- Page 1 and 2: Basel Seminars in Pathology Postgra
- Page 3: UPDATE ON PATHOLOGY STANDARDS FOR B
- Page 7: HISTOLOGIC GRADE UROTHELIAL NEOPLAS
- Page 10 and 11: What’s New in the 2012 Consensus
- Page 12 and 13: Reporting of Bladder Cancer • Gui
- Page 14 and 15: • Seen with instrumentation with
- Page 16 and 17: Squamous Metaplasia • Should be r
- Page 18 and 19: GRADING OF UROTHELIAL LESIONS • F
- Page 20 and 21: NORMAL
- Page 22 and 23: Urothelial Dysplasia • Overall fe
- Page 24 and 25: Urothelial Dysplasia • The diagno
- Page 28: ATYPIA OF UNKNOWN SIGNIFICANCE (WHO
- Page 31 and 32: Grading of Urothelial Carcinoma •
- Page 33 and 34: Papilloma
- Page 35 and 36: PUNLMP
- Page 37 and 38: LOW GRADE
- Page 39 and 40: HIGHGRADE
- Page 41 and 42: P A P I L O M A L M P L O W G R A D
- Page 43 and 44: Courtesy R. Montironi, Italy Exophy
- Page 45 and 46: Inverted High Grade without invasio
- Page 47 and 48: Inverted Papilloma
- Page 49 and 50: Inverted PUNLMP
- Page 51 and 52: Inverted LG
- Page 53 and 54: Inverted HG
- Page 55 and 56:
Inverted HG, Non Inv
- Page 57 and 58:
WHO (2004) /ISUP : Prognostic Signi
- Page 59 and 60:
Contributions of WHO (2004) /ISUP
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Handling grade heterogeneity in bla
- Page 63 and 64:
Grading Papillary Urothelial Neopla
- Page 65:
Papillary Hyperplasia with Cytologi
- Page 68 and 69:
Dysplasia with early papillary feat
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Grading Invasive Cancer • Practic
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• 2 types of muscle - awareness i
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Muscularis Mucosae Muscle • Hyper
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M. mucosae muscle patterns Typical
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M. mucosae muscle pattern Hypertrop
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Muscularis Propria • Several term
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Muscle Involved by UCa, Indetermina
- Page 88 and 89:
Assessment of pT2 vs. pT3 - cystect
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Microinvasive Urothelial Carcinoma
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Substratification or Substaging of
- Page 95 and 96:
Extensive invasion
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Retraction a mimic of vascular-lymp
- Page 99 and 100:
Vascular Lymphatic Invasion (LVI)
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2013 International Society of Urolo
- Page 103 and 104:
Lymph node involvement: • Approx.
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THE BEST BLADDER CANCER PATHOLOGY S
- Page 107 and 108:
PSEUDONEOPLASTIC MIMICS OF BLADDER
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EMPHYSEMATOUS & BULLOUS CYSTITIS
- Page 113 and 114:
AMYLOIDOSIS
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MALAKOPLAKIA
- Page 117:
NORMAL PARAGANGLIONIC TISSUE
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CIS
- Page 125:
REACTIVE ATYPIA History of stones,
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CIS REACTIVE ATYPIA
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RADIATION ATYPIA
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INTRAVESICAL THERAPY
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Polyoma Virus Infection • Usually
- Page 149 and 150:
Papillary tumor Micropapillary U Ca
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Low magnification distinction Broad
- Page 153:
Cystoscopic & microscopic mimic Pap
- Page 158 and 159:
Papillary Polypoid cystitis
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ALL THAT IS PAPILLARY BLADDER IS NO
- Page 165 and 166:
Bladder Biopsy Interpretation, 2nd
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TIGHTLY CLUSTERED UROTHELIUM
- Page 169 and 170:
TIGHTLY CLUSTERED UROTHELIUM
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U Ca. with small tubules Nephrogeni
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NEPHROGENIC ADENOMA - THE BIG MIMIC
- Page 175:
NEPHROGENIC ADENOMA
- Page 181:
NEPHROGENIC ADENOMA
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NEPHROGENIC ADENOMA Clues to benign
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FLORID REACTIVE PROLIFERATIONS norm
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POST-RADIATION PSEUDOCARCINOMATOUS
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LORID CYSTTTIS GLANDULARIS ITH MUCI
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MULLERIANOSIS • Endometriosis, en
- Page 233 and 234:
PSEUDOSARCOMATOUS MYOFIBROBLASTIC P
- Page 235:
Gross PMP • Exophyticpolypoid mas
- Page 246 and 247:
ROLE OF IMMUNOHISTOCHEMISTRY IN THE
- Page 248 and 249:
PROVING UROTHELIAL DIFFERENTIATION
- Page 250 and 251:
CA in the bladder, h.o of lung canc
- Page 252 and 253:
Paraganglioma Epith. LMS PEComa Mel
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p63
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Plasmacytoid U Ca
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• Markers of urothelium and uroth
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S100P S100P GATA3 GATA3 A-F: S100P,
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GATA 3 & S100 P: Diagnostic utility
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PARAGANGLIOMA
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Identification of Succinate Dehydro
- Page 270 and 271:
CIS REACTIVE
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NORMAL
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CK-20
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REACTIVE UROTHELIUM
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CK-20
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Reactive CD44
- Page 282 and 283:
CA-INSITU
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CK-20
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CIS CK20
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CK20 (+) CD44(-)
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p53
- Page 292 and 293:
CD44
- Page 294 and 295:
Reactive CIS
- Page 296 and 297:
Radiation-Reactive Radiation CIS
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AUA GUIDELINE 2007 UPDATE: • Stan
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Typical pattern: • Arranged in gr
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Muscularis mucosae or muscularis pr
- Page 304:
Am J Surg Pathol. 2009 ;33:91-8 SMO
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Smoothelin hyperplastic
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Smoothelin
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SMA - M. Mucosae
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Smoothelin
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CAUTERY: MINIMAL EFFECT ON IHC
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M. Mucosae vs. M. Propria in TURBT
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M. Mucosae vs. M. Propria in TURBT
- Page 323 and 324:
Smoothelin: Negative - Suggestive o
- Page 325:
Courtesy: Dr John Eble
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METASTASIS TO THE BLADDER Prostate
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?Urothelial Carcinoma vs. ?Prostati
- Page 333 and 334:
Concurrent PCa & UCa
- Page 335 and 336:
PCa PCa NKX3.1 P501S PSMA
- Page 338:
100% 100% 90% 88% 88% 88% 80% 70% 6
- Page 342 and 343:
Clear cell Ca Neph. adenoma
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U Ca. with small tubules Nephrogeni
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Nephrogenic adenoma Clear cell aden
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CCCa Pax 2 S100A1 Ki67
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P Ca A Pax 2 S100A1 Ki67
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PMP / Pseudotumors
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SMA
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Sarcomatoid urothelial carcinoma
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Leiomyosarcoma
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Spindle cell lesions Benign (PMP) v
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SARC CA p63 CK 5/6 or HMCK p63
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Session plan Renal Pathology for th
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Tubules - Normal
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Interstitial inflammation - tubuloi
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Tubulointerstitial nephritis Classi
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CKD, previous tuberculosis, HCV pos
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AKI, ANCA positive, cortex - TIN, g
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Male 59 years. Acute rise in creati
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35 patients with IgG4-TIN: 27 (77%)
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Male 70 years AKI Diagnosis?
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Hantavirus nephropathy
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Male, 57 years. Acute renal failure
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Ascending infection (pyelonephritis
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Tubulointerstitial infiltrates in t
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Tubulointerstitial infiltrates in t
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Things in tubules Casts, crystals,
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Acute phosphate nephropathy First c
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Diagnosis?
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Acute tubular injury Ischaemia, dru
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Light chain tubulopathy
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Acute tubular injury in the post mo
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Acute tubular injury in the post mo
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Drug-associated tubular injury Drug
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Gentamicin toxicity Diagnosis?
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Drug-associated tubular injury Mech
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Glomerular lesions Ian Roberts Oxfo
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Tumour nephrectomy specimens Things
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Glomeruli- Normal
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Nodular glomerulosclerosis Diabetic
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Diabetic nephropathy: thickened bas
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Diabetic nephropathy: Diffuse mesan
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Diabetic nephropathy: Insudative le
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Amyloidosis Congo red
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Amyloidosis
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Amyloidosis
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Immunotactoid Fibrillary GN 0.06% o
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Light chain deposition disease
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Focal segmental glomerulosclerosis
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Focal segmental glomerulosclerosis
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Focal segmental glomerulosclerosis
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Glomerular lesions: proliferation M
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Glomerular lesions: proliferation E
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The diagnosis of IgA nephropathy is
- Page 454 and 455:
The histology of IgA nephropathy is
- Page 456 and 457:
Mesangiocapillary GN = Membranoprol
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Mesangiocapillary GN, type I C3
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C3 glomerulopathy MPGN and C3 glome
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Dense deposit disease
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Glomerular lesions: necrosis Ruptur
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Renal vasculitis May be isolated re
- Page 468 and 469:
Renal vasculitis European vasculiti
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Anti-GBM disease Autoantibodies to
- Page 472 and 473:
Remember: multiple pathologies are
- Page 474 and 475:
Male 46 years. Suffered from diabet
- Page 476 and 477:
Diagnoses: Diabetic nephropathy Oxa
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Interactive Kidney Quiz Ian S. Robe
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Test vote How did you learn about t
- Page 482 and 483:
Set 1
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PathoPic B
- Page 486:
PathoPic D
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What is your main diagnosis? 1. chr
- Page 492 and 493:
What is your main diagnosis? 1. amy
- Page 494 and 495:
What is your main diagnosis? 1. no
- Page 496 and 497:
A PathoPic Dg: arteriolosclerosis,
- Page 498 and 499:
Dg: diabetic kidney C PathoPic
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Dg: malignant nephrosclerosis E
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RCPath “Minimum” dataset for tu
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Patterns of scarring Granular subca
- Page 506 and 507:
Patterns of scarring Granular subca
- Page 508 and 509:
Deep pitted cortical scars: Pattern
- Page 510 and 511:
Patterns of scarring Deep pitted co
- Page 512 and 513:
Patterns of scarring Segmental tran
- Page 514 and 515:
Malignant hypertension A cause of a
- Page 516 and 517:
Malignant hypertension A cause of a
- Page 518 and 519:
Malignant hypertension A cause of a
- Page 520 and 521:
Malignant vs benign vascular diseas
- Page 522 and 523:
PathoPic G
- Page 524:
PathoPic I
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What is your main diagnosis? 1. gou
- Page 530 and 531:
What is your main diagnosis? 1. met
- Page 532 and 533:
What is your main diagnosis? 1. ren
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Solutions (M.J. Mihatsch)
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Descripition Involvement of cortex
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Description Whitish discoloration a
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Description Massive enlargement of
- Page 542 and 543:
Description Brownish discoloration
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Papillary necrosis Pg: i.e. vascula
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Papillary necrosis Pg: i.e. vascula
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Types of papillary necrosis: Extend
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Black papillary necrosis Think of p
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Phenacetin kidney Compete necrosis
- Page 554 and 555:
Phenacetin kidney Note massive base
- Page 556 and 557:
Phenacetin kidney Note: Massive lip
- Page 558 and 559:
Typical examples of papillary necro
- Page 560 and 561:
White papillary necrosis Think of v
- Page 562 and 563:
Red papillary necrosis Think of vas
- Page 564 and 565:
I hope you will never overlook papi
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Challenges for Pathologists Renal M
- Page 568:
Do the morphotypes of RCC have prog
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Potential of Needle Biopsy • Diag
- Page 573 and 574:
Novel renal tumor types with clear
- Page 575 and 576:
Am J Surg Path 28, 2004 41 Carcinom
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Should Acquired Cystic Disease- RCC
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Clear cell papillary RCC has: 1. PO
- Page 582 and 583:
Which name should be used for 1. Cl
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1. Yes 2. No Should Thyroid-Like Fo
- Page 587 and 588:
If focal (
- Page 589 and 590:
Denote AMLs with epithelioid morpho
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Differential Diagnosis of Cystic Re
- Page 594 and 595:
smaller cysts with phyllodes glands
- Page 596 and 597:
Are Cystic Nephroma and Mixed Epith
- Page 598 and 599:
If you consider CN and MEST variati
- Page 600 and 601:
Should Tubulocystic-RCC be recogniz
- Page 602 and 603:
Prognosis • Type • Stage • Gr
- Page 604:
Papillary renal cell carcinoma Type
- Page 608 and 609:
Differential Diagnosis: metanephric
- Page 610 and 611:
The distinction between type 1 vers
- Page 612 and 613:
Should Oncocytic Papillary-RCC be r
- Page 614:
Leiomyomas of the Skin
- Page 618 and 619:
Fuhrman Grading in RCC Hong SK, BJU
- Page 620 and 621:
How should we grade clear cell RCC?
- Page 622:
How should we grade chromophobe RCC
- Page 625 and 626:
For Sarcomatoid Tumors Do You Repor
- Page 627 and 628:
Do You Consider a Tumor Area Sarcom
- Page 629 and 630:
Tumor Staging
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When invasion of the renal sinus is
- Page 633 and 634:
Should the presence or absence of t
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Should any assessment of amount (pe
- Page 637 and 638:
ISUP Consensus Conference Vancouver
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Molecular Pathways and Targeted The
- Page 641:
Chemokine receptor CXCR4 downregula
- Page 644 and 645:
Agents such as sunitinib act throug
- Page 646 and 647:
VHL-Mutation ↔ Gene expression Ba
- Page 648 and 649:
Driver and Passenger VHL Mutations
- Page 650:
Differential Diagnosis of Renal Cel
- Page 653:
Renal Tumors with Eosinophilic Cyto
- Page 658:
Birt Hogg Dubé syndrome
- Page 661 and 662:
Are the hybrid tumors associated wi
- Page 663 and 664:
For distinguishing clear cell RCC f
- Page 665 and 666:
Clear Cell Renal Cancer VHL Deletio
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Early on in VHL disease, the vast m
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Distinct tumor suppressor mechanism
- Page 671 and 672:
A Ksp-Cre - pos - pos - pos Vhlh fl
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pVHL localizes to primary cilia in
- Page 675 and 676:
a c b d Montani et al.: Am J Surg P
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Multilocular cystic renal cell carc
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What terminology for a multicystic
- Page 681 and 682:
In the setting of acquired cystic d
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„Translocation“ Type of Renal C
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„Translocation“ Type of Renal C
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t(X;1)
- Page 690 and 691:
Should t(6;11) RCC be Recognized as
- Page 693 and 694:
When a translocation carcinoma is s
- Page 696:
Leiomyomatous Renal Cell Carcinoma
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Edmunds W: Trans.Path.Soc.London 43
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Are Cystic Nephroma and Mixed Epith
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Renal Tumors with Papillary Archite
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In the absence of classical histolo
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Clin Cancer Res 2009;15:3297-3304 -
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A, Western blot analysis of HK-2 ce
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Tumors with Spindle Cell Morphology
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Which marker do you use most freque
- Page 719 and 720:
Primary Renal Synovial Sarcoma Immu
- Page 721:
SYT-SSX Fusion from translocation t
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Renal carcinoid from a horseshoe ki
- Page 729:
DD „Small round blue“ cell tumo
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Xu X. et al.L Cell 148, 886-895, 20
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Polybromo-1 (BAF180) in ccRCC ~40%
- Page 738 and 739:
wt versus VHL-/- cells VHL-loss der
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VHL and a Serum Screening Test for