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

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and patients with pT 2 tumours have a survival rate of 75% {1003,1834}. Survival for patients with pT 3 and pT 4 tumours, tumours with positive nodal disease and residual tumour after surgery is poor {1995}. Other prognostic factors include patient age, type of treatment, and presence and severity of concurrent urothelial neoplasia {163,2884}. Squamous cell carcinoma Squamous cell carcinoma is more common in the renal pelvis than in the ureter, although it is the next most common tumour after urothelial carcinoma, it is very rare in both locations. Pure squamous cell carcinomas are usually high grade and high stage tumours and frequently invade the kidney. These tumours may occur in the background of nephrolithiasis with squamous metaplasia. Survival for 5 years is rare {248}. Adenocarcinoma Pure adenocarcinomas of the renal pelvis and ureters are rare and enteric, mucinous or signet-ring cell phenotypes, often occur concurrently. Glandular (intestinal) metaplasia, nephrolithiasis and repeated infections are predisposing factors. Most adenocarcinomas are high grade and are widely invasive at presentation {590}. Benign epithelial tumours Urothelial papilloma and inverted papilloma Urothelial papilloma is usually a small, delicate proliferation with a fibrovascular core lined by normal urothelium. It is extraordinarily rare and often found incidentally. Inverted papilloma is also rare being twice as common in the ureter as in the renal pelvis. Most lesions are incidentally discovered. Villous adenoma and squamous papilloma These benign tumours are rare in the upper urinary tract. The presence of a villous adenoma histology in a limited biopsy does not entirely exclude the possibility of adenocarcinoma, and complete excision is essential. Non-epithelial tumours of renal pelvis and ureter Malignant tumours The most frequent malignant stromal tumour of the ureter is leiomyosarcoma. Other malignant tumours reported are rhabdomyosarcoma, osteosarcoma, fibrosarcoma, angiosarcoma, malignant schwannoma, and Ewing sarcoma {416, 506,657,746,1745,1925,2634}. Benign tumours Fibroepithelial polyps are exophytic intraluminal masses of vascular connective tissue and varying amounts of inflammatory cells, covered by normal transitional epithelium. These are most frequently seen in the proximal ureter in young male adults and, in contrast to urethral polyps, children are rarely affected {2828}. Renal pelvic and ureteric leiomyoma, neurofibroma, fibrous histiocytoma, haemangioma, and periureteric lipoma, including hibernoma, have been reported {91,974, 1456,2449,2573,2712,2870}. Miscellaneous tumours Neuroendocrine tumours Few cases of ureteric phaeochromocytoma have been reported {128}. Pelvic and ureteric carcinoid is similarly rare {45,1217,2260} and must be differentiated from metastatic disease {231}. Carcinoids also occur in ureteroileal conduits {1343}. Small cell carcinoma of the renal pelvis is confined to elderly patients {971,1347}. These aggressive tumours usually contain foci of urothelial carcinoma {971,1321,1326} and have a typical neuroendocrine immunohistochemical profile {971,1326,1347}. Lymphoma Renal pelvic and ureteric lymphomas are usually associated with systemic disease {200,331,2635}, while localized pelvic plasmacytoma has been reported {1165}. Other Rare cases of sarcomatoid carcinoma of the pelvis and ureter can show either homologous or heterologous stromal elements {621,774,2727,2882}. The tumours may be associated with urothelial carcinoma in situ {2727,2882} and have a poor prognosis {621,774,2882}. Wilms tumour confined to the renal pelvis or extending into the ureter {1114} and cases of malignant melanoma and choriocarcinoma of the renal pelvis have been described {669,800,2680}. Tumours of the renal pelvis and ureter 153
Tumours of the urethra F. Hofstädter M.B. Amin B. Delahunt A. Hartmann Definition Epithelial and non-epithelial neoplasms of the male and female urethra, frequently associated with chronic HPV infection. Introduction and epidemiology Epithelial tumours of the urethra are distinctly rare but, when encountered, are usually malignant and perhaps unique among genitourinary malignancies, as they are three to four times more common in women than in men {85,920, 1799,2318}. Urethral carcinomas occurring in men are strikingly different in clinical and pathologic features when compared to tumours in women. The dissimilarities may chiefly be attributable to the distinct differences in the anatomy and histology of the urethra in the two sexes. Benign epithelial tumours are exquisitely rare in the urethra of either sex. Etiology Human papilloma virus plays a crucial role in the etiology of condyloma of the urethra. Congenital diverticulum as well as acquired strictures of the female urethra, contribute to female preponderance of carcinomas. Columnar and mucinous adenocarcinoma are thought to arise A Fig. 2.97 Urethra. A Transurethral endoscopic view of a non-invasive warty carcinoma of the Fossa navicularis urethrae (pTa), Courtesy Dr. Peter Schneede, Dept. of Urology, LMU Munich. B Transurethral endoscopic view of an invasive squamous cell carcinoma of the distal urethra (pT1) (Fossa navicularis), Courtesy Dr. Peter Schneede, Dept. of Urology, LMU Munich. B from glandular metaplasia, whereas cribriform adenocarcinoma showed positive PSA staining indicating origin from prostate (male or female) {1837}. Villous adenoma has been shown to occur associated with tubulovillous adenoma and adenocarcinoma of the rectum {1782}. Leiomyoma may show expression of estrogen receptors and is related to endocrine growth stimulation during pregnancy {72}. Leiomyoma may occur as a part of diffuse leiomyomatosis syndrome (esophageal and rectal leiomyomata). Molecular pathology Squamous cell carcinoma of the urethra is associated with HPV infection in female and male patients. High risk HPV 16 or 18 was detected in 60 % of urethral carcinomas in women {2822}. A B Fig. 2.98 A, B Non-invasive verrucous squamous cell carcinoma of the urethra with HPV infection and numerous koilocytes. 154 Tumours of the urinary system
Page 1 and 2:
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
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WHO histological classification of
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TNM classification of carcinomas of
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The risk of bladder cancer goes dow
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Tumour spread and staging Urinary b
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feature in such patients undergoing
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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 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: nodular, ulcerative or infiltrative
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
Page 189 and 190: Prostatic intraepithelial neoplasia
Page 191 and 192: A B Fig. 3.63 A Micropapillary high
Page 193 and 194: A B Fig. 3.68 A Ductal carcinoma in
Page 195 and 196: Ductal adenocarcinoma X.J. Yang L.
Page 197 and 198: Papillary pattern can be seen in bo
Page 199 and 200: 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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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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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.
Page 301 and 302:
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
Page 307 and 308:
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)
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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
Page 349 and 350:
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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