Professor John G. Azzopardi - Obituary

The international community of pathologists hasrecently lost one of its icons, John G. Azzopardi. Hewas born in Valetta (Malta) on the 25th of June 1929and died on the 2nd of January 2013 in London (UK).He has been laid to rest in Sliema (Malta).He started his medical training at the Royal Uni-

versity of Malta in 1942 at the tender age of 13. Lec-tures were scattered in time and space because of thesiege of Malta during the Second World War. Hospitaltraining was under wartime emergency conditions.He qualified as M.D. in 1949, standing first in hisyear. He moved to England, where he spent the firstyears in junior house jobs in Sheffield, then took up ascholarship to attend a course of Pathology at theRoyal Postgraduate Medical School (RPMS), Hammer-smith Hospital, London. Apart from brief sabbaticals,he never left ‘his’ hospital. He was appointed to theacademic hospital staff and rose through the ranks

from junior posts to Lecturer, Reader and Professor ofOncology until retirement.He was invited to spend a year (1960–61) at the

prestigious Armed Forces Institute of Pathology, Wash-ington, DC, and 2 months at the University of Bolognain 1972. He gave several well-received lectures in vari-ous European countries, but he was fully ‘discovered’by the North American Pathologists in 1975, when hewas invited to speak and give a slide seminar at theannual California Tumor Registry at Stanford Univer-sity. This visit resulted in several job offers in pursuingan academic career in the United States. He wasthrilled by all these offers, but he never left the RPMSas he did not like changes nor did he look for honors.Interestingly, he has never compiled his CV; the reasongiven by those who have worked with him, ‘he was thesort of man that did not need one’.Mentioning Azzopardi’s name results in an immedi-

ate association with breast pathology. However, JohnG. Azzopardi was far from being a pure specialist andhe can be included into the general surgical patholo-gist-morphologist-pathobiologist species, which hasflourished in Europe, to use J. Rosai’s words.1 Themajority of the papers he has written have becomethe standard reference for the respective entities: theschwannian origin of myoblastoma;2 the mucin pro-file of salivary gland tumors;3 the insuperable descrip-tion of bronchial oat-cell carcinoma with DNAincrustration of the wall of blood vessels (since thenknown as the Azzopardi’s phenomenon);4 the genesisof adenolymphoma of parotid in lymph nodes;5 theneuroendocrine (divergent) differentiation in gastric,6

cervical,7 prostatic8 and breast carcinomas;9,10 theretrogression in testicular seminomas with viablemetastases;11 the systemic effects of neoplasia (para-neoplastic syndromes);12 the pathology of ‘non-endo-crine tumors’ associated with Cushing syndrome;13

the distinctive tumor entity of bone and soft tissueassociated with acquired vitamin-D-resistant osteoma-lacia;14 and the occurrence of blue nevi in the cap-sule of lymph nodes,15 just to cite a few. Asimpressive as this work is, it pales in comparison withhis magnum opus, the book ‘Problems in BreastPathology’, published in 1979 (Volume 11 in the ser-ies Major Problems in Pathology, Bennington JL).1

As of today, it is regarded as the best and mostinsightful work on the morphologic analysis of breasttumors; a book which laid the foundation for subse-quent publications to come. The masterly histologicdescriptions are combined with clear definition ofentities. The critical analysis of the literature is

As a testament to Dr. Azzopardi’s contributions to our field at large,

this obituary is also being jointly published in the forthcoming

issues of the following journals: American Journal of Surgical

Pathology, Human Pathology, and Virchows Archiv.

© The Authors

Histopathology © 2013 Blackwell Publishing Limited.

Histopathology 2013, 62, 822–823. DOI: 10.1111/his.12128

presented in an admirable ‘reader-friendly’ fashion. Inthe preface of the book Azzopardi states: ‘all the refer-ences, unless otherwise stated, have been read intheir entirety, many of them more times than I careto remember’. James Bennington (consulting editor ofthe series) predicted this book would become ‘anindispensable and timeless reference for all those whoare interested in the surgical pathology of breasttumors’. Tirty years later, an issue of Seminars inDiagnostic Pathology entitled ‘Problems in breastpathology revisited’ was written by some of thosewho had worked directly with him or had been influ-enced by his unique insights to the field.Most of the trainees have learnt that in order to

work with Professor Azzopardi the following simple‘rules’ had to be respected: (i) adhere strictly to theofficial starting time; (ii) complete the requested taskwith accuracy and celerity; (iii) during the consultsessions, not to speak until asked to address the ques-tion ‘What’s the story?’ Start with the age followedby the gender of the patient; (iv) Not to carry histolo-gic slides (even if it is only one) in hand or pockets,but must place them on slide trays, with the lidclosed. Once these rules were followed, one wouldthen discover a fatherly teacher, a generous friend,and sometimes be the target of one of his abrasivebut well intentioned remarks. To a famous professorof pathology, expert in morphometry, who asked himwhat he thought of that technique, he replied that heliked it very much, provided he was not involvedwith it. On another instance, a young pathologistshowed him a tumor case accompanied by the intro-ductory remark ‘I do not know what this is butwould diagnose it as benign’. Professor Azzopardilooked at the poor pathologist with a sight of unfor-gettable commiseration and let him know that it wasvery dangerous to label a tumor as benign or malig-nant if one did not know its nature.Professor Azzopardi has been consulted by patholo-

gists from all over the world. He provided expert opin-ion free of charge. He kept the most educational anddiagnostically challenging cases in ‘black slide boxes’,accompanied by his handwritten notes containingunderlined key points organized perfectly for futurestudies. Most of this highly instructive histologic slidecollection is currently available in the Department ofPathology at the University of Bologna.A meeting of breast pathology in Professor Azzop-

ardi’s honor was held in Malta in May 2006. A largeaudience/speakers from all parts of the world con-vened, including several of his pupils that he used tocall ‘his stable’ as well as pathologists who wanted to

meet Professor Azzopardi for the first time. To quote aSouth American pathologist, ‘meeting him was anunforgettable experience’.Professor J.G. Azzopardi is survived by his wife

Sally, (who lovingly typed the entire book, in the pre-computer era, as he did not trust anybody else withsuch a task) two children (Timothy and Joanna), andfour grand-daughters.

Vincenzo Eusebi, MD, FRCPathDepartment of Anatomic and Surgical Pathology,

University of Bologna, Bologna, Italy,Thomas Krausz, MD, FRCPath

Department of Anatomic and Surgical, Pathology,University of Chicago, Chicago, IL, USA

References

1. Rosai J. Preface to “problems in breast pathology revisited”. Se-

min. Diagn. Pathol. 2010; 27; 2–4.2. Azzopardi JG. Histogenesis of the granular-cell “myoblastoma”.

J. Pathol. Bacteriol. 1956; 71; 85–94.3. Azzopardi JG, Smith OD. Salivary gland tumours and their

mucins. J. Pathol. Bacteriol. 1959; 77; 131–140.4. Azzopardi JG. Oat-cell carcinoma of the bronchus. J. Pathol.

Bacteriol. 1959; 78; 513–519.5. Azzopardi JG, Hou LT. The genesis of adenolymphoma.

J. Pathol. Bacteriol. 1964; 88; 213–218.6. Azzopardi JG, Pollock DJ. Argentaffin and argyrophil cells

in gastric carcinoma. J. Pathol. Bacteriol. 1963; 86;

443–451.7. Azzopardi JG, Tsun HL. Intestinal metaplasia with argentaffin

cells in cervical adenocarcinoma. J. Pathol. Bacteriol. 1965; 90;

686–690.8. Azzopardi JG, Evans DJ. Argentaffin cells in prostatic carci-

noma: differentiation from lipofuscin and melanin in prostatic

ephitelium. J. Pathol. 1971; 104; 247–251.9. Capella C, Eusebi V, Mann B, Azzopardi JG. Endocrine differen-

tiation in mucoid carcinoma of the breast. Histopathology

1980; 4; 613–630.10. Azzopardi JG, Muretto P, Goddeeris P, Eusebi V, Lauweryns

JM. “Carcinoid” tumours of the breast: the morphological

spectrum of argyrophil carcinomas. Histopathology 1982; 6;

549–569.11. Azzopardi JG, Hoffbrand AV. Retrogression in testicular semi-

noma with viable metastases. J. Clin. Pathol. 1965; 18;

135–141.12. Azzopardi JG. Systemic effects of neoplasia. In Harrison CV ed.

Recent Advances in Pathology. Boston: Little, Brown and Com-

pany, 1966; 98–175.13. Azzopardi JG, Williams ED. Pathology of “nonendocrine”

tumors associated with Cushing’s syndrome. Cancer 1968; 22;

274–286.14. Evans DJ, Azzopardi JG. Distinctive tumours of bone and soft

tissue causing acquired vitamin-D-resistant osteomalacia. Lan-

cet 1972; 12; 353–354.15. Azzopardi JG, Ross CMD, Frizzera G. Blue naevi of lymph node

capsule. Histopathology 1977; 1; 451–461.

© The Authors

Histopathology © 2013 Blackwell Publishing Ltd, Histopathology, 62, 822–823.

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