Eble JN, Sauter G., Epstein JI, Sesterhenn IA - iarc

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Urothelial carcinoma in situ I.A. <strong>Sesterhenn</strong> Definition A non-papillary, i.e. flat, lesion in which the surface epithelium contains cells that are cytologically malignant. ICD-O code 8120/2 Synonym High grade intraurothelial neoplasia. Incidence De novo (primary) carcinoma in situ accounts for less than 1-3% of urothelial neoplasms, but is seen in 45–65% of invasive urothelial carcinoma. It is present in 7-15% of papillary neoplasms {744,1362,1850,2315,2836}. Site of involvement Urothelial carcinoma in situ is most commonly seen in the urinary bladder. In 6 - 60%, the distal ureters are involved. Involvement of the prostatic urethra has been reported in 20-67% and in the prostate, involving ducts and acini, in up to 40%. It may be seen in the renal pelvis and proximal ureters {744,798,921,1362, 1596,2187,2319,2679}. extend into the upper cell layers. The cytoplasm is often eosinophilic or amphophilic. There is loss of cell polarity with irregular nuclear crowding {425,706, 743,1547,1798,1844,1845,1982}. The neoplastic change may or may not involve the entire thickness of the epithelial layer and umbrella cells may be present. It may be seen at the basal layer only or may overlay benign appearing epithelium. Individual cells or clones of neoplastic cells may be seen scattered amidst apparently normal urothelial cells and this is referred to as pagetoid spread {425,1547,1552,1678,1982}. Loss of Fig. 2.43 Carcinoma in situ. intercellular cohesion may result in a denuded surface ("denuding cystitis") {688} or in residual individual neoplastic Clinical features CIS patients are usually in the 5th to 6th decade of life. They may be asymptomatic or symptomatic with dysuria, frequency, urgency or even hematuria. In patients with associated urothelial carcinoma, the symptoms are usually those of the associated carcinoma. A Macroscopy The mucosa may be unremarkable or erythematous and oedematous. Mucosal erosion may be present. Histopathology Urothelial carcinoma in situ shows nuclear anaplasia identical to high grade urothelial carcinoma. The enlarged nuclei are frequently pleomorphic, hyperchromatic, and have a coarse or condensed chromatin distribution; they may show large nucleoli. Mitoses including atypical ones are common and can B Fig. 2.44 Non-invasive urothelial neoplasm. A, B Urothelial carcinoma in situ. Urothelial carcinoma in situ 119
A Fig. 2.45 Non-invasive urothelial neoplasms. A, B Urothelial carcinoma in situ. B cells attached to the surface referred to as "clinging" CIS. In such cases cytology is very helpful. Von Brunn nests and cystitis cystica may be completely or partially replaced by the cytologically malignant cells. CIS may consist of predominantly small cells referred to as small cell variant or of rather large cells. CIS commonly is multifocal and may be diffuse. It can involve several sites in the urinary tract synchronously or metachronously. The degree of cellular atypia may vary from site to site. The lamina propria usually shows an inflammatory infiltrate, some degree of oedema and vascular congestion. Immunoprofile Markers, which are abnormally expressed in invasive and papillary urothelial neoplasm have also been evaluated in CIS {494,964}. Cytokeratin 20 is abnormally expressed in CIS {1023}. Abnormal expression of p53 and RB protein may correlate with progression of CIS {498,725,1530,2294,2331,2364, 2457}. The nuclear matrix protein NMP22 is present in CIS {2484}. Ploidy The DNA analysis shows an aneuploid cell population, in some patients several aneuploid cell populations are present in the same lesion {977,1918,2060,2641}. Prognosis Data suggest that de novo (primary) CIS is less likely to progress to invasive disease than secondary CIS {1981,2115, 2237,2803}. Patients with CIS and concomitant invasive tumours die in 45-65% of cases compared to 7-15% of patients with CIS and concomitant non-invasive papillary tumour {1846}. CIS with multiple aneuploid cell lines appears to be at high risk of progression {1918}. Extensive lesions associated with marked symptoms have a guarded prognosis. Genetics and predictive factors of non-invasive urothelial neoplasias R. Simon P.A. Jones D. Sidransky C. Cordon-Cardo P. Cairns M.B. Amin T. Gasser M.A. Knowles Genetics of urinary bladder cancer development and progression The genetic studies to date have used tumours classified according to the 1973 WHO Tumours Classification; studies are underway to link available genetic information to the current classification. Urinary bladder cancer has earlier been categorized into "superficial" (pTa, pT1, CIS) and "invasive" (pT2-4) cancer depending on whether or not tumour infiltration extended to the muscular bladder wall {2133}. The available genetic data now suggest another subdivision of urinary bladder neoplasia. Two genetic subtypes with marked difference in their degree of genetic instability correspond to morphologically defined entities. The genetically stable category includes low grade non-invasive papillary tumours (pTa). The genetically unstable category contains high grade (including pTa G3 and CIS) and invasively growing carcinomas (stage pT1-4). Non-invasive low grade papillary bladder neoplasms (pTa, G1-2) have only few genomic alterations and are therefore viewed as “genetically stable” {2189, 2418,2552,2934}. Losses of chromosome 9, often involving the entire chromosome, and mutations of FGFR3 are the most frequent known genetic alterations in these tumours. Gene amplifications and TP53 mutations are rare {818,1748,2066,2190,2421,2422}. DNA aneuploidy occurs in less than 50% {2304,2599,2931}. Invasively growing and high grade neoplasias are markedly different from noninvasive papillary low grade tumours. They appear to be genetically unstable and have many different chromosomal 120 Tumours of the urinary system
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World Health Organization Classific
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This volume was produced in collabo
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Contents 1 Tumours of the kidney 9
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CHAPTER 1 Tumours of the Kidney Can
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TNM classification of renal cell ca
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one quarter of kidney cancers in bo
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Familial renal cell carcinoma M.J.
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Table 1.02 Genotype - phenotype cor
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A B Fig. 1.11 A Multiple cutaneous
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A B Fig. 1.14 Birt-Hogg-Dubé syndr
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Clear cell renal cell carcinoma D.J
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Fig. 1.20 Clear cell renal cell car
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Papillary renal cell carcinoma B. D
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A B Fig. 1.29 Papillary renal cell
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Fig. 1.33 Chromophobe RCC with sarc
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Carcinoma of the collecting ducts o
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Renal medullary carcinoma C.J. Davi
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Renal carcinomas associated with Xp
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Renal cell carcinoma associated wit
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Papillary adenoma of the kidney J.N
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of this tumour. Microscopic extensi
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A B Fig. 1.59 Metanephric adenoma.
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esults in intratumoral aneurysms. O
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peritumoural fibrous pseudocapsule.
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increases in prevalence to approxim
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Nephrogenic rests and nephroblastom
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Cystic partially differentiated nep
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A B Fig. 1.80 Clear cell sarcoma of
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A B Fig. 1.85 Rhabdoid tumour of th
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transcription factor is fused to th
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Leiomyosarcoma S.M. Bonsib Definiti
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Angiomyolipoma G. Martignoni M.B. A
Page 65 and 66: melanocytic and smooth muscle marke
Page 67 and 68: Multinucleated and enlarged ganglio
Page 69 and 70: Haemangioma P. Tamboli Definition H
Page 71 and 72: Fig. 1.107 Juxtaglomerular cell tum
Page 73 and 74: Intrarenal schwannoma I. Alvarado-C
Page 75 and 76: Mixed epithelial and stromal tumour
Page 77 and 78: Synovial sarcoma of the kidney J.Y.
Page 79 and 80: Renal carcinoid tumour L.R. Bégin
Page 81 and 82: Primitive neuroectodermal tumour (E
Page 83 and 84: Paraganglioma / Phaeochromocytoma P
Page 85 and 86: Leukaemia A. Orazi Interstitial inf
Page 87 and 88: WHO histological classification of
Page 89 and 90: TNM classification of carcinomas of
Page 91 and 92: The risk of bladder cancer goes dow
Page 93 and 94: Tumour spread and staging Urinary b
Page 95 and 96: feature in such patients undergoing
Page 97 and 98: A Fig. 2.12 Infiltrative urothelial
Page 99 and 100: A Fig. 2.15 A Infiltrating urotheli
Page 101 and 102: A B Fig. 2.19 A Infiltrative urothe
Page 103 and 104: Fig. 2.23 Infiltrative urothelial c
Page 105 and 106: ing systems have been proposed on t
Page 107 and 108: Non-invasive urothelial tumours G.
Page 109 and 110: chronically inflamed urothelium and
Page 111 and 112: Inverted papilloma G. Sauter Defini
Page 113 and 114: muscle invasive disease, but there
Page 115: Fig. 2.42 Non-invasive urothelial n
Page 119 and 120: for DBCCR1 silencing {984,2476}. Th
Page 121 and 122: Squamous cell carcinoma D.J. Grigno
Page 123 and 124: Fig. 2.51 Squamous cell carcinoma.
Page 125 and 126: Adenocarcinoma A.G. Ayala P. Tambol
Page 127 and 128: A B Fig. 2.61 A Adenocarcinoma in s
Page 129 and 130: A B Fig. 2.65 Intramural urachal ca
Page 131 and 132: Müllerian origin is postulated for
Page 133 and 134: A Fig. 2.69 Small cell carcinoma. A
Page 135 and 136: Carcinoid L. Cheng Definition Carci
Page 137 and 138: Leiomyosarcoma J. Cheville Definiti
Page 139 and 140: Osteosarcoma L. Guillou Definition
Page 141 and 142: Leiomyoma J. Cheville Definition A
Page 143 and 144: Haemangioma L. Cheng Definition Hae
Page 145 and 146: Metastatic tumours and secondary ex
Page 147 and 148: Tumours of the renal pelvis and ure
Page 149 and 150: nodular, ulcerative or infiltrative
Page 151 and 152: Tumours of the urethra F. Hofstädt
Page 153 and 154: usually show enteric, colloid or si
Page 155 and 156: CHAPTER 3X Tumours of of the the Pr
Page 157 and 158: TNM classification of carcinomas of
Page 159 and 160: contrast, mortality among migrants
Page 161 and 162: Fig. 3.06 Transrectal ultrasound of
Page 163 and 164: PSA-related diagnostic strategies.
Page 165 and 166: A B C Fig. 3.10 A,B Section of pros
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pale-clear, similar to benign gland
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A B Fig. 3.20 A, B Adenocarcinoma w
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prostate adenocarcinomas exhibit AR
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A Fig. 3.27 A, B Foamy gland adenoc
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A B Fig. 3.32 A Sarcomatoid carcino
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A B Fig. 3.37 A Gleason score 1+1=2
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A B Fig. 3.43 A Prostate cancer Gle
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Fig. 3.48 Heat map-nature. From S.M
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Fig. 3.51 Prostate cancer. Major su
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many stage T1b cancers. Stage T2 Mo
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Fig. 3.58 Patterns of seminal vesic
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Prostatic intraepithelial neoplasia
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A B Fig. 3.63 A Micropapillary high
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A B Fig. 3.68 A Ductal carcinoma in
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Ductal adenocarcinoma X.J. Yang L.
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Papillary pattern can be seen in bo
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A B Fig. 3.74 A Inflammation withou
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Squamous neoplasms T.H. Van der Kwa
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Neuroendocrine tumours P.A. di Sant
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Mesenchymal tumours J. Cheville F.
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Fig. 3.89 Sarcoma of the prostate.
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Miscellaneous tumours P.H. Tan L. C
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A Fig. 3.96 A Adenocarcinoma of the
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WHO histological classification of
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Introduction F.K. Mostofi I.A. Sest
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wartime birth cohorts illustrate th
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Similar tumours as those of group 1
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crucial for the development of this
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A B Fig. 4.09 Spermatocytic seminom
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A B Fig. 4.14 Intratubular germ cel
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A B Fig. 4.19 Seminoma. A Typical s
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Fig. 4.24 Seminoma. Vascular invasi
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Fig. 4.28 Spermatocytic seminoma wi
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A B Fig. 4.33 Embryonal carcinoma.
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A B Fig. 4.38 Yolk sac tumour. A En
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have cytoplasmic lacunae that conta
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A Fig. 4.46 Teratoma. A Longitudina
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A B Fig. 4.51 A Cut surface of derm
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Fig. 4.54 Mixed germ cell tumour. L
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Sex cord / gonadal stromal tumours
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A B C Fig. 4.67 Malignant Leydig ce
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A Fig. 4.73 A Sertoli cell tumour.
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ICD-O codes Granulosa cell tumour 8
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ICD-O code 8592/1 Clinical features
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A B Fig. 4.83 Germ cell-sex cord/go
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A Fig. 4.85 A, B Brenner tumour of
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typical grade III follicular morpho
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testicular parenchyma and tumour te
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A B the surgical scar and adjacent
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Immunoprofile Ordóñez and associa
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often have a grey-white cut surface
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Fig. 4.111 Angiomyofibroblastoma-li
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A B Fig. 4.119 Embryonal rhabdomyos
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Table 4.05 Secondary tumours of the
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WHO histological classification of
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A Fig. 5.04 A, B Squamous cell carc
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deformed by an exophytic mass. In s
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A B C Fig. 5.12 A Warty (condylomat
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A Fig. 5.20 Bowenoid papulosis. A,
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three had been circumcized by 9 yea
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Mesenchymal tumours J.F. Fetsch M.
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Fig. 5.31 Neurofibroma of the penis
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oectodermal tumour/Ewing sarcoma [p
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Secondary tumours of the penis C.J.
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Dr John N. EBLE* Dept. of Pathology
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Dr Ricardo PANIAGUA Department of C
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Source of charts and photographs 1.
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References 1. Anon. (1955). Case re
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115. Ariel I, Sughayer M, Fellig Y,
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246. Birt AR, Hogg GR, Dube WJ (197
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374. Cardone G, Malventi M, Roffi M
Page 309 and 310:
502. Corti B, Carella R, Gabusi E,
Page 311 and 312:
633. Donhuijsen K, Schmidt U, Richt
Page 313 and 314:
768. Fischer J, Palmedo G, von Knob
Page 315 and 316:
900. Goedert JJ, Cote TR, Virgo P,
Page 317 and 318:
1028. Hartmann A, Dietmaier W, Hofs
Page 319 and 320:
1162. Iezzoni JC, Fechner RE, Wong
Page 321 and 322:
1293. Keetch DW, Catalona WJ (1995)
Page 323 and 324:
1424. Ladanyi M, Lui MY, Antonescu
Page 325 and 326:
1548. Lopez-Beltran A, Croghan GA,
Page 327 and 328:
1681. McLaughlin JK, Silverman DT,
Page 329 and 330:
1816. Moudouni SM, En-Nia I, Rioux-
Page 331 and 332:
1945. Ohori M, Wheeler TM, Kattan M
Page 333 and 334:
2070. Phillips G, Kumari-Subaiya S,
Page 335 and 336:
2199. Riou G, Barrois M, Prost S, T
Page 337 and 338:
2327. Schmidt L, Junker K, Weirich
Page 339 and 340:
2450. Smith G, Elton RA, Beynon LL,
Page 341 and 342:
2572. Tamboli P, Mohsin SK, Hailema
Page 343 and 344:
2693. van Echten J, Timmer A, van d
Page 345 and 346:
2816. Wick MR, Berg LC, Hertz MI (1
Page 347 and 348:
2937. Zhuang Z, Park WS, Pack S, Sc
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CCNB, 226 CCND1, 105, 108 CCND2, 22
Page 351 and 352:
J Juvenile type granulosa cell tumo
Page 353 and 354:
Promoter methylation, 21 Prostate s
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Eble JN, Sauter G., Epstein JI, Sesterhenn IA - iarc

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