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

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Angiosarcoma J. Cheville Definition Angiosarcoma of the urinary bladder is a very rare sarcoma that arises from the endothelium of blood vessels. ICD-O code 9120/3 Clinical features Only 10 cases of urinary bladder angiosarcoma have been reported, all as case reports {699}. Males are more frequently affected than females, and tumours occur Fig. 2.77 Angiosarcoma of urinary bladder. CD31 expression. in adults with a mean age at diagnosis of 55 years. Patients present with hematuria, and approximately a third of cases are associated with prior radiation to the pelvis, either for gynecologic malignancies or prostate cancer {699,1874}. Macroscopy Angiosarcoma of the bladder is typically a large tumour but can be as small as 1 cm. Most tumours exhibit local or distant extension beyond the bladder at the time of diagnosis. Histopathology Histopathologic features consist of anastomosing blood-filled channels lined by cytologically atypical endothelial cells. Some angiosarcomas have solid areas, and epithelioid features can be present {2322}. Urinary bladder angiosarcoma stains positively with the immunohistochemical markers of endothelium including CD31 and CD34. The only epithelioid angiosarcoma of the urinary bladder reported to date was negative for cytokeratin, but some epithelioid angiosarcomas at other sites can be cytokeratin positive. Angiosarcoma must be distinguished from haemangioma of the bladder. Haemangioma of the bladder is typically small (usually less than 1 cm), and nearly 80% are of the cavernous type {431}. Urinary haemangioma lacks cytologic atypia and the anastomosing and solid areas of angiosarcoma. Pyogenic granuloma is another benign vascular proliferation that very rarely occurs in the bladder, and is composed of closely spaced capillaries lined by bland endothelium which may show mitotic activity {90}. Kaposi sarcoma may involve the urinary bladder and should be considered in the differential diagnosis, especially in immunocompromised patients {2183,2866}. Rarely, high grade urothelial carcinoma can mimic angiosarcoma but the identification of a clearly epithelial component as well as immunohistochemistry can be diagnostic {2085}. Prognosis Urinary bladder angiosarcoma is a very aggressive neoplasm, and approximately 70% of patients die within 24 months of diagnosis {699}. Leiomyosarcoma / Angiosarcoma 141
Osteosarcoma L. Guillou Definition A malignant mesenchymal tumour showing osteoid production. ICD-O code 9180/3 Epidemiology Most osteosarcomas of the urinary bladder occurred in male patients (male to female ratio: 4:1), with an average age of 60-65 years {215,863,2900}. Etiology One case of bladder osteosarcoma occurred 27 years after radiation therapy for urothelial carcinoma {754}. A few patients had concurrent urinary schistosomiasis {2900}. Localization Most osteosarcomas occurred in the urinary bladder, especially in the trigone region {2900}. Anecdotal cases have been reported in the renal pelvis {655}. Clinical features Haematuria, dysuria, urinary frequency, and recurrent urinary tract infections are the most common presenting symptoms. Pelvic pain and/or palpable abdominal mass are less frequent. Macroscopy Osteosarcoma of the urinary bladder typically presents as a solitary, large, polypoid, gritty, often deeply invasive, variably haemorrhagic mass. Tumour size varies between 2 and 15 cm (median: 6.5 cm) {215,863,2900}. Fig. 2.78 Osteosarcoma of the urinary bladder. Abundant trabeculae of neoplastic bone surrounded by a malignant spindle cell component. Histopathology Histologically, the tumour is a high grade, bone-producing sarcoma. Foci of chondrosarcomatous differentiation and/or spindle cell areas may also be observed {215,2900}. Variably calcified, woven bone lamellae are rimmed by malignant cells showing obvious cytologic atypia (as opposed to stromal osseous metaplasia occurring in some urothelial carcinomas {655}). A recognizable malignant epithelial component should be absent, allowing discrimination from sarcomatoid carcinoma {2057}, which is the most important differential diagnosis. Prognosis Osteosarcoma of the urinary tract is an aggressive tumour with poor prognosis. A majority of patients have advanced stage (pT2 or higher) disease at presentation and die of tumour within 6 months, most from the effects of local spread (urinary obstruction, uremia, secondary infection, etc.) {863,2900}. Metastases often occurred late in the course of the disease, mainly in lungs {215,2900}. The stage of the disease at diagnosis is the best predictor of survival. 142 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
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melanocytic and smooth muscle marke
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Multinucleated and enlarged ganglio
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Haemangioma P. Tamboli Definition H
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Fig. 1.107 Juxtaglomerular cell tum
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Intrarenal schwannoma I. Alvarado-C
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Mixed epithelial and stromal tumour
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Synovial sarcoma of the kidney J.Y.
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Renal carcinoid tumour L.R. Bégin
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Primitive neuroectodermal tumour (E
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Paraganglioma / Phaeochromocytoma P
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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 and 116: Fig. 2.42 Non-invasive urothelial n
Page 117 and 118: A Fig. 2.45 Non-invasive urothelial
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: Leiomyosarcoma J. Cheville Definiti
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
Page 167 and 168: pale-clear, similar to benign gland
Page 169 and 170: A B Fig. 3.20 A, B Adenocarcinoma w
Page 171 and 172: prostate adenocarcinomas exhibit AR
Page 173 and 174: A Fig. 3.27 A, B Foamy gland adenoc
Page 175 and 176: A B Fig. 3.32 A Sarcomatoid carcino
Page 177 and 178: A B Fig. 3.37 A Gleason score 1+1=2
Page 179 and 180: A B Fig. 3.43 A Prostate cancer Gle
Page 181 and 182: Fig. 3.48 Heat map-nature. From S.M
Page 183 and 184: Fig. 3.51 Prostate cancer. Major su
Page 185 and 186: many stage T1b cancers. Stage T2 Mo
Page 187 and 188: 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
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502. Corti B, Carella R, Gabusi E,
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633. Donhuijsen K, Schmidt U, Richt
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768. Fischer J, Palmedo G, von Knob
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900. Goedert JJ, Cote TR, Virgo P,
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1028. Hartmann A, Dietmaier W, Hofs
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2070. Phillips G, Kumari-Subaiya S,
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2327. Schmidt L, Junker K, Weirich
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2450. Smith G, Elton RA, Beynon LL,
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2572. Tamboli P, Mohsin SK, Hailema
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2693. van Echten J, Timmer A, van d
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2816. Wick MR, Berg LC, Hertz MI (1
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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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