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Chapter 1

Summary: Anatomy of the genitourinary tract and histology of genitourinary tumours

  • The most common kidney cancers are clear cell, papillary and chromophobe RCC
  • Urothelium is present in the renal pelvis, ureters, urinary bladder and urethra, but >90% of urothelial neoplasms occur in the urinary bladder
  • The staging system of urothelial neoplasms is unusual as two types of non-invasive lesions exist: pTa and pTis
  • There is a high interobserver variability in staging pTa and pT1 tumours
  • pTa and pT1 tumours represent two different entities at the genetic level and have a completely different clinical course
  • PC is very common and will be found upon examination in >75% of men at the age of 75 years
  • PC is graded according to Gleason grading, the strongest predictor of tumour aggressiveness. Since 2014, the ISUP grading system is also used
  • More than 95% of all testicular neoplasias are GCTs
  • GCTs mostly occur at young age
  • GCTs include seminoma, embryonal carcinoma, yolk sac tumour, choriocarcinoma and teratoma

Further Reading

Carlo MI, Mukherjee S, Mandelker D, et al. Prevalence of germline mutations in cancer susceptibility genes in patients with advanced renal cell carcinoma. JAMA Oncol 2018; 4:1228–1235.

Delahunt B, Eble JN, Egevad L, Samaratunga H. Grading of renal cell carcinoma. Histopathology 2019; 74:4–17.

Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL; ISUP Grading Committee. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol 2005; 29:1228–1242.

Epstein JI, Egevad L, Amin MB, et al; Grading Committee. The 2014 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma: definition of grading patterns and proposal for a new grading system. Am J Surg Pathol 2016; 40:244–252.

Idrees MT, Ulbright TM, Oliva E, et al; Members of the International Society of Urological Pathology Testicular Tumour Panel. The World Health Organization 2016 classification of testicular non-germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology 2017; 70:513–521.

Moch H, Humphrey PA, Ulbright TM, Reuter VE. WHO Classification of Tumours of the Urinary System and Male Genital Organs, fourth edition. Lyon: International Agency for Research on Cancer (IARC); 2016.

Sauter G, Clauditz T, Steurer S, et al. Integrating tertiary Gleason 5 patterns into quantitative Gleason grading in prostate biopsies and prostatectomy specimens. Eur Urol 2018; 73:674–683.

Sauter G, Mihatsch MJ. Pussycats and baby tigers: non-invasive (pTa) and minimally invasive (pT1) bladder carcinomas are not the same! J Pathol 1998; 185:339–341.

Srigley JR, Delahunt B, Eble JN, et al; ISUP Renal Tumour Panel. The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. Am J Surg Pathol 2013; 37:1469–1489.

Tosoni I, Wagner U, Sauter G, et al. Clinical significance of interobserver differences in the staging and grading of superficial bladder cancer. BJU Int 2000; 85:48–53.

Williamson SR, Delahunt B, Magi-Galluzzi C, et al; Members of the ISUP Testicular Tumour Panel. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology 2017; 70:335–

Tumours of the Testis

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