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

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Fig. 5.17 Low grade papillary carcinoma affecting the foreskin. Fig. 5.18 Sarcomatoid (spindle cell) carcinoma of the penis. melanomas {1613}. Sarcomatoid carcinomas are associated with a high rate of regional nodal metastases {521}. Mixed carcinomas About a fourth of penile carcinomas consist of a mixture of various types. A moderate to high grade squamous cell carcinoma in an otherwise typical verrucous carcinoma (so called ‘hybridverrucous’) shows metastatic potential {473,1232}. The warty-basaloid carcinoma has a high incidence of groin metastasis {2574}. Other recognized combinations include adenocarcinoma and basaloid {515} (adenobasaloid) and squamous and neuroendocrine carcinoma. Adenosquamous carcinoma Squamous cell carcinoma with mucinous glandular differentiation arises from surface epithelium. The origin may be related to misplaced or metaplastic mucinous glands {516,1208,1642}. Grossly, it is a firm white grey irregular mass involving the glans. Microscopically, the squamous predominates over the glandular component. The glands stain positive for CEA. Adenocarcinomas and mucoepidermoid carcinomas of the penis have also been reported {810,1455,2702}. Other rare pure primary carcinomas ICD-O codes Merkel cell carcinoma 8247/3 Small cell carcinoma of neuroendocrine type 8041/3 Sebaceous carcinoma 8410/3 Clear cell carcinoma 8310/3 A small number of unusual primary penile neoplasms include the Merkel cell carcinoma {2625}, small cell carcinoma of neuroendocrine type {830}, sebaceous carcinoma {1967}, clear cell carcinoma {2905}, and well differentiated squamous cell carcinoma with pseudohyperplastic features (pseudohyperplastic carcinoma) {524}. Another rare lesion is the papillary basaloid carcinoma consisting of an exophytic growth, with papillae composed of small poorly differentiated cells similar to the cells seen in invasive basaloid carcinomas {515}. Basal cell carcinoma ICD-O code 8090/3 Basal cell carcinoma (BCC) is a rare indolent neoplasm of the penis identical to BCC of other sites {794,1425,2041}. They may be uni- or multicentric {2041}. The localization is on the shaft and rarely on the glans {872,1674}. Of 51 BCC of regions not exposed to sun, 2 were in the penis {1244}. BCCs are differentiated and usually superficial with minimal metastatic potential {1317}. It is impor- A Fig. 5.19 Warty-basaloid carcinoma. A Invasive nests. B Surface appearance. B Malignant epithelial tumours 287
A Fig. 5.20 Bowenoid papulosis. A, B Clinically, two types exist; macular and papular (right). The lesions may be multiple or solitary and the diameter varies from 2-10 mm. B Fig. 5.21 Penile Bowen disease. Bowen disease appearing as a well demarcated reddish plaque on the inner aspect of the foreskin. tant to distinguish them from the aggressive basaloid squamous cell carcinoma, which invades deeply, has abrupt keratinization, comedo necrosis and high mitotic rates. Precursor lesions HPV and penile intraepithelial neoplasia ICD-O code Intraepithelial neoplasia Grade III 8077/2 Human papillomaviruses (HPV) are the most heterogeneous of human viruses {574}. About 30 sexually transmittable genotypes exist that are further classified into "low" and "high risk" types according to oncogenic potential {574,619}. Generally, overt genital warts ("condylomas") are associated with "low risk" HPVs - including types 6 and 11. The "high risk" HPVs - most commonly types 16 and 18 - are predominantly associated with subclinical lesions {2756}. Mucosal infections mainly are transient in young people {670}. Longitudinal studies demonstrate that patients who cannot clear high risk HPV infections within about a year are at risk for malignant transformation. SCC is thought to develop via HPV-associated precursor lesions (intraepithelial neoplasia; IN) that are graded I-III in proportion to the epithelial thickness occupied by transformed basaloid cells. These vary in size and shape, with the nuclei being pleomorphic and hyperchromatic. They are accompanied by loss of polarity. In grade I, the IN occupies the lower one third, in grade II the lower two thirds, and in grade III the full epithelial thickness ("Bowen atypia"; in situ SCC). Concurrent infection with low and high risk types is common. Condylomas and IN sometimes coexist as part of a morphological continuum. Studies of HPV and penile cancer are limited because of the scarce occurrence and the peculiar geographical distribution of this malignancy, being rare in the USA and Europe but fairly common in many developing countries {619,2756}. The predominant HPV that is found in penile SCC is type 16, followed by type 18. HPV types 6/11 have been detected in anecdotal cases. Most patients with IN lack physical symptoms, but itching, tenderness, pain, bleeding, crusting, scaling and difficulty in retracting the foreskin may develop {2756}. Chronic inflammation, phimosis and poor hygiene may be important contributing factors {670,2754-2756}. A pathogenic role of chronic lichen sclerosus and verrucous carcinoma has been discussed, while oncogenic HPVs have been linked more strongly to warty/basaloid carcinomas {945}. The following comments summarize clinical features of three penile conditions presumed to be precancerous: Giant condyloma, Bowenoid papulosis and Bowen disease. Due to clinical overlap and differential diagnostic problems, a vigilant approach to diagnostic biopsy sampling cannot be overly stressed. Fig. 5.22 High grade squamous intraepithelial lesion (SIL), squamous. Giant condyloma "Giant condyloma" (Buschke-Löwenstein) is a rare (about 100 cases published) and peculiar condyloma variant {968,2756} generally arising due to poor hygiene of uncircumcized men (range 18-86 years of age). It is characterized by a semi-malignant slowly growing condylomatous growth often larger than 288 Tumours of the penis
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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
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WHO histological classification of
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Introduction F.K. Mostofi I.A. Sest
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wartime birth cohorts illustrate th
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Similar tumours as those of group 1
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crucial for the development of this
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A B Fig. 4.09 Spermatocytic seminom
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A B Fig. 4.14 Intratubular germ cel
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A B Fig. 4.19 Seminoma. A Typical s
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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
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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: A B C Fig. 5.12 A Warty (condylomat
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
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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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