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Tumors and Tumor-like Conditions of the Male Genital Tract

Prostate and Seminal Vesicles Jae Y. Ro Mahul B. Amin Alberto G. Ayala Steven S. Shen Mukul K. Divatia Chapter Outline Prostate, 913 Tumors and Tumorlike Conditions of the Seminal Vesicles, 980 Prostate Prostatic carcinoma and benign prostatic hyperplasia (BPH) are the two principal conditions that involve the prostate; they account for more than 90% of all prostatic disease. Prostate cancer is the most common and second leading cause of cancer…

Tumors of the Female Genital Tract

Ovary, Fallopian Tube, and Broad Ligament Karuna Garg Charles Zaloudek Chapter Outline Tumors of the Ovary, 702 Tumors of the Fallopian Tube, 777 Tumors of the Broad and Round Ligaments, 781 Tumors of the Ovary There are three main categories of primary ovarian tumors. These are (1) epithelial tumors, which originate from the surface epithelium of the ovary, epithelial inclusions, or endometriosis, and some may actually be of…

Tumors of the Urinary Tract

Tumors of the Kidney John N. Eble David J. Grignon Robert H. Young Chapter Outline Epithelial Tumors of the Kidney, 600 Neuroendocrine Neoplasms of the Kidney, 619 Mesenchymal Tumors of the Kidney, 620 Secondary Neoplasms of the Kidney, 628 Renal Tumors in Children, 628 Since the discovery of renal oncocytoma in 1976, the classification of tumors of the kidney has grown complex. In the following sections on epithelial tumors,…

Tumors of the Exocrine Pancreas

Classification and General Features The classification and nomenclature used in this chapter are based on those proposed by the World Health Organization (WHO) in 2017 and 2019. Its premise is that the cellular phenotype of the tumors of the pancreas usually resembles one of the three main epithelial cell types of this organ: the ductal cell, the acinar cell, and the neuroendocrine cell. Most exocrine pancreatic…

Tumors of the Liver, Gallbladder, and Biliary Tree

Liver Benign Hepatocellular Lesions in Noncirrhotic Liver Hepatocellular Adenoma Clinical Features. Hepatocellular adenomas (HCAs) historically have been seen mostly in younger women during their reproductive years but are rare in men and children. In recent years, however, HCAs have developed in an increasing number of older women as well as men, correlating with the recognition of different histologic subtypes of adenoma (see later discussion). Most HCAs…

Tumors of the Small and Large Intestines, Including Anal Canal

Small Intestine Epithelial Tumors Adenoma Clinical Features. Adenomas of the small intestine are relatively uncommon, compared with adenomas of the large intestine. Around 80% arise in the periampullary duodenum. Duodenal adenomas occur over a wide age range (mean 60 years), with an equal sex distribution. Patients with familial adenomatous polyposis (FAP) have a markedly increased incidence of duodenal and ampullary adenomas (nearly 100%), which are often…

Tumors of the Esophagus and Stomach

Esophagus Epithelial Tumors Squamous Cell Papilloma and Papillomatosis Clinical Features. Squamous cell papilloma may occur anywhere in the esophagus but is found most commonly in the lower third as a single, well-demarcated sessile intraluminal tumor, usually less than 1.5 cm in size. The age distribution is very wide. A giant form has been described. Multiple lesions, sometimes in association with Goltz syndrome (focal dermal hypoplasia), may also…

Tumors of the Salivary Glands

The Normal Salivary Glands Applied Anatomy The salivary gland system comprises three pairs of major glands (parotid, submandibular, and sublingual) and about 500 to 1000 lobules of minor glands dispersed in the submucosa of the oral cavity. The seromucinous glands of the nasal cavity, larynx, and bronchi, although not producing saliva by definition, are histologically similar to the minor salivary glands and share a similar repertoire…

Tumors of the Oral Cavity

Introduction The most common tumors in the mouth arise from the oral epithelium. These are similar to tumors of stratified squamous epithelium occurring at other body sites and only infrequently present problems in diagnosis. The mesenchymal tissues of the mouth are less often the source of neoplasms, but a number of overgrowths occur in response to chronic irritation and it is important that these are distinguished…

Tumors of the Lung and Pleura

Classification The World Health Organization (WHO) classification of tumors of lung and pleura is commonly referenced in pathology practice. The fourth edition, published in 2015, was heavily influenced by joint recommendations from the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society. These recommendations represent a global perspective of pathologists, radiologists, oncologists, surgeons, epidemiologists, and molecular geneticists and…

Tumors of the Upper Respiratory Tract

Nasal Cavity, Paranasal Sinuses, and Pharynx Bruce M. Wenig Chapter Outline Functional Anatomy and Histology, 96 General Considerations: Sinonasal Tract, 98 Benign Epithelial and Neuroectodermal Neoplasms, 100 Benign Minor Salivary Gland Neoplasms, 104 Benign Neuroendocrine/Neuroectodermal Tumors, 106 Benign Mesenchymal Neoplasms, 108 Benign Fibrohistiocytic Tumors, 116 Osseous, Fibroosseous, and Cartilaginous Lesions, 116 Borderline Soft Tissue Tumors, 122 Malignant Epithelial Neoplasms, 124 Malignant Salivary Gland Tumors, 137 General Considerations:…

Tumors of Blood Vessels and Lymphatics

Few groups of tumors can show such a broad spectrum of morphologic appearances and clinical behavior as vascular tumors. Classification is a problem not only because the line between neoplasia and malformation (or so-called hamartoma) remains undefined, but also, and more importantly, because it is frequently difficult to distinguish benign from malignant lesions. It is interesting that in comparison with other soft tissue tumors (see Chapter…

Tumors of the Heart and Pericardium

Tumors of the heart and pericardium are, as in most sites, broadly dichotomized into benign and malignant varieties. Among the benign tumors, some are correctly classified as neoplasms, some as nonneoplastic entities, some as hamartomas or heterotopias, and some as processes somewhere in between. No firm distinctions pertaining to histogenesis are drawn in this discussion as the emphasis is on accurate diagnosis. It is important to…

Gestational Diseases and the Placenta

Introduction The purpose of this chapter is to integrate the most common clinical scenarios faced in obstetric practice with pathologic examination of the placenta. Because much of the pathology has been covered descriptively in Chapter 31, Chapter 32 , the principal intent of this chapter is to discuss pathologic conditions as they present clinically, focusing on pathologic conditions that lead to premature birth, induction of labor,…

Placental Correlates of Unanticipated Fetal Death

Introduction Placenta in Fetal Death General Historical/Clinical Background Examination of the placenta is a critical component in evaluating the etiology of intrauterine demise. This is particularly true as pregnancy progresses, because the cause of demise beyond the first trimester is less likely to be due to intrinsic fetal disease and more likely due to “errors of the intrauterine environment”; that is, as a result of causes…

Evaluation of the Placenta

General Principles Historical and Clinical Background A gross placental examination is important as a means of documenting structural abnormalities of the placenta and as a guide for tissue selection for histology. Many structural abnormalities were classified as significant placental disorders by the 1959–1966 Collaborative Perinatal Study, a large prospective study that evaluated relationships between placental pathology and mental, neurologic, or psychological disturbances in childhood ( Table…

Trophoblast Neoplasia

Introduction Gestational trophoblastic disease (GTD) is defined as a spectrum of abnormal gestations and neoplasms arising from villous or extravillous trophoblast that are associated with pregnancy. As discussed in this chapter, GTD may take several forms, each with its own risk of mortality and responsiveness to chemotherapy. The gestational nature of these disorders justifies their discussion in the context of pregnancy evaluation as (1) most cases…

Placental Development and Complications of Previable Pregnancy

Early Development Embryo The oocyte is usually fertilized near the distal end of the fallopian tube, at approximately day 15 of the menstrual cycle, or the day after ovulation. During the next week, as the zygote travels through the fallopian tube, it undergoes progressive cellular divisions to form first a 16-cell, raspberry-like morula and then a 32-cell, centrally cystic blastocyst. Under normal circumstances, on days 23…

Metastatic Tumors Involving the Ovary

Introduction The distinction between primary and secondary tumors of the ovary is one of the more difficult morphologic dilemmas in gynecologic pathology, because there are similarities in both clinical and histologic features in many cases. The reported frequency of metastatic tumors in the ovary varies with the study design (e.g., autopsy vs. surgical material) and the country of origin ( Table 28.1 ); however, it ranges…