Invasive breast carcinoma - IARC

More documents

Recommendations

Info

Table 7.04 Clark levels of cutaneous melanoma {3120}. Level I Level II Level III Level IV Level V Melanoma in situ Superficial papillary dermis Fills and expands papillary dermis Reticular dermis Deeper than reticular dermis into fat or other deeper tissue s p reading melanoma 4%, with the remainder of the cases being unclassifiable {2320,3120}. Immunoprofile Melanomas usually are immunoreactive for S-100 protein, HMB-45 and Melan A {3119}. Unlike some tumours of epithelial origin, including Paget disease, they are not immunoreactive for AE1/3, cytokeratins 7 and 20, epithelial membrane antigen, carcinoembryonic antigen or gross cystic disease fluid protein-15 {3120}. Somatic genetics The only two malignant melanomas of the vulva so far karyotyped showed trisomy 20 and del(18)(p11), respectively {2897}. Prognosis and predictive factors Clinical criteria Treatment for a vulvar melanoma with a thickness of 0.75 mm or less is usually a wide local excision with a 1-cm circumferential margin and a 1-2 cm deep margin. Melanomas with a thickness of 1-4 mm require a 2 cm circumferential margin and a deep margin of at least 1-2 cm {2949}. Melanomas with a thickness greater than 4 mm are usually treated by radical vulvectomy {2950}. Depending on the tumour size, bilateral inguinofemoral lymphadenectomy may also be performed {1912,2261,2864, 3151}. in thickness, it has little or no metastatic potential {1694,3120}. Survival following a diagnosis of vulvar melanoma is adversely influenced by n u m e rous factors including a tumour thickness exceeding 2 mm, a tumour interpreted as Clark level lV or greater, a mitotic count within the tumour exceeding 10 mitoses per square mm, surface ulceration of the tumour and advanced tumour stage {3120}. Congenital melanocytic naevus The congenital melanocytic naevus is a benign tumour of melanocytes that is present at birth. Tumours may be small or involve a large area. Acquired melanocytic naevus The acquired melanocytic naevus appears in childhood and continues to grow with increasing age. This lesion may be junctional, i.e. at the epidermald e rmal junction, intradermal or compound (junctional and intradermal). Blue naevus The blue naevus is located entirely within the dermis and is composed of spindleshaped or dendritic melanocytes that are typically heavily pigmented. A subtype known as the cellular blue naevus has a low potential for metastasis. Atypical melanocytic naevus of the genital type Definition One type of atypical melanocytic proliferation in the genital area that forms a distinctive clinicopathological entity that can be distinguished from melanoma and dysplastic naevus. Synonym Atypical vulvar naevus. Clinical features The atypical melanocytic naevus of the genital type occurs primarily in young women of reproductive age. Unlike the dysplastic naevus, it is not associated with dysplastic naevi in other sites. Vulvar naevi can be influenced by hormonal changes and may appear more active or atypical during pregnancy. Histopathology The atypical melanocytic naevus of the genital type has junctional melanocytic nests that are variably sized and include some atypical superf i c i a l melanocytes, These lesions lack significant atypia or mitotic activity in the deeper dermal melanocytes and do not involve skin appendages. In addition the lesion is small, well circ u m s c r i b e d and lacks pagetoid spread or necro s i s { 3 1 , 4 9 8 } . Histopathological criteria Clark levels and Breslow thickness measurements are used to assess cutaneous vulvar melanomas. B reslow thickness measurements for cutaneous malignant melanoma require measurement from the deep border of the granular layer of the overlying epithelium to the deepest point of tumour invasion. If a melanoma is less than 0.76 mm Fig. 7.21 Atypical melanocytic naevus of the genital type. The tumour is a compound naevus with variably sized melanocytic nests and atypia confined to the superficial melanocytes.. 332 Tumours of the vulva
Dysplastic melanocytic naevus Definition A naevus that exhibits slight to moderate nuclear atypia that occurs only in the cells in the superficial portion. Clinical features These naevi occur predominantly in young women of reproductive age and present as elevated pigmented lesions with irregular borders typically exceeding 0.5 cm in diameter. Dysplastic naevi are rare on the vulva and may be associated with similar naevi elsewhere on the trunk and extremities. Histopathology They are composed of large epithelioid or spindle-shaped naevus cells with nuclear pleomorphism and pro m i n e n t nucleoli. The atypical naevus cells are clustered in irregularly spaced junctional nests and involve hair shafts and the ducts of sweat glands and other skin appendages {31,498}. The dysplastic naevus may be compound or junctional. F e a t u res that distinguish a dysplastic naevus from malignant melanoma include symmetrical growth evident on full cross-section and the predominance of atypical cells in the superficial cellular component of the naevus. Limited pagetoid spread of single melanocytes with minimal or no involvement of the upper one-third of the epithelium may also be seen {31,498,2362}. Genetic susceptibility These vulvar naevi may occur in patients with the dysplastic naevus synd ro m e . Germ cell, neuroectodermal, lymphoid and secondary tumours E.J. Wilkinson Definition Primary tumours of the vulva that are not epithelial, mesenchymal or melanocytic in type, as well as secondary tumours. ICD-O codes Yolk sac tumour 9071/3 Merkel cell tumour 8247/3 Peripheral primitive neuroectodermal tumour/ 9364/3 Ewing tumour 9260/3 Yolk sac tumour Definition A primitive malignant germ cell tumour characterized by a variety of distinctive histological patterns, some of which recapitulate phases in the development of the normal yolk sac. Synonym Endodermal sinus tumour. Epidemiology Yolk sac tumour is rare in the vulva and has been reported primarily in children and young women {888}. Prognosis and predictive factors Vulvar yolk sac tumour is treated by local wide excision and chemotherapy, which is usually platinum-based {888}. Merkel cell tumour Definition A malignant tumour composed of small neuroendocrine type cells of the lower epidermis. Synonym Neuroendocrine <strong>carcinoma</strong> of the skin. Epidemiology Merkel cell tumours are rare in the vulva and aggressive {324,554,996}. Histopathology The neoplastic cells have scanty cytoplasm and nuclei with finely stippled chromatin. Glandular and squamous differentiation has been reported {2607}. Histopathology For the histological features see the chapter on the ovary. Fig. 7.22 A highly cellular peripheral primitive neuroectodermal tumour of vulva in an 18 year old. Melanocytic tumours / Germ cell, neuroectodermal, lymphoid and secondary tumours 333
Page 2:
Previous volumes in this series Kle
Page 6 and 7:
World Health Organization Classific
Page 8 and 9:
Published by IARC Press, Internatio
Page 10 and 11:
CHAPTER 1 Tumours of the Breast Can
Page 12 and 13:
TNM classification of carcinomas of
Page 14 and 15:
Invasive breast carcinoma I.O. Elli
Page 16 and 17:
Rapid growth and greater adult heig
Page 18 and 19:
tives, administrative and clerical
Page 20 and 21:
Grade 1 - well differentiated: 3-5
Page 22 and 23:
ent and this is occasionally extens
Page 24 and 25:
Most melanotic tumours of the breas
Page 26 and 27:
A Fig. 1.22 A Classic invasive lobu
Page 28 and 29:
yet others at 90% {97,2147}. For pr
Page 30 and 31:
Fig. 1.27 Medullary carcinoma. The
Page 32 and 33:
myoepithelial cells in fibro a d e
Page 34 and 35:
A Fig. 1.33 Neuroendocrine carcinom
Page 36 and 37:
Macroscopy Fisher et al. reported t
Page 38 and 39:
Fig. 1.39 Apocrine carcinoma. Note
Page 40 and 41:
cells contain intracytoplasmic lume
Page 42 and 43:
A Fig. 1.50 Carcinosarcoma. A Two a
Page 44 and 45:
A B C Fig. 1.75 Lobular neoplasia.
Page 46 and 47:
Intraductal proliferative lesions F
Page 48 and 49:
A B absence of either microcalcific
Page 50 and 51:
Fig. 1.83 Atypical ductal hyperplas
Page 52 and 53:
A B Fig. 1.88 Large excision biopsy
Page 54 and 55:
unusual variants as well. Using thi
Page 56 and 57:
esemble those identified in invasiv
Page 58 and 59:
A B Fig. 1.97 Microinvasive carcino
Page 60 and 61:
A Papilloma may be subject to morph
Page 62 and 63:
A B C Fig. 1.103 Papillary intraduc
Page 64 and 65:
colour measuring from 0.5 to 12 cm.
Page 66 and 67:
Immunoprofile The cases studied by
Page 68 and 69:
Glycogen-rich, clear cell carcinoma
Page 70 and 71:
Differential diagnosis There may be
Page 72 and 73:
quality metaphase spreads from an i
Page 74 and 75:
Fig. 1.67 Lobular carcinoma of brea
Page 76 and 77:
detectable distant metastasis displ
Page 78 and 79:
detected at a late stage as small t
Page 80 and 81:
Extent of ductal carcinoma in situ
Page 82 and 83:
Benign epithelial proliferations G.
Page 84 and 85:
Fig. 1.112 Microglandular adenosis.
Page 86 and 87:
A Apocrine adenoma ICD-O code 8401/
Page 88 and 89:
A B Fig. 1.128 Adenomyoepithelioma,
Page 90 and 91:
Mesenchymal tumours M. Drijkoningen
Page 92 and 93:
1113,1275}. There is a complex patt
Page 94 and 95:
A B Fig. 1.137 A Lipoma. Intraparen
Page 96 and 97:
Fig. 1.141 Angiosarcoma after breas
Page 98 and 99:
A Fig. 1.144 Mammary osteosarcoma.
Page 100 and 101:
Fibroepithelial tumours J.P. Belloc
Page 102 and 103:
aged women (average age of presenta
Page 104 and 105:
lished data suggests a 21% rate of
Page 106 and 107:
A Fig. 1.157 Syringomatous adenoma
Page 108 and 109:
Malignant lymphoma and metastatic t
Page 110 and 111:
used. Inflammatory conditions in th
Page 112 and 113:
male population both in the USA and
Page 114 and 115:
CHAPTER 2 Tumours of the Ovary and
Page 116 and 117:
Polyembryoma 9072/3 Non-gestational
Page 118 and 119:
Surface epithelial-stromal tumours
Page 120 and 121:
A Fig. 2.04 A Serous borderline tum
Page 122 and 123:
A Fig. 2.06 Serous borderline tumou
Page 124 and 125:
A Fig. 2.10 Invasive peritoneal imp
Page 126 and 127:
Fig. 2.15 Mucinous carcinoma with i
Page 128 and 129:
Fig. 2.20 Mucinous endocervical-lik
Page 130 and 131:
A Fig. 2.28 Mucinous cystic tumour
Page 132 and 133:
early secretory endometrium {2605}.
Page 134 and 135:
IV, 6% {2233}. Patients with grade
Page 136 and 137:
A Fig. 2.37 A This polypoid intracy
Page 138 and 139:
Fig. 2.40 Endometrioid cyst with at
Page 140 and 141:
1 tumours are extremely rare. Almos
Page 142 and 143:
Fig. 2.50 Borderline Brenner tumour
Page 144 and 145:
express thrombomodulin and have bee
Page 146 and 147:
serous and transitional cell carcin
Page 148 and 149:
is yellow to tan with a variable ad
Page 150 and 151:
Genetic susceptibility JGCTs may pr
Page 152 and 153:
Clinical features F i b romas may b
Page 154 and 155:
distinguishes this tumour from the
Page 156 and 157:
A Fig. 2.77 A Retiform Sertoli-Leyd
Page 158 and 159:
Mean ages of 21 and 38 years and me
Page 160 and 161:
Tumours unassociated with PJS form
Page 162 and 163:
mal origin without crystals of Rein
Page 164 and 165:
Germ cell tumours F. Nogales A. Tal
Page 166 and 167:
cases, anisokaryosis has no prognos
Page 168 and 169:
ation may coexist in the same neopl
Page 170 and 171:
Table 2.06 Grading of ovarian immat
Page 172 and 173:
A B Fig. 2.102 A Mature cystic tera
Page 174 and 175:
Diagnostic procedures Elevated urin
Page 176 and 177:
associated with mature teratomas sh
Page 178 and 179:
atives intimately admixed. The germ
Page 180 and 181:
Fig. 2.113 Mixed germ cell-sex cord
Page 182 and 183:
A Fig. 2.116 A Adenomatous hyperpla
Page 184 and 185:
Fig. 2.117 Small cell carcinoma, hy
Page 186 and 187:
Clinical features Adenoid cystic-li
Page 188 and 189:
Histopathology This epithelial tumo
Page 190 and 191:
sis. Corpus luteum of pregnancy has
Page 192 and 193:
Lymphomas and leukaemias L.M. Roth
Page 194 and 195:
Secondary tumours of the ovary J. P
Page 196 and 197:
Occasionally, the colonic adenocarc
Page 198 and 199:
Peritoneal tumours S.C. Mok J.O. Sc
Page 200 and 201:
A B Fig. 2.140 Cystic adenomatoid m
Page 202 and 203:
whelmingly poor {1038,1547,2310}. H
Page 204 and 205:
CHAPTER 3 Tumours of the Fallopian
Page 206 and 207:
TNM and FIGO classification of carc
Page 208 and 209:
Endometrioid adenocarcinoma Endomet
Page 210 and 211:
Two examples of adenofibroma of bor
Page 212 and 213:
A Fig. 3.11 Adenomatoid tumour. A T
Page 214 and 215:
Clinical features Patients range in
Page 216 and 217:
Fig. 3.16 Uterus-like mass. The cys
Page 218 and 219:
CHAPTER 4 Tumours of the Uterine Co
Page 220 and 221:
TNM and FIGO classification of non-
Page 222 and 223:
Epithelial tumours and related lesi
Page 224 and 225:
endometrioid adenocarcinoma fro m a
Page 226 and 227:
fers from the prototypical type I e
Page 228 and 229:
the ovary and bladder. Unlike prima
Page 230 and 231:
schema {1535,2602}. Although this c
Page 232 and 233:
Table 4.03 Altered gene function in
Page 234 and 235:
Mesenchymal tumours and related les
Page 236 and 237:
areas are limited to less than 30%
Page 238 and 239:
A B C Fig. 4.30 Leiomyosarcoma. A T
Page 240 and 241:
e used sparingly and is reserved fo
Page 242 and 243:
A B Fig. 4.38 Leiomyoma with perino
Page 244 and 245:
cytological atypia, tumour cell nec
Page 246 and 247:
Mixed epithelial and mesenchymal tu
Page 248 and 249:
Prognosis and predictive factors Th
Page 250 and 251:
tumours may superficially invade th
Page 252 and 253:
A Fig. 4.46 A Gestational choriocar
Page 254 and 255:
A Fig. 4.49 A Classic complete hyda
Page 256 and 257:
Sex cord-like, neuroectodermal and
Page 258 and 259:
Secondary tumours of the uterine co
Page 260 and 261:
WHO histological classification of
Page 262 and 263:
Epithelial tumours M. Wells J.M. Ne
Page 264 and 265:
Fig. 5.04 Mechanisms of human papil
Page 266 and 267:
Fig. 5.08 Keratinizing squamous cel
Page 268 and 269:
in their Asian population {2957}. I
Page 270 and 271:
have a strong association with high
Page 272 and 273:
e red by squamous epithelium {380}.
Page 274 and 275:
endometrioid adenocarcinoma of the
Page 276 and 277:
metrial epithelium. In some cases t
Page 278 and 279:
with distinct cell borders and a gr
Page 280 and 281: Mesenchymal tumours M.L. Carcangiu
Page 282 and 283: {781}, liposarcoma {2840,3016}, ost
Page 284 and 285: Mixed epithelial and mesenchymal tu
Page 286 and 287: Fig. 5.44 Wilms tumour. The tumour
Page 288 and 289: A Fig. 5.47 Implant of endometrial
Page 290 and 291: CHAPTER 6 Tumours of the Vagina Alt
Page 292 and 293: Epithelial tumours E.S. Andersen A.
Page 294 and 295: Aetiology The fact that both VAIN a
Page 296 and 297: Fig. 6.10 Fibroepithelial polyp.A m
Page 298 and 299: er of mitoses varies but is usually
Page 300 and 301: ICD-O codes Adenosquamous carcinoma
Page 302 and 303: A C Fig. 6.17 Sarcoma botryoides. A
Page 304 and 305: 1-11 cm. They may arise anywhere in
Page 306 and 307: elsewhere in the female genital tra
Page 308 and 309: A Fig. 6.24 Yolk sac tumour. A The
Page 310 and 311: g rowing in sheets. Some may have s
Page 312 and 313: WHO histological classification of
Page 314 and 315: Epithelial tumours E.J. Wilkinson M
Page 316 and 317: even with additional sectioning, it
Page 318 and 319: type) is a highly diff e rentiated
Page 320 and 321: Clinical features Bartholin gland c
Page 322 and 323: glandular elements surrounded by fi
Page 324 and 325: Mesenchymal tumours R.L. Kempson M.
Page 326 and 327: Table 7.03 Differential diagnosis o
Page 328 and 329: Prognosis and predictive factors A
Page 332 and 333: A Fig. 7.23 Vulvar peripheral primi
Page 334 and 335: Familial aggregation of cancers of
Page 336 and 337: BRCA1 syndrome Definition Inherited
Page 338 and 339: dispose individuals to the developm
Page 340 and 341: Fig. 8.05 To assess whether wild-ty
Page 342 and 343: Fig. 8.07 Factors that modify risk
Page 344 and 345: BRCA2 syndrome R. Eeles S. Piver S.
Page 346 and 347: tubal or ovarian carcinomas. Howeve
Page 348 and 349: in typical nuclear foci that may re
Page 350 and 351: Breast tumours Frequency Breast can
Page 352 and 353: Fig. 8.14 Codon distribution of som
Page 354 and 355: Breast tumours Age distribution and
Page 356 and 357: Hereditary non-polyposis colon canc
Page 358 and 359: essary in the evaluation of the pat
Page 360 and 361: Age distribution and penetrance Mos
Page 362 and 363: Contributors Dr Vera M. ABELER** De
Page 364 and 365: Dr Carlo LA VECCHIA Laboratory of E
Page 366 and 367: Dr Manuel TEIXEIRA Department of Ge
Page 368 and 369: 02.100 Dr. A. Ostor 02.101 Dr. F.A.
Page 370 and 371: 52. Akhtar M, Robinson C, Ashraf Al
Page 372 and 373: 180. Bapat K, Brustein S (1989). Ut
Page 374 and 375: 307. Bolis GB, Maccio T (2000). Cle
Page 376 and 377: 436. Chang J, Sharpe JC, A'Hern RP,
Page 378 and 379: 562. Costa MJ, Ames PF, Walls J, Ro
Page 380 and 381:
689. Di Domenico A, Stangl F, Benni
Page 382 and 383:
820. Falck J, Petrini JH, Williams
Page 384 and 385:
943. Gad A, Azzopardi JG (1975). Lo
Page 386 and 387:
1067. Grimes MM (1992). Cystosarcom
Page 388 and 389:
1197. Herod JJ, Shafi MI, Rollason
Page 390 and 391:
1323. Jacques SM, Qureshi F, Ramire
Page 392 and 393:
1449. Khalifa MA, Mannel RS, Harawa
Page 394 and 395:
1564. Lagios MD (1977). Multicentri
Page 396 and 397:
1687. Loman N, Johannsson O, Kristo
Page 398 and 399:
1807. McCluggage G, McBride H, Maxw
Page 400 and 401:
1937. Mukai M, Torikata C, Iri H (1
Page 402 and 403:
2056. Norris HJ, Taylor HB (1967).
Page 404 and 405:
2180. Park JS, Jones RW, McLean MR,
Page 406 and 407:
2304. Puls LE, Hamous J, Morrow MS,
Page 408 and 409:
2 4 3 4 . Rosen PP, Groshen S, Saig
Page 410 and 411:
2559. Schlesinger C, Silverberg SG
Page 412 and 413:
2686. Silverberg SG (1999). Protoco
Page 414 and 415:
2806. Stutz JA, Evans AJ, Pinder S,
Page 416 and 417:
2942. Tornos C, Silva EG, Ordonez N
Page 418 and 419:
3061. Wargotz ES, Norris HJ (1990).
Page 420 and 421:
3189. Yoshioka T, Tanaka T (2000).
Page 422 and 423:
References 425
Page 424 and 425:
Biphasic teratomas, 168 BLM, 341, 3
Page 426 and 427:
G GADD45, 343, 353 GCDFP-15, 25, 33
Page 428 and 429:
MPNST, see Malignant peripheral ner
Page 430:
Small cell / oat cell carcinoma, 32
show all

Invasive breast carcinoma - IARC

Create successful ePaper yourself

Delete template?

Save as template?