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

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CK20 in the majority of cases and high molecular weight cytokeratin or P63 in about 50% of cases {1951}. Residual basal cells are frequent in the in situ areas {440}. Urothelial cancers may also express thrombomodulin and uroplakins, which are negative in prostate adenocarcinoma. A B Fig. 3.77 A Urothelial carcinoma (lower left) and adenocarcinoma of the prostate (upper right). B Urothelial carcinoma in situ extending into large periurethral prostatic duct. C Urothelial carcinoma in situ with involvement of prostatic epithelium with undermining and pagetoid spread. Fig. 3.78 34betaE12 expressing residual basal cells delineate in situ areas of urothelial carcinoma. C as opposed to cords of cells or focal cribriform glandular differentiation typical of prostatic adenocarcinoma. Immunoprofile The tumour cells are negative for PSA and PAP {440,1951}. Prostatic secretions in the ductal lumens can react positively resulting in faint staining of tumour cells at the luminal surface, a finding that should not be misinterpreted as positive staining. Tumour cells express CK7 and Prognosis and predictive factors For patients with either primary or secondary urothelial carcinoma of the prostate the single most important prognostic parameter is the presence of prostatic stromal invasion. In one series, survival was 100% for patients with noninvasive disease treated by radical cystoprostatectomy {442}. With stromal invasion or extension beyond the confines of the prostate prognosis is poor {261,442,943,1437}. In one series, overall survival was 45% at 5 years in 19 patients with stromal invasion {442}. In 10 cases of primary urothelial carcinoma reported by Goebbels et al. mean survival was 28.8 months (range 1 to 93 months) {899}. However, even if only intraductal urothelial carcinoma is identified on TURP or transurethral biopsy in a patient followed for superficial bladder cancer, patients usually will be recommended for radical cystoprostatectomy as intravesical therapy is in general not thought to be effective in treating prostatic involvement. 204 Tumours of the prostate
Squamous neoplasms T.H. Van der Kwast Definition Tumours with squamous cell differentiation involving the prostate. ICD-O codes Adenosquamous carcinoma 8560/3 Squamous cell carcinoma 8070/3 Epidemiology The incidence of squamous cell carcinoma of the prostate is less than 0.6% of all prostate cancers {1814,1861}. There are 70 cases reported in literature. Even more rare is adenosquamous carcinoma of the prostate, with about 10 cases reported so far. For primary prostatic squamous cell carcinoma an association with Schistosomiasis infection has been described {44}. Approximately 50% of adenosquamous carcinomas may arise in prostate cancer patients subsequent to endocrine therapy or radiotherapy {179}. Localization Squamous cell carcinomas may originate either in the periurethral glands or in the prostatic glandular acini, probably from the lining basal cells, which show a divergent differentiation pathway {606,931}. Adenosquamous carcinomas are probably localized more commonly in the transition zone of the prostate accounting for their more frequent detection in transurethral resection specimens {179,2613}. Clinical features Most, if not all pure squamous cell carcinomas become clinically manifest by local symptoms such as urinary outflow obstruction, occasionally in association with bone pain and haematuria. Most patients have at the time of diagnosis metastatic disease, and bone metastases are osteolytic. PSA levels are not typically elevated. The age range of patients is between 52 and 79 years {1861}. Hormone treatment and chemotherapy are not effective, except for a single case with non-progressive disease after local irradiation and systemic chemotherapy {2657}. In cases of organ-confined disease, radical prostatectomy or cystoprostatectomy, including total urethrectomy is recommended {1513}. Adenosquamous carcinomas may be detected by increased serum PSA, but more typically by obstruction of the urinary outflow, requiring transurethral resection {179}. Patients may also present with metastatic disease. A proportion of cases show an initial response to hormone therapy {32,1176}. Tumour spread Both squamous cell carcinomas and adenosquamous carcinomas tend to metastasize rapidly with a predilection for the skeletal bones {841,1861}. Histopathology By definition pure squamous cell carcinoma does not contain glandular features and it is identical to squamous cell carcinoma of other origin. With rare exception, it does not express PSA or PAP {1861,2657}. Primary prostatic squamous cell carcinoma must be distinguished on clinical grounds from secondary involvement of the gland by bladder or urethral squamous carcinoma. Histologically, squamous cell carcinoma must be distinguished from squamous metaplasia as may occur in infarction or after hormonal therapy. Adenosquamous carcinoma is defined by the presence of both glandular (acinar) and squamous cell carcinoma components. Some authors considered the possibility that adenosquamous carcinomas consist of collision tumours with a de novo origin of adenocarcinoma and squamous cell carcinoma {841}. The glandular tumour component generally expresses PSA and PAP, whereas the squamous component displays high molecular weight cytokeratins {179}. A B Fig. 3.79 A Cross section of squamous cell carcinoma. B Squamous cell carcinoma of the prostate with focal keratinization. Squamous neoplasms 205
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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
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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
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A Fig. 2.15 A Infiltrating urotheli
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A B Fig. 2.19 A Infiltrative urothe
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Fig. 2.23 Infiltrative urothelial c
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ing systems have been proposed on t
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Non-invasive urothelial tumours G.
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chronically inflamed urothelium and
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Inverted papilloma G. Sauter Defini
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muscle invasive disease, but there
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Fig. 2.42 Non-invasive urothelial n
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A Fig. 2.45 Non-invasive urothelial
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for DBCCR1 silencing {984,2476}. Th
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Squamous cell carcinoma D.J. Grigno
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Fig. 2.51 Squamous cell carcinoma.
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Adenocarcinoma A.G. Ayala P. Tambol
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A B Fig. 2.61 A Adenocarcinoma in s
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A B Fig. 2.65 Intramural urachal ca
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Müllerian origin is postulated for
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A Fig. 2.69 Small cell carcinoma. A
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Carcinoid L. Cheng Definition Carci
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Leiomyosarcoma J. Cheville Definiti
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Osteosarcoma L. Guillou Definition
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Leiomyoma J. Cheville Definition A
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Haemangioma L. Cheng Definition Hae
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Metastatic tumours and secondary ex
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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 and 196: Ductal adenocarcinoma X.J. Yang L.
Page 197 and 198: Papillary pattern can be seen in bo
Page 199: A B Fig. 3.74 A Inflammation withou
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.
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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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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
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Promoter methylation, 21 Prostate s
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