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

More documents

Recommendations

Info

sue. Transrectal needle core biopsies may also obtain diagnostic tissue when the tumour is more peripherally located {323}. In addition, areas of ductal adenocarcinoma may be incidentally identified in prostatectomy specimens. Macroscopy/Urethroscopy Centrally occurring tumours appear as exophytic polypoid or papillary masses protruding into the urethra around the verumontanum. Peripherally occurring tumours typically show a white-grey firm appearance similar to acinar adenocarcinoma. Tumour spread and staging Ductal adenocarcinoma usually spread along the urethra or into the prostatic ducts with or without stromal invasion. Other patterns of spread are similar to that of acinar prostatic adenocarcinoma with invasion to extraprostatic tissues and metastasis to pelvic lymph nodes or distal organs. However, ductal adenocarcinomas appear to have a tendency to metastasize to lung and penis {491, 2654}. The metastasis of ductal adenocarcinoma may show pure ductal, acinar or mixed components. Histopathology Ductal adenocarcinoma is characterized by tall columnar cells with abundant usually amphophilic cytoplasm, which form a single or pseudostratified layer reminiscent of endometrial carcinoma. The cytoplasm of ductal adenocarcinoma is often amphophilic and may occasionally appear clear. In some cases, there are numerous mitoses and marked cytological atypia. In other cases, the cytological atypia is minimal, which makes a diagnosis difficult particularly on needle biopsy. Peripherally located tumours are often admixed with cribriform, glandular or solid patterns as seen in acinar adenocarcinoma. Although ductal adenocarcinomas are not typically graded, they are mostly equivalent to Gleason patterns 4. In some cases comedo necrosis is present whereby they could be considered equivalent to Gleason pattern 5. In contrast to ordinary acinar adenocarcinoma, some ductal adenocarcinomas are associated with a prominent fibrotic response often including haemosiderin-laden macrophages. Ductal adenocarcinoma displays a variety of architectural patterns, which are often intermingled {286,720}. Fig. 3.70 Ductal adenocarcinoma. Infiltrating cribriform and pepillary growth pattern. A B Fig. 3.71 A Mixed cribriform acinar and papillary ductal adenocarcinoma. B High magnification shows tall pseudostratified arrangement of nuclei diagnosed as ductal adenocarcinoma despite bland cytology. 200 Tumours of the prostate
Papillary pattern can be seen in both centrally or peripherally located tumours, yet is more common in the former. Cribriform pattern is more commonly seen in peripherally located tumours, although they may be also present in centrally located tumours. The cribriform pattern is formed by back-to-back large glands with intraglandular bridging resulting in the formation of slit-like lumens. Individual gland pattern is characterized by single glands. Solid pattern can only be identified when it is associated with other patterns of ductal adenocarcinoma. The solid nests of tumour cells are separated by incomplete fibrovascular cores or thin septae. Ductal adenocarcinoma must be distinguished from urothelial carcinoma, ectopic prostatic tissue, benign prostatic polyps, and proliferative papillary urethritis. One of the more difficult differential diagnoses is cribriform high grade prostatic intraepithelial neoplasia. Some patterns of ductal adenocarcinoma may represent ductal carcinoma in situ. A Immunoprofile Immunohistochemically ductal adenocarcinoma is strongly positive for PSA and PAP. Tumour cells are typically negative for basal cell specific high molecular weight cytokeratin (detected by 34βE12), however, preexisting ducts may be positive for this marker. Prognosis and predictive factors Most studies have demonstrated that ductal adenocarcinoma is aggressive. Some reported that 25-40% of cases had metastases at the time of diagnosis with a poor 5-year survival rate ranging from 15-43% {462,718,2205}. It is not known whether prognosis correlates with the degree of cytological atypia or growth patterns. Even limited ductal adenocarcinoma on biopsy warrants definitive therapy. Androgen deprivation therapy may provide palliative relief, even though these cancers are less hormonally responsive than acinar adenocarcinoma. B C Fig. 3.72 A Separate acinar (left) and ductal adenocarcinoma (right). B Individual glands of prostatic duct adenocarcinoma, resembling colonic adenocarcinoma. C Ductal adenocarcinoma of the prostate showing close morphologic resemblance to endometrial carcinoma. Ductal adenocarcinoma 201
Page 1 and 2:
World Health Organization Classific
Page 3 and 4:
This volume was produced in collabo
Page 5 and 6:
Contents 1 Tumours of the kidney 9
Page 7 and 8:
CHAPTER 1 Tumours of the Kidney Can
Page 9 and 10:
TNM classification of renal cell ca
Page 11 and 12:
one quarter of kidney cancers in bo
Page 13 and 14:
Familial renal cell carcinoma M.J.
Page 15 and 16:
Table 1.02 Genotype - phenotype cor
Page 17 and 18:
A B Fig. 1.11 A Multiple cutaneous
Page 19 and 20:
A B Fig. 1.14 Birt-Hogg-Dubé syndr
Page 21 and 22:
Clear cell renal cell carcinoma D.J
Page 23 and 24:
Fig. 1.20 Clear cell renal cell car
Page 25 and 26:
Papillary renal cell carcinoma B. D
Page 27 and 28:
A B Fig. 1.29 Papillary renal cell
Page 29 and 30:
Fig. 1.33 Chromophobe RCC with sarc
Page 31 and 32:
Carcinoma of the collecting ducts o
Page 33 and 34:
Renal medullary carcinoma C.J. Davi
Page 35 and 36:
Renal carcinomas associated with Xp
Page 37 and 38:
Renal cell carcinoma associated wit
Page 39 and 40:
Papillary adenoma of the kidney J.N
Page 41 and 42:
of this tumour. Microscopic extensi
Page 43 and 44:
A B Fig. 1.59 Metanephric adenoma.
Page 45 and 46:
esults in intratumoral aneurysms. O
Page 47 and 48:
peritumoural fibrous pseudocapsule.
Page 49 and 50:
increases in prevalence to approxim
Page 51 and 52:
Nephrogenic rests and nephroblastom
Page 53 and 54:
Cystic partially differentiated nep
Page 55 and 56:
A B Fig. 1.80 Clear cell sarcoma of
Page 57 and 58:
A B Fig. 1.85 Rhabdoid tumour of th
Page 59 and 60:
transcription factor is fused to th
Page 61 and 62:
Leiomyosarcoma S.M. Bonsib Definiti
Page 63 and 64:
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 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 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
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: Ductal adenocarcinoma X.J. Yang L.
Page 199 and 200: A B Fig. 3.74 A Inflammation withou
Page 201 and 202: Squamous neoplasms T.H. Van der Kwa
Page 203 and 204: Neuroendocrine tumours P.A. di Sant
Page 205 and 206: Mesenchymal tumours J. Cheville F.
Page 207 and 208: Fig. 3.89 Sarcoma of the prostate.
Page 209 and 210: Miscellaneous tumours P.H. Tan L. C
Page 211 and 212: A Fig. 3.96 A Adenocarcinoma of the
Page 213 and 214: WHO histological classification of
Page 215 and 216: Introduction F.K. Mostofi I.A. Sest
Page 217 and 218: wartime birth cohorts illustrate th
Page 219 and 220: Similar tumours as those of group 1
Page 221 and 222: crucial for the development of this
Page 223 and 224: A B Fig. 4.09 Spermatocytic seminom
Page 225 and 226: A B Fig. 4.14 Intratubular germ cel
Page 227 and 228: A B Fig. 4.19 Seminoma. A Typical s
Page 229 and 230: Fig. 4.24 Seminoma. Vascular invasi
Page 231 and 232: Fig. 4.28 Spermatocytic seminoma wi
Page 233 and 234: A B Fig. 4.33 Embryonal carcinoma.
Page 235 and 236: A B Fig. 4.38 Yolk sac tumour. A En
Page 237 and 238: have cytoplasmic lacunae that conta
Page 239 and 240: A Fig. 4.46 Teratoma. A Longitudina
Page 241 and 242: A B Fig. 4.51 A Cut surface of derm
Page 243 and 244: Fig. 4.54 Mixed germ cell tumour. L
Page 245 and 246: Sex cord / gonadal stromal tumours
Page 247 and 248:
A B C Fig. 4.67 Malignant Leydig ce
Page 249 and 250:
A Fig. 4.73 A Sertoli cell tumour.
Page 251 and 252:
ICD-O codes Granulosa cell tumour 8
Page 253 and 254:
ICD-O code 8592/1 Clinical features
Page 255 and 256:
A B Fig. 4.83 Germ cell-sex cord/go
Page 257 and 258:
A Fig. 4.85 A, B Brenner tumour of
Page 259 and 260:
typical grade III follicular morpho
Page 261 and 262:
testicular parenchyma and tumour te
Page 263 and 264:
A B the surgical scar and adjacent
Page 265 and 266:
Immunoprofile Ordóñez and associa
Page 267 and 268:
often have a grey-white cut surface
Page 269 and 270:
Fig. 4.111 Angiomyofibroblastoma-li
Page 271 and 272:
A B Fig. 4.119 Embryonal rhabdomyos
Page 273 and 274:
Table 4.05 Secondary tumours of the
Page 275 and 276:
WHO histological classification of
Page 277 and 278:
A Fig. 5.04 A, B Squamous cell carc
Page 279 and 280:
deformed by an exophytic mass. In s
Page 281 and 282:
A B C Fig. 5.12 A Warty (condylomat
Page 283 and 284:
A Fig. 5.20 Bowenoid papulosis. A,
Page 285 and 286:
three had been circumcized by 9 yea
Page 287 and 288:
Mesenchymal tumours J.F. Fetsch M.
Page 289 and 290:
Fig. 5.31 Neurofibroma of the penis
Page 291 and 292:
oectodermal tumour/Ewing sarcoma [p
Page 293 and 294:
Secondary tumours of the penis C.J.
Page 295 and 296:
Dr John N. EBLE* Dept. of Pathology
Page 297 and 298:
Dr Ricardo PANIAGUA Department of C
Page 299 and 300:
Source of charts and photographs 1.
Page 301 and 302:
References 1. Anon. (1955). Case re
Page 303 and 304:
115. Ariel I, Sughayer M, Fellig Y,
Page 305 and 306:
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)
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
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
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?