a high fence and hedge and it is not possible for visitors to view the course. There are a number of entrances but these are guarded by very efficient security officers. The Business Manager of the USCAP, Jim Crimmins, acts as a scorer on the third hole at each of the Augusta National Championships. He was able to acquire for me some golfing memorabilia from the clubhouse. He rang my order to the pro shop and then we collected it in a small package from the security officer at one of the entrance gates about one hour later.


One of the entrances to the Augusta National Golf Club. The clubhouse is a tiny white speck above the bonnet of the car which is about to enter the magnolia tree-lined driveway which leads up to the clubhouse. The high fence and hedge surrounding the whole property can be seen on the left.




On the Monday I was in Augusta my host invited me to a Rotary luncheon. This was held in a restaurant directly opposite the main entrance to the Augusta National Golf Course. Looking through this narrow main gate one looks along a drive lined by magnolia trees. In the far distance one sees a small white speck which is the clubhouse. It was raining at the time of the luncheon, so I came back another day when the sun was shining, to take a photograph through this gate. I think this was the biggest Rotary lunch group that I have attended. The speaker was a former FBI agent who had been sent to Augusta many years ago to attempt to break a group which was flying drugs from South America into the small airstrips in the state of Georgia. It was suspected, and he confirmed, that the drug runners were getting good information from FBI and Customs Agents. With a combination of hard work, good luck and serendipidy he was able to break into the ring and bring the offenders to trial. The trial judge who had heard the cases was also in the audience.





28th Annual Scientific Meeting of the Australasian Division of the IAP

The two guest lecturers are:

On Saturday,
Dr Stuart Schnitt from Beth Israel Deconess Medical Center, Boston. He will speak on Breast Pathology.

On Sunday,
Dr Larry Weiss from City of Hope Hospital, Duarte, California. He will speak on Malignant Lymphomas.



Message from the President

Dr Dominoc W Spagnolo


Friday 1st June, 2001

The format for this year is slightly changed to try and accommodate an element of the update sessions which used to be held on the Friday morning each year. As part of the process of emphasizing the central and important role that these Specialty Clubs play in our Annual Scientific Meeting, much more feedback is required from attendees.

Historically there has been a very poor response to the completion of questionnaires available at the Club Meetings and at the main weekend sessions. This year I have asked each Club Convenor to be much more aggressive and insistent that as many attendees as possible fill out the questionnaires provided. Someone will be stationed at the exits of the lecture rooms to collect these forms. With the help of the Secretariat, the questionnaire will be revised to make it more relevant to the change in meeting format and emphasis.

I hope that all attendees will assist us by completing the forms.



(International Society of Gynecological Pathologists Š Australasian Branch)

8.55 - 10.40 Main Auditorium
Convenor: Dr Richard Jaworski

Lecture: "Mind like parachute! Work best when open!"
Speaker: Professor Peter Russell,
Royal Prince Alfred Hospital, Sydney. N.S.W.

This will be followed by a slide seminar of 5 cases of gynaecological surgical pathology.
Dr. Richard Jaworski, I.C.P.M.R., Westmead Hospital, Westmead. N.S.W.
Dr. James Kirker, Diagnostic Medlab, New Zealand.
Associate Professor Robert Osborn, I.C.P.M.R., Westmead Hospital, Westmead. N.S.W.
Dr. Nirmila Pathmanathan, I.C.P.M.R., Westmead Hospital, Westmead. N.S.W.



8.55 - 10.40
Meeting Room 2
Convenor: Dr Richard Ojeda

1. Welcome and aims
Dr Victor J. Ojeda

2. Guest lecture: "Neurosurgeons and Histopathologists: interactions and expectations"
by Dr Marcus A. Stoodley,
Senior Lecturer in Neurosurgery and Consultant Neurosurgeon, Institute of Neurological Sciences, The Prince of Wales Hospital, Randwick NSW.

3. Slide Seminar:
a. Case 1
Dr. Anthony E.G. Tannenberg, Queensland
b. Case 2
Dr. Renate Kalnins, Victoria
c. Case 3
Dr. Victor J. Ojeda, New South Wales
d. Case 4
Prof. Peter C. Blumbergs, South Australia.



8.55 - 10.40 Meeting Room 4
Convenor: Dr Kerry Crotty

A/Professor Steven Kossard, Skin and Cancer Foundation
Atypical lentiginous junctional naevi of the elderly and melanoma

Dr Kerry Crotty, Royal Newcastle Hospital
An approach to the diagnosis of recurrent melanocytic lesions.

Dr Stan McCarthy,
Royal Prince Alfred Hospital,
Subungual melanoma

Dr Chris Henderson,
Liverpool Hospital
An unusual presentation of Wegeners granulomatosis

Dr Bish Dutta, Dutta Pathology
A pigmented nodule on the cheek

Dr Richard Scolyer, Royal Prince Alfred Hospital
Rosai-Dorffmann disease.



8.55 - 10.40 Meeting Room 5
Convenor: Prof Michael Aldred

Murray Walker, Sheena Chan, Michael Aldred, Anastasia Georgiou and Anna Talacko.

This will include keynote addresses on CJD in dentistry (Sheena Chan) and periapical pathology (Michael Aldred) with case presentations on granular cell lesions of the oral cavity, odontogenic cysts and other oral pathology cases.



11.00 - 12.45
Convenor: Dr Richard Jaworski

"An Approach to the Diagnosis of Fatty Tumours"
Speaker: Dr. Phil Allen, Flinders Medical Centre, Bedford Park, South Australia.

This will be followed by a slide seminar of 6 cases of soft tissue tumours from both adult and paediatric patients.

Dr. Mark Coleman, Flinders Medical Centre, Bedford Park. South Australia. Dr. Caroline Fung, I.C.P.M.R., Westmead Hospital, Westmead. N.S.W. Dr. Richard Jaworski, I.C.P.M.R., Westmead Hospital, Westmead. N.S.W. Dr. Andrew Kedziora, New Childrens Hospital, Westmead. N.S.W. Dr. Penelope McKelvie, St. VincentÕs Hospital, Melbourne, Victoria.



11:00am - 12:45pm
Convenor: Dr David Cohn

11:00 - 11:20am
1. Lecture:
Changes in the Management of Chronic Hepatitis B & C Š Update
Speaker: Professor Geoff McCaughan, A.W. Morrow Gastroenterology and Liver Centre, R.P.A.H., Sydney. (5 minutes question time)

11:25 - 11:50am
2. Lecture:
Pathology of Chronic Hepatitis B & C
Speaker: Dr Andrew Clouston, Dept. of Pathology, P.A.H., Brisbane.
(5 minutes question time)

11:55 - 12:10pm
3. Lecture:
Patterns of Drug Induced Liver Injury
Speaker: Dr Andrew Clouston, Dept. of Pathology, P.A.H., Brisbane.
(5 minutes question time)

12:15 - 12:40pm
4. Lecture:
Autoimmune Hepatitis
Speaker: Professor Prithi Bhathal, Dept of Pathology, University of Melbourne.
(5 minutes question time).



11.00 - 12.45 Meeting Room 4
Convenor: Dr Jenny MaWyatt

1. Cystic fibrohistiocytic tumour of lung
Presented by Dr Belinda Clarke

2. Amiodarone lung with nodular lesions
Presented by Dr Jeanette Philips

3. Peripheral primitive neuroectodermal tumour (Extraosseous EwingÕs sarcoma).
Presented by Dr Tony Dare

4. Pulmonary hypertension in childhood (2 cases)
Presented by Dr Susan Arbuckle

5. An unusual pleural sarcoma
Presented by Dr Richard Scolyer

"Old and New Problems in Pleural Pathology Part 2"
By Professor Doug Henderson



2.00 - 3.45 Main Auditorium
Convenor: Dr Robert Eckstein

1. Lecture:
Cytomegalovirus infection (15 minutes)
Speaker : Dr Anthony Gill, PaLMS, Royal North Shore Hospital, Sydney

2. Lecture:
Gastrointestinal infection in immunosuppressed patients (60 minutes)
Speaker: Dr Andrew Field, St Vincents Hospital, Sydney

3. Lecture:
Enterohaemorrhagic E. coli infection (15 minutes)
Speaker: Prof Prithi Bhathal, Dept of Pathology, University of Melbourne; Melbourne Pathology, Collingwood

4. Lecture:
Helicobacter pylori infection (15 minutes)
Speaker: Dr Robert Eckstein, PaLMS, Royal North Shore Hospital, Sydney



2.00 - 3.45pm Meeting Room 2
Convenors: Dr Ann Finney and Dr Judy Bligh

FNA of Head and Neck, an Anatomical Approach.
Speaker: Dr Bridget Cooke, Prince of Wales Hospital, Randwick, Sydney.

Case 1 - Dr Kerry James, Institute of Medical and Veterinary Science, Adelaide

Case 2 - Dr Huw Llewellyn, Alfred Hospital, Prahran, Melbourne

Case 3 - Dr Daniel James, Royal Brisbane Hospital, Herston, Brisbane.

Slides from the case presentations will be available for review at morning tea and lunchtime.



2.00 - 3.45 Meeting Room 4
Convenor: Dr Yee Khong



5.15 - 7.00 Main Auditorium
Convenor: Dr Gelareh Farshid

1. Lecture:
The Pathology of Familial Breast Cancer
Speaker: Dr Jane Armes

2. Lecture:
New Biopsy Techniques in the Investigation of Breast Disease - Potential Problems for the Pathologist.
Speaker: Dr Michael Billous

3. Lecture:
Sentinel Node Biopsy in Breast Cancer.
Speaker: Gelareh Farshid



5.15 - 7.00 Meeting Room 2
Convenor: Dr Colin Ades

"T-cell and NK-Cell Lymphomas"
Speaker: Dr Dominic Spagnolo

1. Dr A S-Y Leong, Hunter Area Pathology Services 15 mins including questions
2. Dr Debbie Norris, Mater Hospital, Brisbane
3. Dr Stehen Braye, Hunter Area Pathology Services
4. Dr Colin Ades, Queensland Medical Laboratories, Brisbane



5.15 - 7.00 Meeting Room 4
Convenor: Dr Geoffrey Watson

1. Renal Mass
Dr Ronald Cohen, QE II Medical Centre, WA

2. Prostatic Core
by Dr Victor Lee, RPAH, NSW.

3. Nephrectomy Specimen
Dr Warrick Delprado, DHM, NSW

4. Partial cystectomy
Dr Wendy Cooper, RPAH, NSW

5. Renal Mass
Dr Veli Marjoniemi, St George Hosp, NSW

6. Nephrectomy specimen
Dr Geoff Watson, RPAH, NSW

7. Nephrectomy specimen
Dr Geoff Watson, RPAH, NSW

8. Extrarenal mass
Dr Geoff Watson, RPAH, NSW

Expert panel discussion on "Hot Issues in Uropathology".
Panelists include Dr Ronald Cohen (Uropath WA), Dr Warrick Delprado (Douglass Hanly Moir Pathology, NSW) and Dr John Rogers (Urologist VMO, RPAH, NSW). The panel will discuss "hot" issues in uropathology, and there will be opportunity for questions from the floor.



1.00 - 3.45 Meeting Room 5
Convenor: Dr John Dowling

1. Lecture:
Minimal change lesion and differential diagnosis of the "normal" biopsy
Speaker: Claire Cooke-Yarborough, Prince of Wales Hospital Sydney.

2. Lecture:
Mesangial immune complex nephropathy - features and differential diagnosis
Speaker: Moira Finlay, Anatomical Pathology, Royal Melbourne Hospital.

3. Lecture:
The thrombotic microangiopathies
Speaker: Duncan MacGregor, Austin & Repatriation Medical Centre.

4. Lecture:
Myeloma kidney and other proteinopathies
Speaker: Prue Hill, St Vincents Pathology, Melbourne.

5. Lecture:
Crescentic GN and its differential diagnosis including renal vasculitis
Speaker: Roy Axelsen, Princess Alexandra Hospital

Emphasis will be on basic pathological features and differential diagnosis. A set of 35mm slides relating to the subjects (approximately 45-50 slides) will be available at cost for order at the meeting.




7th Asia-Pacific Association of Societies of Pathologists Conference

18-23 November, 2001

For more information contact:
Ms Christine Tsiang.
Ph. (65) 773 3750 or (65) 773 772 5345
Fax (65) 775 1757