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

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Basal cell carcinoma P.H. Tan A. Billis Definition This is a neoplasm composed of prostatic basal cells. It is believed that a subset of basal cells are prostatic epithelial stem cells, which can give rise to a spectrum of proliferative lesions ranging from basal cell hyperplasia to basal cell carcinoma {271,1139,2007,2410}. ICD-O code 8147/3 Clinical features Patients are generally elderly, presenting with urinary obstruction with TURP being the most common tissue source of diagnosis. The youngest reported case was 28 years old {597}. Histopathology Some tumours resemble its namesake in the skin, comprising large basaloid nests with peripheral palisading and necrosis. Other patterns have histologic similarity to florid basal cell hyperplasia or the adenoid basal cell pattern of basal cell hyperplasia (the latter pattern of cancer occasionally referred to as adenoid cystic carcinoma). Histologic criteria for malignancy that distinguish it from basal cell hyperplasia include an infiltrative pattern, extraprostatic extension, perineural invasion, necrosis and stromal desmoplasia. Basal cell carcinoma shows immunoreactivity for keratin 34βE12, confirming its relationship with prostatic basal cells. S-100 staining is described as weak to intensely positive in about 50% of tumour cells {954,2893}, raising the possibility of myoepithelial differentiation; but there is no corroborative antismooth muscle actin (HHF35) reactivity {954} nor ultrastructural evidence of a myoepithelial nature {2893}. Distinction from basal cell hyperplasia with a pseudoinfiltrative pattern or prominent nucleoli can be difficult; basal cell carcinoma shows strong BCL2 positivity and high Ki-67 indices as compared to basal cell hyperplasia {2868}. Fig. 3.80 Basal cell carcinoma resembling basal cell hyperplasia. A B Fig. 3.81 Basal cell carcinoma A Note central comedonecrosis. B Basal cell carcinoma resembling adenoid cystic carcinoma. C Perineural invasion. C Prognosis The biologic behaviour and treatment of basal cell carcinoma is not well elucidated in view of the few cases with mostly short follow-up. Local extra-prostatic extension may be seen, along with distant metastases {597,1160}. A benign morphologic counterpart to basal cell carcinoma (basal cell adenoma) has been proposed, although it should be considered as florid nodular basal cell hyperplasia. 206 Tumours of the prostate
Neuroendocrine tumours P.A. di Sant’Agnese L. Egevad J.I. <strong>Epstein</strong> B. Helpap P.A. Humphrey R.Montironi M.A. Rubin W.A. Sakr P.H. Tan A B Fig. 3.82 A, B Adenocarcinoma with fine eosinophilic granules indicating neuroendocrine differentiation. Definition Neuroendocrine differentiation in prostatic carcinoma has three forms: 1. Focal neuroendocrine differentiation in conventional prostatic adenocarcinoma 2. Carcinoid tumour (WHO well differentiated neuroendocrine tumour) and 3. Small cell neuroendocrine carcinoma (new WHO classification poorly differentiated neuroendocrine carcinoma) ICD-O codes Focal neuroendocrine differentiation in prostatic adenocarcinoma 8574/3 Carcinoid 8240/3 Small cell carcinoma 8041/3 Focal neuroendocrine differentiation in prostatic adenocarcinoma All prostate cancers show focal neuroendocrine differentiation, although the majority shows only rare or sparse single neuroendocrine cells as demonstrated by neuroendocrine markers. In 5-10% of prostatic carcinomas there are zones with a large number of single or clustered neuroendocrine cells detected by chromogranin A immunostaining {29,31,272, 609-611,1016,1064,1066}. A subset of these neuroendocrine cells may also be serotonin positive. Immunostaining for neuron-specific enolase, synaptophysin, bombesin/gastrin-releasing peptide and a variety of other neuroendocrine peptides may also occur in individual neoplastic neuroendocrine cells, or in a more diffuse pattern {1178} and receptors for serotonin {16} and neuroendocrine peptides {1017,2537} may also be present. Vascular endothelial growth factor (VEGF) may also be expressed in foci of neuroendorine differentiation {1026}. The definitional context of these other neuroendocrine elements (other than chromogranin A and serotonin) remains to be elucidated. There are conflicting studies as to whether advanced androgen deprived and androgen independent carcinomas show increased neuroendocrine differentiation {446,1185,1222, 1395,1822,2582}. The prognostic significance of focal neuroendocrine differentiation in primary untreated prostatic carcinoma is controversial with some showing an independent negative effect on prognosis {267,478,2802}, while others have not shown a prognostic relationship {30, 335,384,1915,2352,2465}. In advanced prostate cancer, especially androgen independent cancer, focal neuroendocrine differentiation portends a poor prognosis {446,1222,1395,2582} and may be a therapeutic target {228,2317, 2918}. Serum chromogranin A levels (and potentially other markers such as pro-gastin-releasing peptide) {2537, 2582,2853,2802,2871} may be diagnostically and prognostically useful, particularly in PSA negative, androgen independent carcinomas {227,1183,1500, 2871,2918}. Carcinoid tumours True carcinoid tumours of the prostate, which meets the diagnostic criteria for carcinoid tumour elsewhere are exceedingly rare {609,2472,2583}. These tumours show classic cytologic features of carcinoid tumour and diffuse neuroendocrine differentiation (chromogranin A and synaptophysin immunoreativity). They should be essentially negative for PSA. The prognosis is uncertain due to the small number of reported cases. The Fig. 3.83 Chromogranin positivity in adenocarcinoma with eosinophilic granules. Basal cell carcoma / Neuroendocrine tumours 207
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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
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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 and 200: A B Fig. 3.74 A Inflammation withou
Page 201: Squamous neoplasms T.H. Van der Kwa
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
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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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1162. Iezzoni JC, Fechner RE, Wong
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1293. Keetch DW, Catalona WJ (1995)
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1548. Lopez-Beltran A, Croghan GA,
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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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