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

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A B Fig. 3.87 A Malignant phyllodes tumour. High cellularity and cellular pleomorphism are obvious even at this magnification. B Leiomyosarcoma. Fascicular arrangement, high cellularity and mitotic activity are characteristic. ma. Both STUMP and stromal sarcomas characteristically express progesterone receptors (PR) and uncommonly express estrogen receptors (ER), supporting the concept that STUMP and stromal sarcomas are lesions involving hormonally responsive prostatic mesenchymal cells, the specialized prostatic stroma. STUMPS typically react positively with actin, whereas prostatic stromal sarcomas react negatively, suggesting that the expression of muscle markers in these lesions is a function of differentiation. Leiomyosarcoma Leiomyosarcomas are the most common sarcomas involving the prostate in adults {443}. The majority of patients are between 40 and 70 years of age, though in some series up to 20% of leiomyosarcomas have occurred in young adults. Leiomyosarcomas range in size between 2 cm and 24 cm with a median size of 5 cm. Histologically, leiomyosarcomas range from smooth muscle tumours showing moderate atypia to highly pleomorphic sarcomas. As with leiomyosarcomas found elsewhere, these tumours immunohistochemically can express cytokeratins in addition to muscle markers. There have been several well circumscribed lesions with a variable amount of nuclear atypia and scattered mitotic activity which have been referred to as atypical leiomyoma of the prostate {2233}, giant leiomyoma of the prostate {2162}, or circumscribed leiomyosarcoma of the prostate {2505}. Following either local excision or resection of prostatic leiomyosarcomas, the clinical course tends to be characterized by multiple recurrences. Metastases, when present, are usually found in the lung. The average survival with leiomyosarcoma of the prostate is between 3 and 4 years. Because smooth muscle tumours of the prostate are rare, the criteria for distinguishing between leiomyosarcoma and leiomyoma with borderline features have not been elucidated. Although most "atypical leiomyomas" have shown no evidence of disease with short follow-up, a few have recurred. Rhabdomyosarcoma Rhabdomyosarcoma is the most frequent mesenchymal tumour within the prostate in childhood {1522}. Rhabdomyosarcomas of the prostate occur from infancy to early adulthood with an average age at diagnosis of 5 years. Most present with stage III disease, in which there is gross residual disease following incomplete resection or biopsy. A smaller, but significant proportion of patients present with distant metastases. Localized tumour that may be complete- A B Fig. 3.88 A Rhabdomyosarcoma. Note strap cells. B Angiosarcoma with slit-like spaces lined by atypical cells. 210 Tumours of the prostate
Fig. 3.89 Sarcoma of the prostate. ly resected is only rarely present. Because of their large size at the time of diagnosis, distinction between rhabdomyosarcoma originating in the bladder and that originating in the prostate may be difficult. Histologically, most prostate rhabdomyosarcomas are of the embryonal subtype and are considered to be of favourable histology. The use of immunohistochemical, ultrastructural, and molecular techniques may be useful in the diagnosis of embryonal rhabdomyosarcoma. Following the development of effective chemotherapy for rhabdomyosarcomas, those few patients with localized disease (stage I) or microscopic regional disease (stage II) stand an excellent chance of being cured. While the majority of patients with gross residual disease (stage III) have remained without evidence of disease for a long period of time, approximately 15-20% die of their tumour. The prognosis for patients with metastatic tumour (stage IV) is more dismal, with most patients dying of their tumour. Following biopsy or partial excision of the tumour, the usual therapy for localized disease is intensive chemotherapy and radiotherapy. If tumour persists despite several courses of this therapy, then radical surgery is performed. It is important to identify those rare cases of alveolar rhabdomyosarcoma involving Fig. 3.90 Solitary fibrous tumour. the prostate since this histologic subtype is unfavourable and necessitates more aggressive chemotherapy. Miscellaneous sarcomas Rare cases of malignant fibrous histiocytoma {158,450,1403,1741,2369}, angiosarcoma {2446}, osteosarcoma {59, 1899}, chondrosarcoma {631}, malignant peripheral nerve sheath tumours {2143}, and synovial sarcoma {1189} have been reported. Fig. 3.91 Solitary fibrous tumour. Leiomyoma The arbitrary definition of a leiomyoma, to distinguish it from a fibromuscular hyperplastic nodule, is a well-circumscribed proliferation of smooth muscle measuring 1 cm or more {1724}. According to this definition, less than one hundred cases are reported. Its morphology is similar to uterine leiomyoma, and even subtypes, such as the bizarre leiomyoma, are described {1277}. Miscellaneous benign mesenchymal tumours Various benign soft tissue tumours have been described as arising in the prostate including granular cell tumour {824}, and solitary fibrous tumour {928,1912,2079}. Other benign mesenchymal tumours such as haemangiomas {1112}, chondromas {2439}, and neural tumours {1872} have also been described. Mesenchymal tumours 211
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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
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Tumours of the urethra F. Hofstädt
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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 and 202: Squamous neoplasms T.H. Van der Kwa
Page 203 and 204: Neuroendocrine tumours P.A. di Sant
Page 205: Mesenchymal tumours J. Cheville F.
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
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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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1424. Ladanyi M, Lui MY, Antonescu
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1548. Lopez-Beltran A, Croghan GA,
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1681. McLaughlin JK, Silverman DT,
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1816. Moudouni SM, En-Nia I, Rioux-
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1945. Ohori M, Wheeler TM, Kattan M
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2070. Phillips G, Kumari-Subaiya S,
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2199. Riou G, Barrois M, Prost S, T
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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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