Urologic Surgical Pathology

✍ Scribed by Liang Cheng; Greg T. MacLennan; David G. Bostwick

• Publisher: Saunders
• Year: 2019
• Tongue: English
• Leaves: 1259
• Edition: 4
• Category: Library

✦ Synopsis

Offering comprehensive coverage of this fast-changing field for more than 20 years, Urologic Surgical Pathology is an expert guide to all common and rare entities in the genitourinary system. The 4th Edition keeps you fully up to date with discussions of newly recognized tumors and terminologies, the latest classification schemes, current grading approaches, molecular alterations, and commonly used ancillary diagnostic techniques. With its clinical focus on day-to-day urological pathology sign-out and an emphasis on clinicopathologic and radiographic-pathologic correlations, this thoroughly revised uropathology reference is an excellent resource for diagnostic decision making. Includes expanded coverage of differential diagnosis for all tumor types encountered in urological surgical pathology practice. Incorporates the latest TNM staging and WHO classification systems, as well as new diagnostic biomarkers and their utility in differential diagnosis, newly described variants and new histologic entities. Discusses advances in molecular diagnostic testing, its capabilities, and its limitations, including targeted therapy/personalized medicine. Covers new developments in immunohistochemistry and the latest diagnostic tumor markers. Features more than 1,600 high-quality images - all in color - including gross pictures, histopathologic and cytopathologic images, special stains, other ancillaries, drawings, and illustrations. Helps you find information quickly with a consistent chapter format; an abundance of tables, diagrams and flowcharts; boxed lists of types and causes of diseases; differential diagnosis; characteristic features of diseases; complications; classifications; and staging. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

✦ Table of Contents

Cover
Inside Front Cover
UROLOGIC
SURGICAL
PATHOLOGY
Copyright
Contributors
Preface to the Fourth Edition
1
Nonneoplastic Diseases of the Kidney
Introduction
Embryologic Development and Normal Structure
Pronephros
Mesonephros
Metanephros
Nephron Differentiation
Gross Anatomy
Microscopic Anatomy
Parenchymal Maldevelopment and Cystic Kidney Diseases
Abnormalities in Form and Position
Rotation Anomaly
Renal Ectopia
Renal Fusion
Abnormalities in Mass and Number
Supernumerary Kidney
Hypoplasia
Simple Hypoplasia
Oligomeganephronia
Cortical Hypoplasia
Segmental Hypoplasia (Ask-Upmark Kidney)
Renal Agenesis
Unilateral Renal Agenesis
Bilateral Renal Agenesis (Potter Syndrome)
Syndromic Renal Agenesis
Renal Dysplasia
Polycystic Kidney Disease
Autosomal Recessive Polycystic Kidney Disease
Autosomal Dominant Polycystic Kidney Disease
Cystic Diseases (Without Dysplasia) in Hereditary Syndromes
Nephronophthisis
Autosomal Dominant Tubulointerstitial Disease
Von Hippel-Lindau disease
Tuberous Sclerosis
Glomerulocystic Kidneys
Miscellaneous Diseases
Renal Tubular Dysgenesis
Acquired Cystic Kidney Disease
Localized Cystic Kidney Disease
Medullary Sponge Kidney
Simple Cortical Cyst
Hydrocalyx, Megacalycosis, and Calyceal Diverticulum
Vascular Diseases
Hypertension-Associated Renal Disease
Benign Nephrosclerosis
Malignant Nephrosclerosis
Thrombotic Microangiopathy
Renal Artery Stenosis
Atherosclerosis-Related Renal Artery Stenosis
Fibromuscular Dysplasia
Intimal Fibroplasia
Medial Hyperplasia
Medial Fibroplasia With Aneurysms
Perimedial Fibroplasia
Periarterial Fibroplasia
Kidney in Renal Artery Stenosis
Hemolytic Uremic Syndrome
Thrombotic Thrombocytopenic Purpura
Renal Artery Dissection
Renal Artery Aneurysm
Saccular Aneurysm
Fusiform Aneurysm
Intrarenal Aneurysm
Arteriovenous Malformation and Fistula
Renal Emboli and Infarcts
Renal Cortical Necrosis
Renal Papillary Necrosis
Renal Cholesterol Microembolism Syndrome
Renal Artery Thrombosis
Renal Vein Thrombosis
Bartter syndrome
Vasculitis
Tubulointerstitial Disease
Acute and Chronic Renal Failure
Acute Tubular Injury (Necrosis)
Acute Tubulointerstitial Nephritis
Herbal Remedies, Slimming Agents and Aristocholic Acid Nephropathy
Immunoglobulin G4-Related Sclerosing Tubulointerstitial Nephritis
Analgesic Nephropathy
Bacterial Infection-Associated Tubulointerstitial Disease
Acute Pyelonephritis
Pyonephrosis
Perinephric Abscess
Emphysematous Pyelonephritis
Chronic Pyelonephritis
Reflux Nephropathy (Chronic Nonobstructive Pyelonephritis)
Chronic Obstructive Pyelonephritis
Viral Infections
Granulomatous Tubulointerstitial Disease
Sarcoidosis
Xanthogranulomatous Pyelonephritis
Malakoplakia
Tuberculosis
Diverse Other Granulomatous Diseases
Metabolic Abnormalities, Heavy Metals, and Crystal-Associated Tubulointerstitial Diseases
Heavy Metals
Hypercalcemic Nephropathy
Nephrolithiasis
Oxalate-Associated Renal Disease
Cystinosis
Uric Acid-Associated Renal Disease
Diabetic Kidney Disease
Amyloidosis and Paraprotein-Associated Tubulointerstitial Disease
Amyloidosis
Light Chain Cast Nephropathy
Immunoglobulin and Light Chain Deposition Disease
Light Chain Proximal Tubulopathy
Light Chain Crystal Tubulopathy
Crystal-Storing Histiocytosis
Monoclonal Gammopathy of Renal Significance
Renal Transplantation
Evaluation of Preimplantation/Procurement and Zero-Hour Implantation Biopsy
Evaluation of a Transplant Biopsy
Antibody-Mediated Rejection
T-Cell-Mediated Rejection
Calcineurin Inhibitor Nephrotoxicity
References
2
Neoplasms of the Kidney
Renal Cell Carcinomas
General Considerations
Incidence
Epidemiology
Hereditary Aspects of Renal Cell Neoplasia
Grading Renal Cell Carcinoma
Staging Renal Cell Carcinoma
Clear Cell Renal Cell Carcinoma
Multilocular Cystic Renal Neoplasm of Low Malignant Potential
Papillary Renal Cell Carcinoma
Hereditary Leiomyomatosis and Renal Cell Carcinoma-Associated Renal Cell Carcinoma
Chromophobe Renal Cell Carcinoma
Collecting Duct Carcinoma
Renal Medullary Carcinoma
MiT Family Translocation Renal Cell Carcinoma
Xp11 Translocation Renal Cell Carcinoma
t(6;11) Translocation Renal Cell Carcinoma
Succinic Dehydrogenase-Deficient Renal Cell Carcinoma
Mucinous Tubular and Spindle Cell Carcinoma
Tubulocystic Renal Cell Carcinoma
Acquired Cystic Disease-Associated Renal Cell Carcinoma
Clear Cell Papillary Renal Cell Carcinoma
Renal Cell Carcinoma, Unclassified
Emerging or Provisional Renal Cell Carcinomas
Oncocytic Renal Cell Carcinoma Occurring After Neuroblastoma
Eosinophilic Solid and Cystic Renal Cell Carcinoma
Thyroid-like Follicular Carcinoma of the Kidney
ALK Rearrangement-Associated Renal Cell Carcinoma
Renal Cell Carcinoma With Angioleiomyoma-like Stroma
Benign Epithelial Neoplasms
Papillary Adenoma
Oncocytoma
Metanephric Tumors
Metanephric Adenoma
Metanephric Adenofibroma
Metanephric Stromal Tumor
Nephroblastic and Cystic Tumors That Occur Mainly in Children
Nephrogenic Rests
Nephroblastoma (Wilms Tumor)
Cystic Partially Differentiated Nephroblastoma
Pediatric Cystic Nephroma
Mesenchymal Tumors
Mesenchymal Tumors That Occur Mainly in Children
Clear Cell Sarcoma
Rhabdoid Tumor
Congenital Mesoblastic Nephroma
Ossifying Renal Tumor of Infancy
Mesenchymal Tumors That Occur Mainly in Adults
Leiomyosarcoma
Angiosarcoma
Rhabdomyosarcoma
Osteosarcoma
Synovial Sarcoma
Ewing Sarcoma
Angiomyolipoma
Epithelioid Angiomyolipoma
Leiomyoma
Hemangioma
Lymphangioma
Hemangioblastoma
Juxtaglomerular Cell Tumor
Renomedullary Interstitial Cell Tumor
Schwannoma
Solitary Fibrous Tumor
Mixed Epithelial and Stromal Tumor Family
Adult Cystic Nephroma
Mixed Epithelial and Stromal Tumor
Neuroendocrine Tumors
Well-Differentiated Neuroendocrine Tumor
Large Cell Neuroendocrine Carcinoma
Small Cell Neuroendocrine Carcinoma
Paraganglioma
Miscellaneous Tumors
Renal Hematopoietic Neoplasms
Lymphoma
Plasmacytoma
Leukemia
Germ Cell Tumors
Metastatic Tumors
References
3
Renal Pelvis and Ureter
Development
Anatomy
Congenital Malformations
Abnormalities in Number or Location of Ureters
Refluxing Megaureter
Ureteropelvic Junction Obstruction
Primary Megaureter
Ureterocele
Paraureteral Diverticulum
Ureteral Dysplasia
Nonneoplastic Proliferative, Metaplastic, and Inflammatory Lesions
Hyperplasia, von Brunn Nests, and Ureteropyelitis Cystica and Glandularis
Squamous and Glandular Metaplasia
Nephrogenic Adenoma
Reactive Changes (Reactive Atypia)
Malakoplakia
Endometriosis
Retroperitoneal Fibrosis
Neoplasms
Benign Epithelial Neoplasms
Inverted Papilloma
Urothelial Papilloma
Malignant Epithelial Neoplasms
Urothelial Dysplasia and Carcinoma In Situ
Urothelial Carcinoma
Squamous Cell Carcinoma
Adenocarcinoma
Metastases
Mesenchymal Neoplasms
Fibroepithelial Polyp
Leiomyoma and Leiomyosarcoma
Hemangioma
Other Tumors
References
4
Fine Needle Aspiration of the Kidney
Introduction
Background to Renal Fine Needle Aspiration
Indications
Specimen Collection and Preparation
Complications
Accuracy
Adequacy
Normal Elements
Glomeruli
Proximal Tubular Cells
Distal Tubular Cells
Benign Lesions
Oncocytoma
Papillary Adenoma
Angiomyolipoma
Metanephric Adenoma
Cystic Nephroma/Mixed Epithelial and Stromal Tumor
Renal Abscess
Xanthogranulomatous Pyelonephritis
Renal Infarct
Renal Cysts
Acquired Cystic Disease and Adult Polycystic Disease
Malignant Lesions
Renal Cell Carcinoma
Clear Cell Renal Cell Carcinoma
Papillary Renal Cell Carcinoma
Chromophobe Renal Cell Carcinoma
Sarcomatoid Renal Cell Carcinoma
Collecting Duct Carcinoma
Translocation-Associated Renal Cell Carcinomas [TFE3-Associated Tumors, Including the MiT Family, Xp11, and t6,11]
Mucinous Tubular and Spindle Cell Carcinoma
Clear Cell Papillary Renal Cell Carcinoma
Other Subtypes of Renal Cell Carcinoma
Metastases
Urothelial Carcinoma
Other Rare Tumors
Future Trends
Fine Needle Aspiration in Pediatric Patients
Renal Mass Ablation
Conclusions
References
5
Nonneoplastic Disorders of the Urinary Bladder
Embryology and Anatomy
Embryology
Gross Anatomy
Histology
Epithelial Abnormalities
von Brunn Nests
Cystitis Glandularis and Intestinal Metaplasia
Cystitis Glandularis and Cystitis Cystica
Intestinal Metaplasia (Cystitis Glandularis, Intestinal Type)
Squamous Metaplasia
Nephrogenic Adenoma
Papillary Hyperplasia
Inflammation and Infection
Nonspecific Cystitis
Polypoid and Papillary Cystitis
Follicular Cystitis
Giant Cell Cystitis
Hemorrhagic Cystitis
Special Types of Cystitis
Interstitial Cystitis (Bladder Pain Syndrome)
Eosinophilic Cystitis
Postsurgical Necrobiotic Granulomas
Bacillus Calmette-Guérin Granulomas
Other Noninfectious Granulomas
Radiation Cystitis
Reaction to Chemotherapy
Calculi
Infectious Cystitis
Bacterial Cystitis
Gangrene
Encrusted Cystitis
Emphysematous Cystitis
Other Rare Lesions
Urachal Abscess
Malakoplakia
Tuberculous Cystitis
Fungal and Actinomycotic Cystitis
Viral Cystitis
Human Papillomavirus
Other Viruses
Schistosomiasis
Polyps and Other Mass Lesions
Ectopic Prostate
Other Polyps
Hamartoma
Amyloidosis
Proteinoma (Tamm-Horsfall Protein Deposits)
Fallopian Tube Prolapse
Postoperative Spindle Cell Nodule
Inflammatory Myofibroblastic Tumor (Pseudosarcomatous Fibromyxoid Tumor; Inflammatory Pseudotumor)
Müllerian Lesions
Endometriosis
Endocervicosis
Müllerian Cyst
Malformations
Agenesis
Exstrophy
Duplication and Septation of the Bladder
Urachal Cysts and Persistence
Diverticulum
Other Congenital Malformations and Anomalies
References
6
Neoplasms of the Urinary Bladder
Benign Urothelial Neoplasms
Urothelial Papilloma and Diffuse Papillomatosis
Inverted Papilloma
Squamous Papilloma
Urothelial Proliferation of Uncertain Malignant Potential
Papillary Urothelial Hyperplasia/Urothelial Proliferation of Uncertain Malignant Potential
Flat Urothelial Hyperplasia/Urothelial Proliferation of Uncertain Malignant Potential
Flat Intraepithelial Lesions
Histologic Variants of Carcinoma In Situ
Large Cell Carcinoma In Situ
Small Cell Carcinoma In Situ
Denuding and Clinging Pattern´´ Carcinoma In Situ Pagetoid and Undermining (Lepidic) Carcinoma In Situ Carcinoma In Situ With Squamous or Glandular Differentiation Carcinoma In Situ With Micropapillary Pattern Carcinoma In Situ With Microinvasion Urothelial Reactive Atypia Reactive Atypia Atypia of Unknown Significance Therapy-Induced Changes in the Urothelium and Mimics of Urothelial Flat Neoplasia Urothelial Dysplasia Primary Dysplasia Secondary Dysplasia Urothelial Carcinoma In Situ (High-Grade Intraurothelial Neoplasia) Microscopic Pathology Urothelial Carcinoma General Features Epidemiology and Risk Factors Signs and Symptoms Field Cancerization and Tumor Multicentricity Molecular Taxonomy Immune Checkpoint Inhibitor Therapy Histologic Grading Staging of Invasive Bladder Cancer General Features of Invasive Urothelial Carcinoma Stage pT1 Tumor Histologic Grade Stroma-Epithelial Interface Invading Epithelium Stromal Response Diagnostic Pitfalls Substaging of pT1 Tumors Stage pT2 Tumor Stage pT3 Tumor Stage pT4 Tumor Histologic Grading According to the 1973 World Health Organization Classification Grade 1 Urothelial Carcinoma Grade 2 Urothelial Carcinoma Grade 3 Urothelial Carcinoma Histologic Grading According to the 2004/2016 World Health Organization Classification Papillary Urothelial Neoplasm of Low Malignant Potential Low-Grade Urothelial Carcinoma High-Grade Urothelial Carcinoma Histologic Grading of Urothelial Carcinoma: The Four-Tier Proposal Grade 1 Urothelial Carcinoma (Low Grade) Grade 2 Urothelial Carcinoma (Low Grade) Grade 3 Urothelial Carcinoma (High Grade) Grade 4 Urothelial Carcinoma (High Grade) Other Proposals for Bladder Cancer Grading and Tumor Heterogeneity The ANCONA 2001 Refinement of the 1973 World Health Organization Classification The 1999 World Health Organization Grading Proposal Tumor Heterogeneity: Implications for Grading Histologic Variants of Urothelial Carcinoma Urothelial Carcinoma With Divergent Differentiation Micropapillary Urothelial Carcinoma Plasmacytoid Urothelial Carcinoma Nested Urothelial Carcinoma Microcystic Urothelial Carcinoma Lymphoepithelioma-like Urothelial Carcinoma Lipid-Rich Urothelial Carcinoma Clear Cell (Glycogen-Rich) Urothelial Carcinoma Sarcomatoid Urothelial Carcinoma Giant Cell Urothelial Carcinoma Poorly Differentiated Tumors (Including Those With Osteoclast-like Giant Cells) Other Aspects and Variants of Urothelial Carcinoma Not Included in the Current World Health Organization Classification Urothelial Carcinoma, Inverted Growth (Inverted Papilloma-like) Pseudoangiosarcomatous (Pseudoangiosarcoma-like) Urothelial Carcinoma Urothelial Carcinoma With Chordoid Features Urothelial Carcinoma With Syncytiotrophoblastic Giant Cells Urothelial Carcinoma With Acinar/Tubular Differentiation Undifferentiated Carcinoma (Including Those With Rhabdoid Features) Urothelial Carcinoma With Unusual Stromal Reactions Urothelial Carcinoma in Augmentation Cystoplasties and Neurogenic Bladder Urothelial Carcinoma in Children and Young Adults Urothelial Carcinoma in Bladder Diverticulum Specimen Handling and Reporting Glandular Neoplasms Villous Adenoma Clear Cell Carcinoma (Tumors of Müllerian Type) Adenocarcinoma Hepatoid Adenocarcinoma Urachal Adenocarcinoma Squamous Cell Neoplasms Squamous Papilloma Squamous Cell Carcinoma In Situ Squamous Cell Carcinoma Schistosoma-Associated Squamous Cell Carcinoma Verrucous Squamous Cell Carcinoma Basaloid Squamous Cell Carcinoma Neural and Neuroendocrine Tumors Small Cell Carcinoma Epidemiology and Clinical Features Staging, Treatment, and Outcome Histogenesis and Genetics Pathology Immunohistochemistry Differential Diagnosis Large Cell Neuroendocrine Carcinoma Well-Differentiated Neuroendocrine Tumor (Carcinoid) Paraganglioma Clinical Features Histogenesis Genetics Pathology Immunohistochemistry Differential Diagnosis Neurofibroma Schwannoma Primitive Neuroectodermal Tumor Malignant Peripheral Nerve Sheath Tumor Sarcomatoid Carcinoma Definition and Terminology Clinical Features Histogenesis and Genetics Pathology Differential Diagnosis and Immunohistochemistry Soft Tissue Tumors Other Rare Soft Tissue Tumors Arising in the Bladder Myofibroblastic Proliferations and Benign Soft Tissue Tumors Inflammatory Myofibroblastic Tumor Postoperative Spindle Cell Nodule Leiomyoma Hemangioma Granular Cell Tumor Solitary Fibrous Tumors Perivascular Epithelioid Cell Tumor Malignant Soft Tissue Tumors Leiomyosarcoma Rhabdomyosarcoma Angiosarcoma Undifferentiated Pleomorphic Sarcoma Osteosarcoma Miscellaneous Tumors Malignant Melanoma Germ Cell Tumors Hematologic Malignancies Metastatic Tumors and Secondary Extension Metastatic Urothelial Carcinoma References 7 Urine Cytology Introduction Utility of Urine Cytology Indications Sources Specimen Adequacy Reporting and Classification The Paris System 2013 Normal Components of the Urinary Sediment Superficial (Umbrella) Cells Cells Originating From the Deeper Layers of the Urothelium Columnar Cells Mucus-Containing Epithelial Cells Squamous Cells Renal Epithelial Cells Convoluted Tubular Cells Collecting Duct Cells Other Benign Cells Inflammatory Cells Noncellular Components of the Urinary Sediment Pigment and Pigmented Cells Cytoplasmic Eosinophilic Inclusions (Melamed-Wolinska Bodies) Crystals Casts and Other Findings Attributable to Renal Diseases in Urine Diagnostic Criteria Infections Bacteria Fungi Viruses Trematodes and Other Parasites Reactive Cytologic Changes Lithiasis Drug Effects Effects of Radiation Therapy Degenerative Changes Instrumentation Atypia Laser-Induced Changes and Other Ablation Changes Neobladder and Ileal Conduit Urine Urine Cytology in Renal Transplant Recipients Other Benign Conditions Benign Tumors and Tumor-like Processes Atypical Urothelial Cells Suspicious Low-Grade Urothelial Carcinoma High-Grade Carcinoma Correlation of Urine Cytology and Biopsy Findings (Diagnostic Accuracy) Urinary Cells Originating From Other Sites Prostate Urethra Upper Tract Kidney Medulla and Cortex Secondary Tumors Anticipatory Positive Cytology Other Types of Carcinoma Squamous Cell Carcinoma Adenocarcinoma Small Cell Undifferentiated Carcinoma (Oat Cell Carcinoma) Mixed Carcinoma Rare Variants of Urothelial Carcinoma Major Diagnostic Pitfalls Trauma or Instrumentation Cell Preservation Human Polyomavirus Lithiasis Drugs and Other Therapeutic Procedures Ancillary Studies and Immunocytology Digital Image Analysis and Morphometry Cytochemical Stains Acid Hematoxylin Stain CellDetect Immunocytochemical Stains Telomerase HER2 and Cytokeratins Vimentin ImmunoCyt/uCyt Immunocytology ProExC Other Immunostains Fluorescence In Situ Hybridization The Problem of Hematuria Routine Laboratory Investigation of Hematuria Dysmorphic Red Blood Cells Indicate Glomerular Disease Comprehensive Analysis of Urine for Evaluation of Hematuria References 8 Nonneoplastic Diseases of the Prostate Embryology and Fetal-Prepubertal History Anatomy Zonal Anatomy Prostatic Urethra, Verumontanum, and Bladder Neck Capsule and the Retroprostatic Fascia (Denonvilliers Fascia) Blood Supply Nerve Supply Prostate Sampling Techniques Needle Biopsy Fine Needle Aspiration Transurethral Resection Tissue Artifacts Nonprostatic Tissues in Biopsies Seminal Vesicle and Ejaculatory Duct Tissue in Biopsies Cowper Gland Tissue in Biopsies Rectal Tissue in Biopsies Benign Epithelium Secretory Luminal Cells Basal Cells Neuroendocrine Cells Stem Cells Luminal Products Pigment Immunohistochemistry Prostate-Specific Antigen Prostatic Acid Phosphatase Keratin 34βE12 p63 p40 Racemase c-Myc Panel of Keratin 34βE12, p63, Racemase, and c-Myc NKX3.1 GATA3 ERG Prostate-Specific Membrane Antigen Human Glandular Kallikrein 2 Androgen Receptors Other Immunohistochemical Markers Benign Stroma Inflammation Prostatic Immune Response Acute Bacterial Prostatitis Chronic Prostatitis Granulomatous Prostatitis Xanthoma and Xanthogranulomatous Prostatitis Idiopathic Granulomatous Prostatitis Infectious Granulomatous Prostatitis Malakoplakia Iatrogenic Granulomatous Prostatitis Post-TURP Granulomatous Prostatitis Postradiation Granulomatous Prostatitis BCG-Associated Granulomatous Prostatitis Teflon-Associated Granulomatous Prostatitis Systemic Granulomatous Prostatitis Allergic (Eosinophilic) Granulomatous Prostatitis Granulomatosis With Polyangiitis and Other Forms of Vasculitis Autoimmune Prostatitis With Immunoglobulin G4-Related Disease Other Rare Forms of Granulomatous Prostatitis AIDS-Associated Prostatitis Virus-Associated Prostatitis Inflammation After Needle Biopsy Inflammation and Nodular Hyperplasia Inflammation and Prostate Cancer Atrophy Nonneoplastic Metaplasia Squamous Metaplasia Mucinous Metaplasia Neuroendocrine Cells With Eosinophilic Granules (Paneth Cell-like Change) Urothelial Metaplasia Nephrogenic Metaplasia Hyperplasia and Nodular Hyperplasia Nodular Hyperplasia Postatrophic Hyperplasia Prostatic Stromal Hyperplasia With Atypia Basal Cell Hyperplasia and Basal Cell Proliferations Typical Basal Cell Hyperplasia Atypical Basal Cell Hyperplasia Basal Cell Adenoma Immunohistochemical Findings Differential Diagnosis Cribriform Hyperplasia Atypical Adenomatous Hyperplasia Sclerosing Adenosis Verumontanum Mucosal Gland Hyperplasia Hyperplasia of Mesonephric Remnants Pseudoangiomatous Stromal Hyperplasia Benign Nonneoplastic Conditions Amyloidosis Melanosis Endometriosis Treatment Changes Androgen Deprivation Therapy Histopathologic Findings After 5α-Reductase Inhibitors Immunohistochemical Findings After Androgen Deprivation Therapy Radiation Therapy Immunohistochemical Findings After Radiation Therapy Cryotherapy (Cryoablation) Hyperthermia Laser Therapy Irreversible Electroporation Electrical Membrane Breakdown References 9 Neoplasms of the Prostate Benign Epithelial Tumors and Tumor-like Proliferations Prostatic Cysts Ejaculatory Duct Adenofibroma Prostatic Intraepithelial Neoplasia Epidemiology of Prostatic Intraepithelial Neoplasia Diagnosis of Prostatic Intraepithelial Neoplasia Immunohistochemical Markers for Prostatic Intraepithelial Carcinoma Keratin 34βE12 and Other Keratins p63 Racemase c-Myc ERG Molecular Biology of Prostatic Intraepithelial Neoplasia Treatment Effects in Prostatic Intraepithelial Neoplasia Radiation Therapy Androgen Deprivation Therapy and Other Therapies Differential Diagnosis of Prostatic Intraepithelial Neoplasia Inflammation, Atrophy, and High-Grade Prostatic Intraepithelial Neoplasia Clinical Significance of Prostatic Intraepithelial Neoplasia Predictive Value of Prostatic Intraepithelial Neoplasia Clinical Response to Prostatic Intraepithelial Neoplasia Atypical Small Acinar Proliferation Diagnosis of Atypical Small Acinar Proliferation Subsets of Atypical Small Acinar Proliferation Clinical Significance of Atypical Small Acinar Proliferation Atypical Small Acinar Proliferation + Prostatic Intraepithelial Neoplasia Malignancy-Associated Changes Intraductal Carcinoma Separation of Intraductal Carcinoma and Prostatic Intraepithelial Neoplasia Clinical Significance of Intraductal Carcinoma Adenocarcinoma and Other Tumors Epidemiology Latent Carcinoma Prostate Cancer and Benign Prostatic Hyperplasia Tissue Methods of Detection Needle Core Biopsy Detecting Cancer: Factors That Influence Diagnostic Yield in Biopsies Number, Length, and Location of Needle Cores Obtained Magnetic Resonance Imaging-Transrectal Ultrasound-Guided Fusion-Targeted Biopsies Histotechnologists Skill in Processing Biopsies Number of Needle Cores Embedded per Cassette Number of Tissue Cuts Obtained per Specimen Future Trends in Biopsies Fine Needle Aspiration Transurethral Resection Prostatic Enucleation (Suprapubic Prostatectomy; Adenectomy) Radical Prostatectomy Pathologic Interpretation Gross Pathology Microscopic Pathology Cancer-Associated Pathologic Findings Luminal Mucin Luminal Proteinaceous Secretions Crystalloids Collagenous Micronodules Perineural Invasion Lymphatic and Vascular Invasion Microvessel Density (Angiogenesis) Significant Problems in Interpretation Atypical Small Acinar Proliferation Prostatic Intraepithelial Neoplasia Versus Large Acinar Variant of Gleason Grade 3 and Intraductal Carcinoma Clear Cell Pattern of Carcinoma Versus Benign AciniVanishing´´ Prostate Cancer in Radical Prostatectomies
Grading
Gleason Grading System
Recent Trends in Grading
International Society of Urological Pathology Modifications to the Gleason Grading System
International Society of Urological Pathology 2005 Modified Gleason Grading System
International Society of Urological Pathology 2014 Modified Gleason Scoring System (Grade Groupings)
Biopsy Versus Prostatectomy Grade
Dedifferentiation
Other Proposed Grading Changes
Tertiary Grade
Nuclear Grading and Morphometric Grading
Grade Compression (Dichotomization) and Weighted Average Score
Percent Gleason 4 and 5
Should Gleason 3 + 3 = 6 Be Called Cancer?
Gleason 7 Subdivision (3 + 4 Versus 4 + 3)
Grade Group 4 Heterogeneity
Gleason Pattern 5
Reactive Stromal Grading
Digital Pathology and Deep Learning
Grading After Therapy
Grading After Radiation Therapy
Grading After Androgen Deprivation Therapy
Clinical Significance of Grading
Grade and Outcome
Grade and Cancer Volume
Grade and Prostate-Specific Antigen
Grade and Pathologic Stage
Grade and Cancer Location
Variants and Other Carcinomas, Including Neuroendocrine Tumors
Atrophic Adenocarcinoma
Pseudohyperplastic Adenocarcinoma
Microcystic Adenocarcinoma
Foamy Gland Carcinoma (Microvacuolated)
Mucinous (Colloid) Carcinoma
Signet Ring Cell Carcinoma
Pleomorphic Giant Cell Adenocarcinoma
Sarcomatoid Carcinoma (Carcinosarcoma)
Ductal Adenocarcinoma
Cribriform, Papillary, and Solid Carcinomas
Comedocarcinoma
Adenocarcinoma With Neuroendocrine Differentiation
Adenocarcinoma With Neuroendocrine Cells With Large Eosinophilic Granules (Paneth Cell-like Change)
Low-Grade Neuroendocrine Carcinoma (Carcinoid)
High-Grade Neuroendocrine Carcinoma (Small Cell and Large Cell Carcinoma)
Adenocarcinoma With Glomeruloid Features
Carcinoma With Oncocytic Features
Lymphoepithelioma-like Carcinoma
Clear Cell Carcinoma
Basal Cell Carcinoma (Adenoid Cystic/Basal Cell Carcinoma)
Squamous Cell and Adenosquamous Cell Carcinoma
Urothelial Carcinoma
Immunohistochemistry of Prostate Cancer
Identifying Prostatic Origin in Metastases
TMPRSS2:ERG and the ETS Family Gene Fusions
Phosphatase and Tensin Homolog
Prostate Cancer Antigen 3
c-Myc
Telomerase
Apoptosis-Suppressing Oncoprotein Bcl-2
p53
p16
p21
p27Kip1
Androgen Receptors
Methylation
Mitochondrial DNA Testing
Integrins
Heat Shock Protein 90
Pro-PSA
Prostatic Membrane Antigen
Proliferating Cell Nuclear Antigen
Ki67/MIB1
BRCA1 and BRCA2
Engrailed Nuclear Protein-2
Sarcosine and Other Metabolites
Other Immunohistochemical Markers of Prognosis in Prostate Cancer
Molecular Biology of Prostate Cancer
Genetics of Familial Prostate Cancer
DNA Ploidy
MicroRNA
Chromosome 7
Chromosome 8
Chromosome 10
Chromosome 16
Other Chromosomes
DNA Mismatch Repair Genes
Treatment Changes in Prostate Cancer
Androgen Deprivation Therapy
Pathologic Findings After Androgen Deprivation
Pathologic Findings After 5α-Reductase Inhibitors
Differential Diagnosis
Stage and Surgical Margins After Androgen Deprivation Therapy
Immunohistochemical Findings After Androgen Deprivation Therapy
Radiation Therapy
Differential Diagnosis of Prostate Cancer After Radiotherapy
Immunohistochemical Findings After Radiotherapy
Cryotherapy
Ultrasound Hyperthermia, Microwave Hyperthermia, Laser Therapy, and Hot Water Balloon Therapy
High-Intensity Focused Ultrasound
Irreversible Electroporation
Predictive Factors in Prostate Cancer
Prostate-Specific Antigen
Stage
National Comprehensive Cancer Network/American Urological Association Risk Classification
Pathology of Prostate-Specific Antigen-Detected Adenocarcinoma (Clinical Stage T1c)
Extraprostatic Extension
Seminal Vesicle Invasion (Stage pT3b Prostate Cancer)
Microscopic Bladder Neck Invasion (Stage pT3a Prostate Cancer)
Surgical Margins
Perineural Invasion
Biopsy Cancer Volume
Location of Cancer
Lymph Node Metastases
Distant Metastases
Morphometric Markers
Benign Mesenchymal Tumors and Tumor-like Conditions
Stromal Hyperplasia (Stromal Subtype of Nodular Hyperplasia)
Leiomyoma
Pseudosarcomatous Myofibroblastic Proliferation
Postoperative Spindle Cell Nodule (Postsurgical Inflammatory Myofibroblastic Tumor)
Solitary Fibrous Tumor
Blue Nevus
Other Rare Benign Soft Tissue Tumors
Sarcoma of the Prostate
Rhabdomyosarcoma
Leiomyosarcoma
Phyllodes Tumor
Stromal Sarcoma
Other Sarcomas
Other Malignancies of the Prostate
Hematologic Malignancies
Leukemia
Malignant Lymphoma
Multiple Myeloma
Germ Cell Tumors
Other Rare Malignancies
Metastases to the Prostate
References
10
Seminal Vesicles
Introduction
Embryology and Anatomy
Age-Associated Changes
Congenital and Acquired Malformations
Cysts
Ectopic Prostatic Tissue
Nonneoplastic Abnormalities
Amyloidosis
Stromal Hyaline Bodies
Fibrosis
Inflammation
Calcification and Calculi
Radiation Changes
Neoplasms
Adenocarcinoma
Metastasis and Contiguous Spread
Soft Tissue Tumors and Other Tumors
References
11
Urethra
Embryologic Development and Normal Anatomy
Congenital Anomalies
Urethral Valves
Urethral Diverticula
Duplication of the Urethra
Congenital Urethral Polyp
Nonneoplastic Diseases
Urethritis
Caruncle
Polypoid Urethritis
Nephrogenic Adenoma (Metaplasia)
Malakoplakia
Amyloidosis
Condyloma Acuminatum
Metaplasia of the Urothelium
Ectopic Prostatic Tissue and Prostatic Urethral Polyp
Neoplastic Diseases
Benign Neoplasms
Papilloma
Inverted Papilloma
Malignant Neoplasms
Urothelial Carcinoma in Association With Carcinoma of the Urinary Bladder
Primary Urethral Carcinoma
Urethral Carcinoma in Women
Adenocarcinoma
Adenocarcinoma of Accessory Glands
Clear Cell Carcinoma
Other Histologic Types of Carcinoma
Malignant Melanoma
Soft Tissue Tumors
References
12
Nonneoplastic Diseases of the Testis
Embryology and Anatomy of the Testis
Embryology
Development of the Testis
Genetic Mechanisms Involved in Sex Determination and Testicular Differentiation
Development of the Bipotential Gonad
Formation of the Gonadal Ridge
Primordial Germ Cells: Origin, Migration, and Formation of the Gonadal Blastema
Male-Female Determination
Testis Differentiation: Development of Seminiferous Cords and Interstitium
Early Organization of the Gonadal Blastema
Differentiation of Primordial Germ Cells
Sertoli Cell Differentiation
Peritubular Myoid Cell Differentiation
Leydig Cell Development
Rete Testis Formation
Development of the Urogenital Tract
Hormonal Control of Male Genital Tract Differentiation
Fetal Testis Structure
Supporting Structures
Seminiferous Cords
Germ Cells
Sertoli Cells
Peritubular Myoid Cells
Leydig Cells
Other Testicular Cell Types
Vascularization of the Fetal Testis
Fetal Epididymis
Testicular Descent
Anatomic Structures Involved in Testicular Descent
Prerequisites for Testicular Descent
Normal Hormonal Stimulation
Adequate Intraabdominal Pressure
Adequate Development of the Processus Vaginalis
Factors That Regulate Testicular Descent
Prepubertal Testis
Development of the Testis From Birth to Puberty
The Testis at Birth
Neonatal Development of the Testis
Testis in Infancy
The Testis in Childhood
Relationship of Testis and Epididymis During Infancy, Childhood, and Puberty
Interpretation of Testicular Biopsy From Prepubertal Testes
Tunica Albuginea
Seminiferous Tubules
Mean Tubular Diameter
Germ Cell Number
Sertoli Cell Number
Leydig Cell Number
Intertubular Connective Tissue
Adult Testis
Anatomy
Supporting Structures
Seminiferous Tubules
Sertoli Cells
Germ Cells
Spermatogonia
Spermatocytes
Spermiogenesis
Cycle of the Seminiferous Epithelium
Tunica Propria
Testicular Interstitium
Connective Tissue Cells
Leydig Cells
Macrophages, Neuron-like Cells, and Mast Cells
Blood and Lymphatic Vessels
Nerves
Rete Testis
Congenital Anomalies of the Testis
Alterations in Number, Size, and Location
Anorchidism
Monorchidism
Testicular Regression Syndrome
True Agonadism (46,XY Gonadal Agenesis Syndrome)
Rudimentary Testes Syndrome
Congenital Bilateral Anorchidism
Vanishing Testes Syndrome
Leydig Cell-Only Syndrome
Microorchidism
Polyorchidism
Testicular Hypertrophy (Macroorchidism)
Congenital Leydig Cell Hyperplasia
Compensatory Hypertrophy of the Testis
Idiopathic Benign Macroorchidism
Bilateral Megalotestes With Low Gonadotropins
Fragile X Chromosome; Martin-Bell Syndrome
Other Causes of Testicular Hypertrophy
Testicular Hypertrophy Secondary to Follicle-Stimulating Hormone-Secreting Pituitary Adenoma
Precocious Puberty
Central Precocious Puberty
Peripheral Precocious Puberty
Familial Testotoxicosis: Gonadotropin-Independent Precocious Puberty or Familial Male-Limited Precocious Puberty
Precocious Pseudopuberty Secondary to Functioning Tumors
Precocious Pseudopuberty Secondary to Disorders in Aromatase Activity
Aromatase Excess Syndrome
Aromatase Deficiency Syndrome
Precocious Pseudopuberty Secondary to Leydig Cell Hyperplasia With Focal Spermatogenesis
Mixed Precocious Puberty
Testicular Ectopia
Testicular Exstrophy (Scrotoschisis)
Testicular Fusion
Bilobed Testis
Hamartomatous Testicular Lesions
Cystic Dysplasia of the Testis
Cystic Dysplasia of the Rete Testis
Cystic Dysplasia of the Epididymis
Hamartoma of the Rete Testis
Fetal Gonadoblastoid Testicular Dysplasia
Sertoli Cell Nodule (Hypoplastic Zones or Dysgenetic Tubules)
Tubular Hamartoma (Androgen Insensitivity Syndrome)
Lymphangiectasis
Congenital Testicular Lymphangiectasis
Epididymal Lymphangiectasis
Other Hamartomatous Testicular Lesions
Ectopias
Persistence of Gonadal Blastema
Seminiferous Tubule Ectopia
Leydig Cell Ectopia
Adrenal Cortical Ectopia
Other Ectopias
Undescended Testes
True Cryptorchidism
Etiology
Congenital Cryptorchidism
Acquired Cryptorchidism
Pathogenesis
Histology
Prepubertal Testes: Morphologic Classification
Pubertal and Adult Testes
Validation of the Morphologic Classification of the Prepubertal Undescended Testes Lesions
Effectiveness of Treatment in Undescended Testes
Congenital Anomalies Associated With Undescended Testes
Complications of Cryptorchidism
Testicular Cancer
Infertility
Testicular Torsion
Iatrogenic Atrophy
Psychological Problems
Benefit of Testicular Biopsy in Patients With Cryptorchidism
Obstructed Testes
Retractile Testes
Testicular Microlithiasis
Incidence
Pathology and Histogenesis
Microlithiasis and Testicular Cancer
Rete Testis, Epididymis, and Vaginal Microlithiasis and Calcifications
Disorders of Sex Development
Gonadal Dysgenesis
Types of Gonads in Patients With Gonadal Dysgenesis and Correlation With Clinical Syndromes
Classic Streak Gonad
Hypoplastic Ovary (Dysgenetic Ovary)
Streak Gonad With Epithelial Cord-like Structures
Dysgenetic Testis
Streak Testis
True Agonadism
45,X0 Gonadal Dysgenesis
Patients With Chromosomal Mosaicisms
46,XX Gonadal Dysgenesis
46,XY Gonadal Dysgenesis
Mixed Gonadal Dysgenesis
Dysgenetic Male Pseudohermaphroditism
Persistent Müllerian Duct Syndrome
Other Forms of Gonadal Dysgenesis
Ovotesticular Disorder (True Hermaphroditism)
Undermasculinization (Male Pseudohermaphroditism)
Impaired Leydig Cell Activity
Androgen Synthesis Deficiencies
Congenital Lipoid Adrenal Hyperplasia
3β-Hydroxysteroid Dehydrogenase Deficiency
17α-Hydroxylase/17,20-Lyase Deficiency
17,20-Desmolase Deficiency
17β-Hydroxysteroid Dehydrogenase Deficiency
Leydig Cell Hypoplasia
Impaired Androgen Metabolism in Peripheral Tissues
Androgen Insensitivity Syndromes
Complete Androgen Insensitivity Syndrome (Complete Testicular Feminization Syndrome)
Partial Androgen Insensitivity Syndrome (Partial Testicular Feminization Syndrome)
Mild Androgen Insensitivity Syndrome
Kennedy Disease
5α-Reductase Deficiency
Other Forms of Male Undermasculinization
Smith-Lemli-Opitz Syndrome
Opitz Syndrome
ATRX Syndrome
Infertility
Testicular Biopsy
Indications
Qualitative and Quantitative Evaluation
Common Lesions
Sertoli Cell-Only Syndrome
Sertoli Cell-Only Syndrome With Immature Sertoli Cells
Sertoli Cell-Only Syndrome With Dysgenetic Sertoli Cells
Sertoli Cell-Only Syndrome With Mature Sertoli Cells
Sertoli Cell-Only Syndrome With Involuting Sertoli Cells
Sertoli Cell-Only Syndrome With Dedifferentiated Sertoli Cells
Tubular Hyalinization
Dysgenetic Hyalinization
Hyalinization Caused by Hormonal Deficit
Ischemic Hyalinization
Postobstructive Hyalinization
Postinflammatory Hyalinization
Hyalinization Caused by Physical or Chemical Agents
Diffuse Lesions in Spermatogenesis
Lesions in the Adluminal Compartment of Seminiferous Tubules
Young Spermatid Sloughing
Late Primary Spermatocyte Sloughing
Early Primary Spermatocyte Sloughing
Etiology Overview
Rete Testis Obstruction
Seminiferous Tubule Obstruction
Lesions in the Basal and Adluminal Compartments of Seminiferous Tubules
Hypospermatogenesis: Types and Etiology
Etiology of Hypospermatogenesis: Overview
Hormonal Dysregulation
Congenital Germ Cell Deficiency
Sertoli Cell Dysfunction
Leydig Cell Dysfunction
Androgen Insensitivity
Physical and Chemical Agents
Etiology of Hypospermatogenesis Associated With Primary Spermatocyte Sloughing
Spermatogonial Maturation Arrest
Focal Lesions in Spermatogenesis (Mixed Atrophy)
Germ Cell Anomalies in Infertile Patients
Giant Spermatogonia
Multinucleate Spermatogonia
Dislocated Spermatogonia
Megalospermatocytes
Multinucleate Spermatids
Malformed Spermatids
Morphologically Abnormal Spermatozoa
Anomalies of the Spermatozoal Head
Anomalies of the Spermatozoal Tail
Cytoplasmic Remnants
Bent Tail
Coiled Tail
Tail Stump (Short-Tail Spermatozoa)
Multiple Tails
Sperm Tail Agenesis
Sperm With Abnormal Elongation of the Tail
Anomalies of the Connecting Piece
Anomalies of the Axoneme
Anomalies of Periaxonemal Structures
Presence of Tumoral Cells
Anomalies of Leydig Cells
Mast Cells
Macrophages
Correlation Between Testicular Biopsy and Spermiogram
Obstructive Azoospermia and Oligozoospermia
Classification of Obstructive Azoospermia by Location
Proximal Obstruction
Distal Obstruction
Mixed Obstruction
Etiology of Obstructive Azoospermia
Congenital Azoospermia
Agenesis of All Mesonephric Duct Derivatives
Epididymal Anomalies
Vas Deferens Anomalies
Anomalies of Seminal Vesicle and Ejaculatory Duct
Acquired Azoospermia
Testicular and Epididymal Lesions Resulting From Obstruction of Sperm Excretory Ducts
Location of Obstruction
Etiology of Obstruction
Duration of Obstruction
Functional Azoospermia and Oligozoospermia
Young Syndrome
Alterations in Spermatozoon Transport
Summary of Diagnostic Groups Suggested by Testicular Biopsy
Infertility and Chromosomal Anomalies
Abnormalities in Sex Chromosomes
Klinefelter Syndrome
Genetic and Clinical Aspects
Klinefelter Syndrome 46,XY/47,XXY
Klinefelter Syndrome 48,XXYY
Klinefelter Syndrome 48,XXXY and 49,XXXYY
Association With Malignancy
Occurrence in Childhood
Association With Precocious Puberty
Association With Hypogonadotropic Hypogonadism
46,XX Males (XX Sex Reversal, Testicular Disorder of Sex Development)
46,XX Males With Male Phenotype and Normal External Genitalia
46,XX Males With Ambiguous External Genitalia
Etiology
47,XYY Syndrome
Structural Anomalies of the Y Chromosome
Deletions and Microscopically Visible Rearrangements in Infertile Patients
Monocentric Deleted Yq Chromosome
Dicentric Yq Isochromosomes
Ring Y Chromosome
Y/Y Translocation Chromosome
Translocation of Y Chromosome to X Chromosome
Autosomal translocation of Y Chromosome
Microdeletions of Y Chromosome
Structural Anomalies of the X Chromosome
Anomalies in Autosomes
Chromosomal Translocations and Inversions
Down Syndrome
Other Syndromes Associated With Hypergonadotropic Hypogonadism
Secondary Idiopathic Hypogonadism
Gonadotropin-Releasing Hormone Deficit
Constitutional Delay of Growth and Puberty
Isolated Gonadotropin Deficit
Idiopathic Normosmic Hypogonadotropic Hypogonadism
Hypogonadism Associated With Anosmia
Kallmann Syndrome
CHARGE Syndrome
Isolated Luteinizing Hormone Deficiency
Isolated Follicle-Stimulating Hormone Deficiency
Bioinactive Follicle-Stimulating Hormone and Luteinizing Hormone
Mutations in Gonadotropin Receptor Genes
Growth Hormone Deficit
Prader-Willi Syndrome or Hypotonia-Hypomentia-Hypogonadism-Obesity Syndrome
Bardet-Biedl Syndrome
Hypogonadotropic Hypogonadism Associated With Dermatologic Diseases
Hypogonadotropic Hypogonadism Associated With Ataxia
Ataxia-Telangiectasia
Friedreich Ataxia
Boucher-Neuhäuser Syndrome
Gordon-Holmes Syndrome
Carpenter Syndrome
Biemond Syndrome
Fraser Syndrome (Meyer-Schwickerath Syndrome or Ullrich-Feichtiger Syndrome)
Hypogonadism Secondary to Endocrine Gland Dysfunction and Other Disorders
Hypothalamus-Hypophysis
Hypopituitarism
Hyperprolactinemia
Thyroid Gland
Adrenals
Congenital Adrenal Hypoplasia With Hypogonadotropic Hypogonadism
Congenital Adrenal Hyperplasia
Deficit in 17β-Hydroxylase
Deficit in 20α-Hydroxylase
Deficit in 3β-Hydroxysteroid Dehydrogenase
Steroid 17α-Hydroxylase Deficiency
Cushing Syndrome
Adrenal Cortical Tumors
Primary Pigmented Adrenocortical Disease
Adrenocorticotropic Hormone-Independent Macronodular Adrenal Hyperplasia
Pancreas
Diabetes Mellitus
Mucoviscidosis
Liver
Hypogonadism, Liver Disease, and Excessive Alcohol Consumption
Nonalcoholic Liver Diseases and Infertility
Kidney
Autosomal Dominant Polycystic Renal Disease
Chronic Renal Insufficiency
Chronic Inflammatory Bowel Disease
Celiac Disease
Inflammatory Bowel Disease
AIDS
Chronic Anemia
β-Thalassemia
α-Thalassemia
Sickle Cell Anemia
Fanconi Anemia Syndrome
Obesity
Starvation
Autoimmune Polyglandular Syndrome
Features of Hypogonadism in Patients With Polyglandular Autoimmune Syndrome
Inherited Metabolic Diseases
Hemochromatosis and Infertility
Galactosemia
Kearns-Sayre Syndrome
Adrenoleukodystrophy (Adrenal Testicular Myeloneuropathy)
Primary Hyperoxaluria
D-Bifunctional Protein Deficiency
Fabry Disease
Wolman Disease
Niemann-Pick Disease
Cystinosis
CDG1 (Abnormal Glycosylated Proteins)
Alström Syndrome
Selenoprotein Deficiency Disorder
Infertility Secondary to Physical and Chemical Agents
Occupational Exposure
Carbon Disulfide
Dibromochloropropane
Lead
Oral Contraceptive Manufacture
Endocrine-Disrupting Compounds
Recreational Drugs and Doping
Radiation
Heat
Testicular Trauma
Traumatic Hematocele
Testicular Dislocation or Luxation
Testicular Trauma and Infertility
Cancer Therapy
Radiation Therapy
Chemotherapy
Potential for Fertility After Cancer Treatment in Childhood
Estrogen and Antiandrogen Therapy
Surgery
Infertility in Patients With Spinal Cord Injury
Inflammation and Infection
Orchitis
Viral Orchitis
Bacterial Orchitis
Granulomatous Orchiepididymitis
Tuberculosis
Syphilis
Leprosy
Brucellosis
Sarcoidosis
Malakoplakia
Orchiepididymitis Caused by Fungi and Parasites
Idiopathic Granulomatous Orchitis
Peritumoral Granulomatous Orchitis
Focal Orchitis (Primary Autoimmune Orchitis)
Testicular Pseudolymphoma
Histiocytosis With Testicular Involvement
Other Testicular and Epididymal Lesions
Epididymitis Nodosa
Epididymitis Induced by Amiodarone
Ischemic Granulomatous Epididymitis
Vasculitis
Polyarteritis Nodosa
Wegener Disease
Thromboangiitis Obliterans
Giant Cell Arteritis
Henoch-Schönlein Purpura
Cogan Disease
Behçet Disease
Amyloidosis
Testicular Infarct
Spermatic Cord Torsion
Other Causes of Testicular Infarct
Other Testicular Diseases
Cystic Malformation
Cyst of the Tunica Albuginea
Cyst of the Rete Testis
Simple Cyst of the Testis
Disorders of the Rete Testis
Dysgenesis
Acquired Disorders of the Rete Testis
Metaplasia
Reactive Hyperplasia of the Rete Testis
Cystic Ectasia of the Rete Testis (Acquired Cystic Transformation)
Simple Cystic Transformation
Cystic Transformation With Epithelial Metaplasia
Cystic Transformation With Crystalline Deposits
Adenomatous Hyperplasia
Hyperplasia With Hyaline Globule Formation
Intracavitary Polypoid Nodular Proliferation
References
13
Neoplasms of the Testis
Staging
Patterns of Metastasis
Gross Examination
Germ Cell Tumors
Classification
Histogenesis
Epidemiology
Cryptorchidism
Prior Testicular Germ Cell Tumor
Family History
Disorders of Sex Development
Infertility
Other Associations
Germ Cell Neoplasia in Situ and Related Germ Cell Tumors
Germ Cell Neoplasia in Situ
Special Studies
Differential Diagnosis
Prognosis
Biopsy Diagnosis
Treatment
Seminoma
Clinical Features
Pathologic Findings
Seminoma With Syncytiotrophoblast Cells
Special Studies
Differential Diagnosis
Treatment and Prognosis
Embryonal Carcinoma
Clinical Features
Pathologic Features
Special Studies
Differential Diagnosis
Treatment and Prognosis
Yolk Sac Tumor, Postpubertal-Type
Clinical Features
Pathologic Features
Special Studies
Differential Diagnosis
Treatment and Prognosis
Choriocarcinoma and Other Trophoblastic Neoplasms
Clinical Features
Pathologic Features
Special Studies
Differential Diagnosis
Treatment and Prognosis
Nonchoriocarcinomatous Trophoblastic Tumors
Teratoma, Postpubertal-Type
Clinical Features
Pathologic Features
Special Studies
Differential Diagnosis
Treatment and Prognosis
Teratoma With Somatic-Type Malignancy
Primitive Neuroectodermal Tumor
Mixed Germ Cell Tumor
Clinical Features
Pathologic Features
Polyembryoma and Diffuse Embryoma
Treatment and Prognosis
Germ Cell Tumors of Unknown Type
Regressed Germ Cell Tumors
Postchemotherapy Specimens
Germ Cell Tumors Not Derived From Germ Cell Neoplasia in Situ
Spermatocytic Tumor
Clinical Features
Pathologic Features
Special Studies
Treatment and Prognosis
Differential Diagnosis
Spermatocytic Tumor With Sarcoma
Teratoma, Prepubertal-Type
Dermoid Cyst
Epidermoid Cyst
Well-Differentiated Neuroendocrine Tumor (Monodermal Teratoma)
Mixed Teratoma and Yolk Sac Tumor, Prepubertal-Type
Yolk Sac Tumor, Prepubertal-Type
Sex Cord-Stromal Tumors
Leydig Cell Tumor
Clinical Features
Pathologic Features
Treatment and Prognosis
Differential Diagnosis
Sertoli Cell Tumor, Not Otherwise Specified
Clinical Features
Pathologic Features
Differential Diagnosis
Treatment and Prognosis
Large Cell Calcifying Sertoli Cell Tumor
Intratubular Large Cell Hyalinizing Sertoli Cell Neoplasia
Granulosa Cell Tumor
Adult Granulosa Cell Tumor
Juvenile Granulosa Cell Tumor
Tumors in the Fibroma-Thecoma Group
Myoid Gonadal Stromal Tumor
Mixed and Unclassified Sex Cord-Stromal Tumors
Tumors Containing Both Germ Cell and Sex Cord-Stromal Elements
Gonadoblastoma
Clinical Features
Pathologic Features
Special Studies
Treatment and Prognosis
Differential Diagnosis
Miscellaneous Tumors of the Testis and Paratesticular Tissue
Ovarian-Type Epithelial Tumors
Miscellaneous Lesions
Juvenile Xanthogranuloma
Hemangioma
Other Soft Tissue Tumors
Hematolymphoid Tumors
Lymphoma
Clinical Features
Pathologic Features
Prognosis
Differential Diagnosis
Plasmacytoma
Leukemia, Including Myeloid Sarcoma
Rosai-Dorfman Disease
Tumors of Collecting Duct and Rete Testis
Adenoma
Cystic Dysplasia
Adenocarcinoma
Metastatic Tumors
Diagnostic Approach to Testicular Tumors
References
14
Spermatic Cord and Testicular Adnexa
Introduction
Embryology and Normal Anatomy
Embryology
Anatomy
Scrotum and Testicular Tunics
Rete Testis
Epididymis
Vas Deferens (Ductus Deferens) and Spermatic Cord
Congenital Anomalies
Splenogonadal Fusion
Adrenal Heterotopia and Renal Ectopia
Wolffian and Müllerian Remnants
Appendix Testis (Hydatid of Morgagni)
Appendix Epididymis (Vestigial Caudal Mesonephric Collecting Tubule)
Paradidymis (Organ of Giraldes)
Vasa Aberrantia (Organ of Haller)
Other Lesions Associated With the Epididymis
Walthard Rest
Hernia Sac Specimens: Glandular Inclusions Versus Vas Deferens or Epididymis
Cystic Fibrosis
Nonneoplastic Diseases of the Spermatic Cord and Testicular Adnexa
``Celes´´ and Cysts
Hydrocele
Hematocele (Hematoma)
Varicocele
Spermatocele (Acquired Epididymal Cyst)
Mesothelial Cyst
Epidermoid Cyst (Epidermal Cyst)
Dermoid Cyst (Mature Teratoma)
Simple Cyst and Cystic Dysplasia of the Rete Testis
Inflammatory and Reactive Diseases
Epididymitis
Acute Epididymitis
Chronic Epididymitis
Sperm Granuloma
Vasitis and Vasitis Nodosa
Funiculitis (Inflammation of the Spermatic Cord)
Meconium-Induced Inflammation
Vasculitis
Other Nonneoplastic Diseases
Torsion of the Spermatic Cord and Embryonic Remnants
Calculi and Calcification
Neoplasms
Benign Neoplasms and Pseudotumors
Lipoma
Adenomatous Hyperplasia
Adenomatoid Tumor (Benign Nonpapillary Mesothelioma)
Hamartoma (Smooth Muscle Hyperplasia)
Reactive Mesothelial Hyperplasia
Benign Papillary Mesothelioma
Papillary Cystadenoma of the Epididymis
Fibrous Pseudotumor (Nodular and Diffuse Fibrous Proliferation)
Leiomyoma
Melanotic Neuroectodermal Tumor of Infancy (Progonoma; Retinal Anlage Tumor)
Brenner Tumor
Gonadal Stromal Tumor
Other Benign Tumors
Malignant Neoplasms
Liposarcoma
Rhabdomyosarcoma
Leiomyosarcoma
Malignant Mesothelioma
Papillary Serous Tumor of Müllerian Epithelium (Benign and Malignant)
Adenocarcinoma of the Epididymis
Malignant Fibrous Histiocytoma
Other Sarcomas and Malignancies
Germ Cell Tumor
Malignant Lymphoma and Hematopoietic Neoplasms
Metastases
References
15
Penis and Scrotum
Penis
Normal Anatomy and Histology
Congenital Anomalies
Nonneoplastic Diseases
Inflammation
Phimosis and Paraphimosis
Fibroepithelial (Lymphedematous) Polyp
Plasma Cell Balanitis (Zoon Balanitis)
Balanitis Xerotica Obliterans (Penile Lichen Sclerosus)
Reiter Syndrome
Peyronie Disease
Cutaneous Horn and Leukoplakia
Penile Prosthesis
Priapism
Infections
Gonorrhea
Syphilis
Herpes Simplex and Zoster
Lymphogranuloma Venereum
Granuloma Inguinale (Donovanosis)
Chancroid (Soft Chancre)
Candidiasis and Other Fungal Infections
Scabies
Pediculosis Pubis
Molluscum Contagiosum
Erythrasma
Penile Lesions in AIDS
Tumor-like Conditions
Condyloma Acuminatum
Pearly Penile Papules
Penile Cysts
Pseudoepitheliomatous Keratotic and Micaceous Balanitis
Verruciform Xanthoma
Neoplastic Diseases
Benign Neoplasms
Premalignant Lesions of the Penis
Malignant Neoplasms
Squamous Cell Carcinoma
Variants of Squamous Cell Carcinoma (Human Papillomavirus Related)
Basaloid Carcinoma, Including Papillary Variant
Warty (Condylomatous) Carcinoma
Warty-Basaloid Carcinoma
Clear Cell Carcinoma
Medullary Carcinoma of the Penis
Variants of Squamous Cell Carcinoma: Non-Human Papillomavirus Related
Verrucous Carcinoma
Papillary Carcinoma, Not Otherwise Specified
Carcinoma Cuniculatum
Pseudohyperplastic Nonverruciform Squamous Cell Carcinoma
Spindle Cell (Sarcomatoid) Squamous Cell Carcinoma
Mixed Carcinoma
Adenosquamous Carcinoma
Acantholytic Squamous Cell Carcinoma
Molecular Pathology of Penile Squamous Carcinoma
Other Malignant Tumors (Nonsquamous Neoplasms)
Basal Cell Carcinoma
Malignant Melanoma
Sarcoma and Other Tumors
Lymphoma
Germ Cell Tumors
Metastases to the Penis
Scrotum
Normal Anatomy and Histology
Nonneoplastic Diseases
Fournier Gangrene
Hidradenitis Suppurativa
Idiopathic Scrotal Calcinosis
Lipogranuloma
Epidermal Cyst
Fat Necrosis
Neoplastic Diseases
Squamous Cell Carcinoma
Basal Cell Carcinoma
Paget Disease
Sarcoma
References
16
Adrenal Glands
Embryology and Normal Gross Anatomy
Adrenal Cortex
Adrenal Medulla
Microscopic Anatomy
Examination of the Adrenal Glands
Congenital and Other Abnormalities
Congenital Adrenal Aplasia and Hypoplasia
Adrenal Heterotopia
Union and Adhesion
Adrenal Cytomegaly
Adrenoleukodystrophy
Congenital Adrenal Hyperplasia
Pathology of Adrenal Glands in Congenital Adrenal Hyperplasia
Testicular Adrenal Rest Tumors in Congenital Adrenal Hyperplasia
Other Tumors Associated With Congenital Adrenal Hyperplasia
Stress-Related Changes of the Adrenal Gland
Other Abnormalities
Nonneoplastic Diseases
Chronic Adrenal Cortical Insufficiency (Addison Disease)
Idiopathic or Autoimmune Addison Disease
Adrenal Tuberculosis
Histoplasmosis and Other Fungal Infections
Amyloidosis
Acute Adrenal Cortical Insufficiency
Inflammation and Other Infections
Nonspecific Adrenalitis
Herpetic Adrenalitis
Rare Infections
Adrenal Cortical Hyperplasia
Nodular Adrenal Gland
Incidental Cortical Nodule/Adenoma at Autopsy
Incidental Adrenal Mass Discovered in Vivo
Incidental Pigmented Cortical Nodule
Management of the Incidental Adrenal Mass Discovered in Vivo
Adrenal Cortical Hyperplasia With Hypercortisolism
Pituitary or Adenocorticotropic Hormone-Dependent Hypercortisolism (Cushing Disease)
Diffuse and Micronodular Adrenal Cortical Hyperplasia
Macronodular Hyperplasia
Ectopic Adrenocorticotropin Hormone Syndrome With Secondary Hypercortisolism
Primary Pigmented Nodular Adrenal Cortical Disease
Complex of Myxomas, Spotty Pigmentation, and Endocrine Overactivity: Carney Complex
Macronodular Hyperplasia With Marked Adrenal Enlargement
Multiple Endocrine Neoplasia Type 1
Other Rare Causes of Cushing Syndrome
Adrenal Cortical Hyperplasia With Hyperaldosteronism
Adrenal Cortical Hyperplasia With Excess Sex Steroid Secretion
Adrenal Medullary Hyperplasia
Adrenal Cyst
Adrenal Hemorrhage
Adrenal Neoplasms
Adrenal Cortical Neoplasms
Adrenal Cortical Adenoma With Cushing Syndrome
Adrenal Cortical Adenoma With Primary Hyperaldosteronism (Conn Syndrome)
Functional Pigmented (Black) Adrenal Cortical Adenoma
Adrenal Cortical Neoplasms With Virilization or Feminization
Oncocytic Adrenal Cortical Neoplasms (Adrenal Oncocytoma)
Adrenal Cortical Carcinoma
Other Adrenal Cortical Neoplasms
Pheochromocytoma
Hereditary Pheochromocytoma-Paraganglioma
Pathology of Pheochromocytoma
Pheochromocytoma in Multiple Endocrine Neoplasia Type 2
Composite Pheochromocytoma
Pseudopheochromocytoma
Immunohistochemistry and Other Features
Malignant Pheochromocytoma
Peripheral Neuroblastic Tumors: Neuroblastoma, Ganglioneuroblastoma, and Ganglioneuroma
In Situ Neuroblastoma
Peripheral Neuroblastic Tumors
Original Age-Linked Classification of Neuroblastoma
International Neuroblastoma Pathology Classification
Ancillary Techniques
Molecular Genetics in Neuroblastomas
Staging of Neuroblastoma and Ganglioneuroblastoma
Stage IV-S Neuroblastoma and Patterns of Spread by Peripheral Neuroblastic Tumors
Ganglioneuroma
Other Adrenal Tumors
Myelolipoma
Adenomatoid Tumor
Malignant Lymphoma
Mesenchymal Tumors
Malignant Melanoma
Other Unusual Tumors and Tumor-like Lesions
Tumors Metastatic to the Adrenal Glands
References
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Inside Back Cover