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

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A B Fig. 1.96 Angiomyolipoma. A Microscopic angiomyolipoma composed of smooth muscle with a minority of fat cells, arising in the renal interstitium. B Rarely, angiomyolipoma may closely resemble renal oncocytoma. nents or with prominent cystic change may be difficult to distinguish from an epithelial neoplasm preoperatively {2388}. In some of these cases the diagnosis is possible by fine-needle aspiration, supplemented if necessary by immunohistochemistry {275}. Macroscopy AMLs usually are well demarcated from the adjacent kidney, but not encapsulated. The colour varies from yellow to pinktan, depending on the relative proportions of the various tissue components. Tumours composed of all three components may mimic a clear cell RCC whereas a smooth muscle predominant AML may mimic a leiomyoma. Although AMLs may grow to great size, they bulge into rather than infiltrate the perirenal fat. Most AMLs are solitary, but multiple tumours may be present; in such situations, a large dominant tumour associated with smaller lesions is typical. Tumour spread and staging Infrequently, AML extends into the intrarenal venous system, the renal vein or the vena cava. Vascular invasion and multifocality have occasionally been misinterpreted as evidence of malignancy and metastasis. Regional lymph node involvement can occur; it is considered to represent a multifocal growth pattern rather than metastasis {18,2570}. Only three cases of sarcoma developing in sporadic AML have been reported; two patients had pulmonary metastases and one had hepatic metastases {466,757,1636}. Histopathology Most AMLs are composed of a variable mixture of mature fat, thick-walled poorly organized blood vessels and smooth muscle (classic triphasic histology). The border between AML and the kidney is typically sharp, although renal tubules may be entrapped at the periphery of some tumours. The smooth muscle cells appear to emanate from blood vessel walls in a radial fashion, and expansile growth thereafter may be fascicular. The smooth muscle cells are most frequently spindle cells but may appear as rounded epithelioid cells. Rarely, striking degrees of nuclear atypia (occasionally with mitotic activity and multinucleation) may be seen in these cells, raising the possibility of malignancy. Some AMLs that are often located subcapsularly and composed almost entirely of smooth muscle cells ("capsulomas") resemble leiomyomas. Cells associated with thin-walled, branching vessels with a pattern similar to lymphangioleiomyoma is another variation of the smooth muscle component. A The lipomatous component consists typically of mature adipose tissue but may contain vacuolated adipocytes suggesting lipoblasts, thus mimicking a liposarcoma when there is extensive adipocytic differentiation. The blood vessels are thick-walled and lack the normal elastic content of arteries. AMLs with a prominent vascular component may mimic a vascular malformation. Prominent cystic change may very rarely be present in AML. Immunoprofile AMLs are characterized by a coexpression of melanocytic markers (HMB45, HMB50, CD63, tyrosinase, Mart1/Melan A and microophthalmia transcription factor) and smooth muscle markers (smooth muscle actin, muscle-specific actin and calponin); CD68, neuron-specific enolase, S-100 protein, estrogen and progesterone receptors, and desmin may also be positive, whereas epithelial markers are always negative {125,762,1254, 1258,1419,2037,2922}. Coexpression of Fig. 1.97 Angiomyolipoma. A Deposit of angiomyolipoma in a para-aortic lymph node in the drainage basin of a kidney bearing an angiomyolipoma. B Cytologic specimen from renal angiomyolipoma. Scattered HMB45 positive cells within cytologic specimen. B 66 Tumours of the kidney
melanocytic and smooth muscle markers in myoid-appearing and lipid-distended cells supports the unitary nature of AML being a neoplasm with ability for phenotypic and immunotypic modulation. Ultrastructure Ultrastructurally, AMLs show spindle cells with features of smooth muscle cells. Some spindle cells contain lipid droplets indicating transition forms between smooth muscle cells and adipocytes {1103}. Ultrastructural evidence of melanogenesis is reported, and intracytoplasmic membrane-bound dense bodies, crystals and granules (rhomboid and spherical) have been linked to renin and premelanosomes without conclusive or consistent evidence {1825,2796,2913}. Precursor lesions Small nodules with some features of AML are often present in the kidney bearing AMLs, suggesting that these lesions may be the source of AMLs. The smallest nodules are often composed predominantly of epithelioid smooth muscle cells, and the proportion of spindle cells and adipocytes increase as the lesions become larger {459}. Intraglomerular lesions with features Fig. 1.98 Angiomyolipoma of the kidney. LOH of TSC2 gene locus in both sporadic and tuberous sclerosis-associated tumours. overlapping those of AML have been reported in patients with and without TS {1315,1632,1865}. Somatic genetics Two genes are known to cause TS. The TSC1 gene is located on chromosome 9q34, consists of 23 exons and encodes hamartin, a 130 kDa protein {2704}. The TSC2 gene is located on chromosome 16p13, consists of 41 exons and encodes tuberin, a 180 kDa GTPase-activating protein for RAP1 and RAB5 {2604}. Tuberin and hamartin interact with each other, forming a cytoplasmic complex {1878, 2088}. AML frequently shows loss of heterozygosity (LOH) of variable portions of TSC2 gene locus in both sporadic and TS-associated tumours {370, 1078}. TSC1 gene is involved occasionally in LOH. Prognosis and predictive factors The classic AMLs are benign. A very small minority are associated with complications and morbidity and mortality {1936}. Haemorrhage into the retroperitoneum, usually in tumours greater than 4.0 cm or in pregnant patients, may be life threatening. Renal cysts and multiple AMLs in TS patients can lead to renal failure {2321}. Fig. 1.99 Intraglomerular lesion associated with angiomyolipoma of the kidney. Focal positive immunoreactivity to actin in a glomerulus containing a group of smooth muscle epithelioid cells. SMA expression. Angiomyolipoma 67
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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
Page 13 and 14: Familial renal cell carcinoma M.J.
Page 15 and 16: Table 1.02 Genotype - phenotype cor
Page 17 and 18: A B Fig. 1.11 A Multiple cutaneous
Page 19 and 20: A B Fig. 1.14 Birt-Hogg-Dubé syndr
Page 21 and 22: Clear cell renal cell carcinoma D.J
Page 23 and 24: Fig. 1.20 Clear cell renal cell car
Page 25 and 26: Papillary renal cell carcinoma B. D
Page 27 and 28: A B Fig. 1.29 Papillary renal cell
Page 29 and 30: Fig. 1.33 Chromophobe RCC with sarc
Page 31 and 32: Carcinoma of the collecting ducts o
Page 33 and 34: Renal medullary carcinoma C.J. Davi
Page 35 and 36: Renal carcinomas associated with Xp
Page 37 and 38: Renal cell carcinoma associated wit
Page 39 and 40: Papillary adenoma of the kidney J.N
Page 41 and 42: of this tumour. Microscopic extensi
Page 43 and 44: A B Fig. 1.59 Metanephric adenoma.
Page 45 and 46: esults in intratumoral aneurysms. O
Page 47 and 48: peritumoural fibrous pseudocapsule.
Page 49 and 50: increases in prevalence to approxim
Page 51 and 52: Nephrogenic rests and nephroblastom
Page 53 and 54: Cystic partially differentiated nep
Page 55 and 56: A B Fig. 1.80 Clear cell sarcoma of
Page 57 and 58: A B Fig. 1.85 Rhabdoid tumour of th
Page 59 and 60: transcription factor is fused to th
Page 61 and 62: Leiomyosarcoma S.M. Bonsib Definiti
Page 63: Angiomyolipoma G. Martignoni M.B. A
Page 67 and 68: Multinucleated and enlarged ganglio
Page 69 and 70: Haemangioma P. Tamboli Definition H
Page 71 and 72: Fig. 1.107 Juxtaglomerular cell tum
Page 73 and 74: Intrarenal schwannoma I. Alvarado-C
Page 75 and 76: Mixed epithelial and stromal tumour
Page 77 and 78: Synovial sarcoma of the kidney J.Y.
Page 79 and 80: Renal carcinoid tumour L.R. Bégin
Page 81 and 82: Primitive neuroectodermal tumour (E
Page 83 and 84: Paraganglioma / Phaeochromocytoma P
Page 85 and 86: Leukaemia A. Orazi Interstitial inf
Page 87 and 88: WHO histological classification of
Page 89 and 90: TNM classification of carcinomas of
Page 91 and 92: The risk of bladder cancer goes dow
Page 93 and 94: Tumour spread and staging Urinary b
Page 95 and 96: feature in such patients undergoing
Page 97 and 98: A Fig. 2.12 Infiltrative urothelial
Page 99 and 100: A Fig. 2.15 A Infiltrating urotheli
Page 101 and 102: A B Fig. 2.19 A Infiltrative urothe
Page 103 and 104: Fig. 2.23 Infiltrative urothelial c
Page 105 and 106: ing systems have been proposed on t
Page 107 and 108: Non-invasive urothelial tumours G.
Page 109 and 110: chronically inflamed urothelium and
Page 111 and 112: Inverted papilloma G. Sauter Defini
Page 113 and 114: 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
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Fig. 4.28 Spermatocytic seminoma wi
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A B Fig. 4.33 Embryonal carcinoma.
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A B Fig. 4.38 Yolk sac tumour. A En
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have cytoplasmic lacunae that conta
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A Fig. 4.46 Teratoma. A Longitudina
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A B Fig. 4.51 A Cut surface of derm
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Fig. 4.54 Mixed germ cell tumour. L
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Sex cord / gonadal stromal tumours
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A B C Fig. 4.67 Malignant Leydig ce
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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
Page 309 and 310:
502. Corti B, Carella R, Gabusi E,
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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
Page 333 and 334:
2070. Phillips G, Kumari-Subaiya S,
Page 335 and 336:
2199. Riou G, Barrois M, Prost S, T
Page 337 and 338:
2327. Schmidt L, Junker K, Weirich
Page 339 and 340:
2450. Smith G, Elton RA, Beynon LL,
Page 341 and 342:
2572. Tamboli P, Mohsin SK, Hailema
Page 343 and 344:
2693. van Echten J, Timmer A, van d
Page 345 and 346:
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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