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

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Epidemiology Nodular mesothelial hyperplasia (NMH) was first described in 1975 {2228}. Approximately one case of NMH occurs in 800 to 1000 hernia sacs that are examined microscopically. Approximately 70% of cases are diagnosed in patients 10 years of age or less, (median 1.5 years, range 6 weeks-84 years). There is a 3-10:1 male predilection, reflecting the predominance of inguinal hernias in male children {1519}. Fig. 4.99 Malignant mesothelioma. Exophytic tumour growth into the scrotal sac. Note in situ malignant change of mesothelial surface. invariably positive {1239,2051}. CEA, B72.3, Leu M1 and Ber-Ep4 have been negative {2664}. Ultrastructure Ultrastructural features are characteristic of mesothelial cells. Benign mesothelioma This designation has been given to the rare examples of cystic mesothelioma and to the well differentiated papillary mesothelioma (WDPM) both of which are similar to those occurring in the peritoneum. The cystic mesotheliomas present as scrotal swellings suggestive of hydrocele and consist of multiple cystic structures with no cellular atypia. Lymphangioma is almost invariably the lesion to be excluded and this should be readily accomplished with the epithelial and endothelial markers {1434,2051}. The WDPMs present as one or more superficial nodules or granular deposits over the surface of the hydrocele sac {353,2051}. Microscopically there is a single row of flattened or cuboidal mesothelial cells lining fibrovascular papillae {348,353,2051,2852}. Cellular features are bland. Most of these occur in young men in the second and third decades and have behaved in a benign fashion although it is widely regarded as a borderline mesothelioma since some have proved to be aggressive {348,353, 1239}. Nodular mesothelial hyperplasia Definition A proliferative process typically discovered in a hernia sac as an incidental finding consisting of cohesive collections of polygonal cells forming one or more attached or unattached nodules. Etiology The presumptive etiology is a reaction of the hernia sac to a variety of injuries including incarceration and inflammation. Clinical features Clinical manifestations are those of a hernia. Histopathology One or more nodules, either attached or unattached to the mesothelial surface of the hernia sac are identified. Adjacent to the nodule, the surface mesothelium is hyperplastic with individual cuboidal cells and a population of submesothelial cells resembling those of the nodule. The unattached nodule is often accompanied by individual cells floating within the lumen of the hernia sac and pseudoglandular and papillary profiles of cells are present in some cases. The polygonal cells vary from innocuous to moderately pleomorphic. Mitotic activity is low. Fibrin and inflammatory cells are also present. The lesion lacks the overtly malignant features of a malignant mesothelioma, carcinoma or sarcoma. Multinucleated cells and especially strap-like cells in NMH have been confused with embryonal rhabdomyosarcoma in the past. A Fig. 4.100 Benign mesothelioma. A Well differentiated papillary mesothelioma. Note superficial nature of the tumours. B Well differentiated papillary mesothelioma. Note papillations with bland cuboidal cell lining. B Fig. 4.101 Nodule of proliferating mesothelial cells. Tumours of paratesticular structures 269
Immunoprofile Ordóñez and associates {1973} examined one case by immunohistochemistry and concluded that the so-called mesothelial cells are histiocytes, although the originally described lesions may not represent the same process {2769}. An analogous proliferation of the pleura has been encountered and reported as nodular histiocytic hyperplasia {401,455}. Prognosis The lesion is benign. Adenocarcinoma of the epididymis Fig. 4.102 Carcinoma of the epididymis. Definition Adenocarcinoma of the epididymis is a rare gland forming, malignant neoplasm derived from epididymal epithelial cells. ICD-O code 8140/3 Incidence and clinical features It occurs in men from 27-82 years, mean age, 67 years. Only 10 well documented cases have been reported {418,770,833, 1095,1240,1438,2814}. The clinical presentation is a palpable scrotal mass and/or testicular pain and frequently a hydrocele. Macroscopy and histopathology The tumours are centred in the epididymis and range from 1.0-7.0 cm. in greatest dimension with a tan or greywhite colouration. Foci of haemorrhage and necrosis may be present. Epididymal adenocarcinoma may have tubular, tubulopapillary, papillary or cystic growth patterns often in combination {1240}. Tumour cells are columnar or cuboidal and often contain clear cytoplasm due to glycogen. The immunohistochemical profile of these tumours includes strong reactivity for cytokeratins (AE1/3) and epithelial membrane antigen. Staining for CEA, Leu M1, prostate specific antigen, Leucocyte common antigen and S100 protein have been reported as negative {418,833,1240}. Electron microscopic features include desmosomal junctions, cilia, glycogen particles and multivesicular bodies {1240}. Prognosis Meaningful follow-up data exists in only 5 patients, three of whom developed Fig. 4.103 Papillary cystadenoma of the epididymis. Ectatic duct with clear cell lining and colloid-like luminal fluid. metastases {418,770,833,1240}. The tumour invades locally and metastatic spread is to the retroperitoneal lymph nodes and lungs. Papillary cystadenoma of epididymis Definition A benign papillary epithelial tumour in the epididymal ducts. ICD-O code 8450/0 Incidence These benign tumours are seen in about 17% of patients with von Hippel-Lindau disease {1431,2664} but, overall, they are generally regarded as rare or uncommon {206,877}. Clinical feature These present as asymptomatic nodules in the region of the head of the epididymis. They have usually been present for a number of years and enlarged very little {1800}. Some have been discovered during evaluation for infertility, and this diagnosis should be considered when azoospermia is associated with an epididymal mass {2104}. They occur between 16 and 81 years (mean 36 years) although a few have been seen in females in the broad ligament and pelvic cavity {2384}. A few have also occurred in the spermatic cord {206}. The lesions have been bilateral in 30-40% of cases. In von Hippel-Lindau disease they are more frequently bilateral {287,2111}. Macroscopy Grossly, the tumours range from 1.6 to 6.0 cm and are solid or cystic and tan, 270 Tumours of the testis and paratesticular tissue
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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
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CHAPTER 3X Tumours of of the the Pr
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TNM classification of carcinomas of
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contrast, mortality among migrants
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Fig. 3.06 Transrectal ultrasound of
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PSA-related diagnostic strategies.
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A B C Fig. 3.10 A,B Section of pros
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pale-clear, similar to benign gland
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A B Fig. 3.20 A, B Adenocarcinoma w
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prostate adenocarcinomas exhibit AR
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A Fig. 3.27 A, B Foamy gland adenoc
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A B Fig. 3.32 A Sarcomatoid carcino
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A B Fig. 3.37 A Gleason score 1+1=2
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A B Fig. 3.43 A Prostate cancer Gle
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Fig. 3.48 Heat map-nature. From S.M
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Fig. 3.51 Prostate cancer. Major su
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many stage T1b cancers. Stage T2 Mo
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Fig. 3.58 Patterns of seminal vesic
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Prostatic intraepithelial neoplasia
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A B Fig. 3.63 A Micropapillary high
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A B Fig. 3.68 A Ductal carcinoma in
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Ductal adenocarcinoma X.J. Yang L.
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Papillary pattern can be seen in bo
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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
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: A B the surgical scar and adjacent
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
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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
Page 347 and 348:
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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