60 59

(1)

Fig. 59 Malignant phaeochromocytoma, hepatic metastasis.

X 120

Fig. 60 Malignant sympathetic paraganglioma, lymph node metastasis

Primary in bladder. x 1 20

Hypertension

(2)

Fig. 61 Malignant parasympathetic paraganglioma, carotid body

local invasion and lymph node metastasis occurred. x 75

Fig. 62 Neuroblastoma, adrenal medulla

X 120

(3)

Fig. 63 Neuroblastoma, adrenal medulla

Neurofibrillary area. x 300

Fig. 64 Mixed neuroendocrine-neural tumour, adrenal medulla

Ganglioneuromatous area. Fig. 64 to 66 are from same case.

X 120

Hypertension

(4)

Partly ganglioneuromatous, partly diffuse phaeochromocy- toma (centre of field). x 120

Area of malignant phaeochromocytoma with mitotic activity.

X 300

Hypertension

(5)

Fig. 67 Adenoma, parathyroid

Adenoma with attached normal gland and thyroid. x 5

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Fig. 68 Chief cell adenoma, parathyroid Rim of suppressed gland. x 120

Hyperparathyroidism

(6)

Fig. 69 Chief cell adenoma, parathyroid Nuclear pleomorphism. X 120

Fig. 7Q Chief cell adenoma, parathyroid Follicular architecture simulates thyroid. x 120

Hyperparathyroidism

(7)

Fig. 71 Chief cell adenoma, parathyroid

Portion of fibrous wall of cystic tumour. x 50

Fig. 72 Water-clear cell adenoma, parathyroid

Rim of inactive chief cells with some oxyphils. x 30

Hyperparathyroidism

(8)

Fig. 73 Oxyphil cell adenoma, parathyroid

Abundant granular eosinophilic cytoplasm. x 300

Fig. 74 Inactive parathyroid gland

Small chief cells, fat. Same case as Fig. 70. x 300

Hyperparathyroidism

(9)

Fig. 75 Carcinoma, parathyroid Hyperparathyroidism Broad trabecular pattern, fibrous bands. X 50

Fig. 76 Carcinoma, parathyroid Hyperparathyroidism

Invasion of muscle and vessels at edge of tumour. X 50

(10)

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Fig. 77 Carcinoma, parathyroid

Vascular invasion. X 120

Fig. 78 Carcinoma, parathyroid

Uniform cells, mitotic activity. x 75 '

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Hyperparathyroidism

(11)

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Fig. 79 Lipoadenoma, parathyroid

Section of 5 cm tumour. x 50

Fig. 80 Primary nodular hyperplasia, parathyroids

Large upper, small lower glands. x 3

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Hyperparathyroidism, MEN I

(12)

Fig. 81 Primary nodular hyperplasia, parathyroid

Chief and oxyphil cell nodules. x 50

Fig. 82 Primary nodular hyperplasia, parathyroid

Multiple ill-defined oxyphil cell nodules. x 50

Hyperparathyroidism. MEN I

(13)

Fig. 83 Primary nodular hyperplasia, parathyroid Nodules of differing architecture and cell type. X 120

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Fig. 84 Primary water-clear cell hyperplasia, parathyroid.

X 120

(14)

Fig. 85 Secondary hyperplasia, parathyroid Uniform appearance found in all glands. Renal failure. X 30

Fig. 86 Secondary hyperplasia, parathyroids Long-standing renal failure. Early nodularity in one gland.

X 3

Secondary hyperparathyroidism

(15)

Fig. 87 Nodular hyperplasia, parathyroids

Nodularity in all glands. Hypercalcaemia and long-standing renal failure. x 3

Fig. 88 Adenomas, parathyroids

Two adenomas and two suppressed glands. Hypercalcaemia and long-standing renal failure. x 3

Tertiary hyperparathyroidism

(16)

Fig. 89 Nodular hyperplasia, parathyroid

Hypercalcaemia and renal failure. x 12

Fig. 90 Nodular hyperplasia, parathyroid

Oxyphil and chief cell nodules. x 50

Tertiary hyperparathyroidism

(17)

Fig. 91 EC-cell carcinoid, ileum

Mainly submucosal tumour extending through thickened muscle to serosa. x 5

Solid islands of cells in a fibrous stroma. X 50

(18)

Submucosal tumour. Islands of cells with glandular differen- tiation. x 50

Fig. 94 EC-cell carcinoid, appendix

Islands and strands of tumour in fibrous stroma. x 120

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(19)

Fig. 95 EC-cell carcinoid, appendix

Oiazo-positivity most marked in basigranular peripheral cells.

Alkaline diazonium. X 120

Carcinoid invading mucosa. Note distinction between normal Paneth cells and eosinophilic granular tumour cells. x 300

(20)

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Same case and area as Fig. 96. Bodian. x 300

(21)

Fig. 99 EC-cell carcinoid, ileum Carcinoid syndrome Hepatic metastasis, partial cystic change. Grimelius x 120

Fig. 100 G-cell tumour, pancreas Zollinger-EIIison syndrome Trabecular pattern. Tumour metastasized. MEN I. x 120

(22)

Fig. 101 G-cell tumour, pancreas Mitotic activity. X 300

Fig. 1 02 G-cell tumour, pancreas

Argyrophilic cells. Small tumour in MEN I. Grimelius. X 120

Zollinger-EIIison syndrome

(23)

Fig. 103 G-cell tumour, pancreas Argyrophilic cells. Grimelius. x 300

Fig. 1 04 Bronchial carcinoid

Regular cells, granular cytoplasm. x 300

Zollinger-EIIison syndrome

(24)

Solid islands of cells. Resemblance to classic carcinoid pattern. Same case as Fig. 1 07 and 1 OB. x 120

Ribbon pattern, same case as Fig. 1 04. x 300

(25)

Fig. 107 Bronchial carcinoid

Encroaching on bronchial lumen. Diffuse pattern. x 120

Scattered argyrophilic cells. Same case and area as Fig.

1 07. Grimelius. X 120

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(26)

Fig. 109 Bronchial carcinoid

Strongly argyrophilic tumour. Bodian. x 120

Fig. 11 0 Thymic carcinoid X 120

Cushing"s syndrome (ectopic ACTH)

(27)

Fig. 111 Gastric carcinoid X 120

Fig. 112 Gastric carcinoid

Argyrophil cells and glandular structures. Bielschowsky.

X 120

Cushing"s syndrome (ectopic ACTH)

(28)

Fig. 113 Pancreatic carcinoid

X 75

Fig. 114 Pancreatic carcinoid

Grimelius-neutral red. x 190

Verner-Morrison syndrome

(29)

Fig. 115 Duodenal carcinoid

X 30

Fig. 11 6 Duodenal carcinoid Trabecular pattern. X 120

(30)

Fig. 117 Duodenal carcinoid Argyrophilia. Grimelius. X 120

Fig. 118 Rectal carcinoid

Small submucosal tumour. Trabecular pattern. x 30

(31)

Mixed pattern. x 50

Ribbon pattern. x 120

(32)

Fig. 121 Gall bladder carcinoid

X 120

Fig. 122 Mucocarcinoid, appendix

Well-differentiated goblet cells invading muscle. X 120

(33)

Isolated argentaffin cells. Masson-Fontana-Mucicarmine.

X 120

Perineural invasion in appendiceal muscle. Argentaffin cells.

Masson-Fontana-Mucicarmine. x 300

(34)

Fig. 125 Mixed carcinoid-adenocarcinoma, rectum

Carcinoid component. X 120

Carcinoma with signet-ring cells. Same tumour as Fig. 1 25.

X 120

(35)

Both patterns of growth. Argyrophil cells.

Bodian-mucicarmine x 120

Fig. 128 Adenocarcinoma, rectum

Scattered EC-cells present. See Fig. 129. x 120

(36)

Fig. 129 Adenocarcinoma, rectum

EC-cells. Same case and area as Fig. 128. Masson- Hamperl. x 120

Fig. 130 Mucinous carcinoma, ovary

Numerous very prominent EC-cells seen in haematoxylin·

eosin section. x 300

(37)

Fig. 131 Normal islets of Langerhans

B cells (purple). Aldehyde fuchsin. x 300

Fig. 1 32 Normal islets of Langerhans

A cells (argyrophilic). Grimelius. X 1 20

(38)

Fig. 133 Islet cell adenoma

8-cell adenoma, trabecular pattern. X 120

Fig. 134 Islet cell adenoma Stromal amyloid. x 120

Hypoglycaemia

(39)

B-cell adenoma. x 300

B-cell adenoma. x 190

Hypoglycaemia

(40)

Capsule. hyperplastic islets. x 50

Clear cells, resemblance to adrenal cortex. x 120

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MEN I

(41)

B-cell adenoma. Aldehyde fuchsin-positive cells. Aldehyde fuchsin. x 300

Fig. 140 Islet cell carcinoma

B-cell tumour. Stromal fibrosis, calcification and amyloid. X 75

Hypoglycaemia

(42)

Fig. 141 Islet cell carcinoma Hypoglycaemia B-cell tumour. Hepatic metastases occurred. x 190

Fig. 142 Islet cell carcinoma Hypoglycaemia

Liver metastasis. Regular cells, mitotic activity. x 480

(43)

Fig. 143 Poorly differentiated endocrine carcinoma, pancreas

Liver metastasis. x 120

Fig. 144 Poorly differentiated endocrine carcinoma, pancreas

X 300

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Hyperglycaemia

(44)

Fig. 145 Islet cell hyperplasia

Large numerous islets in normal exocrine pancreas. x 50

Fig. 146 Islet cell hyperplasia

Chronic pancreatitis. Crowded islets, destroyed exocrine pancreas. x 50

MEN I

60 59

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