Diagnostic Pathology: Genitourinary

Mahul B. Amin, MD is the returning lead author from the previous edition. He is currently Clinical Professor at the Department of Pathology at the University of Tennessee Health Science Center and the Endowed Chair for Cancer Research and Adjunct Professor, at the Department of Urology, University of Southern California, Keck School of Medicine in Los Angeles, California. His is board certified by the American Board of Pathology in both Anatomic and Clinical Pathology. Dr. Amin was the Editor in Chief of the 8th Edition AJCC TNM Staging Manual, as well as the Editor in Chief of Advances in Anatomic Pathology. His special research interests include urological cancer, quality assurance and improvement, laboratory medicine, and molecular pathology.

SECTION 1: KIDNEY

Introduction and Overview

4 Introduction to Renal Cell Tumors

Satish K. Tickoo, MD and Victor E. Reuter, MD

10 Classification of Kidney Tumors and Tumor-Like Lesions

Satish K. Tickoo, MD and Victor E. Reuter, MD

Familial Cancer Syndromes

12 von Hippel-Lindau Syndrome

Satish K. Tickoo, MD and Victor E. Reuter, MD

16 Birt-Hogg-Dubé Syndrome

Satish K. Tickoo, MD and Victor E. Reuter, MD

20 Hereditary Leiomyomatosis Renal Cell Carcinoma Syndrome

Satish K. Tickoo, MD, Victor E. Reuter, MD, and Mahul B. Amin, MD

24 Tuberous Sclerosis Complex

Satish K. Tickoo, MD and Victor E. Reuter, MD

28 Succinate Dehydrogenase Complex Deficiency Syndrome

Satish K. Tickoo, MD and Victor E. Reuter, MD

32 Hereditary Papillary Renal Cancer and Miscellaneous Other Familial Cancer Syndromes

Satish K. Tickoo, MD and Victor E. Reuter, MD

Nonneoplastic Lesions

38 Renal Tuberculosis, Xanthogranulomatous Pyelonephritis, Renal Malakoplakia

Satish K. Tickoo, MD and Victor E. Reuter, MD

Renal Cell Tumors, Benign

44 Papillary Adenoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

48 Renal Oncocytoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

Renal Cell Carcinoma

54 Clear Cell Renal Cell Carcinoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

64 Multilocular Cystic Renal Neoplasm of Low Malignant Potential

Satish K. Tickoo, MD and Victor E. Reuter, MD

68 Clear Cell Renal Cancers With Fibromyomatous Stroma, Including ELOC (Formerly TCEB1) Mutated Renal Cell Carcinoma

Judy Sarungbam, MD, Satish K. Tickoo, MD, and Victor E. Reuter, MD

74 Clear Cell Papillary Renal Cell Tumor

Satish K. Tickoo, MD and Victor E. Reuter, MD

82 Papillary Renal Cell Carcinoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

92 Chromophobe Renal Cell Carcinoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

100 Collecting Duct Carcinoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

106 SMARCB1-Deficient Renal Medullary Carcinoma and SMARCB1-Deficient Medullary-Like Renal Cell Carcinoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

112 TFE3- and TFEB-Rearranged Renal Cell Carcinomas

Satish K. Tickoo, MD and Victor E. Reuter, MD

120 Mucinous Tubular and Spindle Cell Carcinoma

Satish K. Tickoo, MD, Yingbei Chen, MD, and Victor E. Reuter, MD

126 Tubulocystic Renal Cell Carcinoma

Satish K. Tickoo, MD, Judy Sarungbam, MD, and Victor E. Reuter, MD

130 Thyroid-Like Follicular Carcinoma of Kidney

Satish K. Tickoo, MD and Victor E. Reuter, MD

134 Acquired Cystic Disease-Associated Renal Cell Carcinoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

140 Fumarate Hydratase-Deficient Renal Cell Carcinoma

Jatin S. Gandhi, MD and Mahul B. Amin, MD

144 ALK Rearrangement-Associated Renal Cell Carcinoma

Jatin S. Gandhi, MD and Mahul B. Amin, MD

148 Eosinophilic Solid and Cystic Renal Cell Carcinoma

Jatin S. Gandhi, MD and Mahul B. Amin, MD

150 Other Eosinophilic/Oncocytic Tumors, Including ESC, EVT, and LOT

Satish K. Tickoo, MD and Victor E. Reuter, MD

154 Subsequent 2nd Tumors

Satish K. Tickoo, MD and Victor E. Reuter, MD

158 Renal Cell Carcinoma, Not Otherwise Specified

Satish K. Tickoo, MD and Victor E. Reuter, MD

Metanephric Tumors

162 Metanephric Adenoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

168 Metanephric Tumors Other Than Metanephric Adenoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

Nephroblastic Tumors

172 Nephrogenic Rests

Satish K. Tickoo, MD and Victor E. Reuter, MD

176 Nephroblastoma (Wilms Tumor)

Satish K. Tickoo, MD and Victor E. Reuter, MD

186 Cystic Partially Differentiated Nephroblastoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

Mesenchymal Tumors

188 Angiomyolipoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

194 Epithelioid Angiomyolipoma/Epithelioid PEComa

Satish K. Tickoo, MD and Victor E. Reuter, MD

200 Congenital Mesoblastic Nephroma

Satish K. Tickoo, MD and Victor E. Reuter, MD

204 Clear Cell Sarcoma of Kidney

Satish K. Tickoo, MD and Victor E. Reuter, MD

208 Rhabdoid Tumor of Kidney

Satish K. Tickoo, MD and Victor E. Reuter, MD

Mixed Mesenchymal and Epithelial Tumors

212 Mixed Epithelial and Stromal Tumor (MEST) Family Tumors

Satish K. Tickoo, MD and Victor E. Reuter, MD

220 Pediatric Cystic Nephroma

Satish K. Tickoo, MD and Victor E. Reuter, MD

224 Synovial Sarcoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

Neuroendocrine Tumors

228 Renal Neuroendocrine Tumor/Carcinoid Tumor and Neuroendocrine Carcinoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

232 Renal Ewing Sarcoma

Satish K. Tickoo, MD and Victor E. Reuter, MD

Hematopoietic Tumors

236 Hematopoietic Tumors

Satish K. Tickoo, MD, Judy Sarungbam, MD, and Victor E. Reuter, MD

Metastatic and Other Tumors

242 Juxtaglomerular Cell Tumor (Reninoma)

Satish K. Tickoo, MD and Victor E. Reuter, MD

246 Renomedullary Interstitial Cell Tumor

Satish K. Tickoo, MD and Victor E. Reuter, MD

250 Other Rare Tumors

Satish K. Tickoo, MD and Victor E. Reuter, MD

258 Metastatic Tumors

Satish K. Tickoo, MD and Victor E. Reuter, MD

Immunohistochemical Profiles for Tumors Involving Kidney

262 Immunohistochemistry, Kidney

Satish K. Tickoo, MD and Victor E. Reuter, MD

SECTION 2

Introduction and Overview

270 Classification of Bladder Tumors and Tumor-Like Lesions

Steven Christopher Smith, MD, PhD

Microscopic Anatomy

272 Microscopic Anatomy of Urinary Bladder

Hikmat Al-Ahmadie, MD and Mahul B. Amin, MD

276 Microscopic Anatomy of Urethra

Hikmat Al-Ahmadie, MD and Mahul B. Amin, MD

280 Microscopic Anatomy of Ureter

Steven Christopher Smith, MD, PhD

282 Microscopic Anatomy of Renal Pelvis

Steven Christopher Smith, MD, PhD

Nonneoplastic Lesions of Urinary Tract

286 Overview of Cystitis

Steven Christopher Smith, MD, PhD

292 Polypoid Cystitis

Steven Christopher Smith, MD, PhD

300 Malakoplakia

Steven Christopher Smith, MD, PhD

306 Schistosomiasis

Steven Christopher Smith, MD, PhD

308 von Brunn Nests

Steven Christopher Smith, MD, PhD

314 Nephrogenic Adenoma (Metaplasia)

Steven Christopher Smith, MD, PhD

322 Fibroepithelial Polyp

Steven Christopher Smith, MD, PhD

326 Prostatic-Type Polyp (Ectopic Prostate)

Steven Christopher Smith, MD, PhD

330 Amyloidosis

Steven Christopher Smith, MD, PhD

332 Müllerian Lesions

Steven Christopher Smith, MD, PhD

336 Pseudocarcinomatous Hyperplasia

Steven Christopher Smith, MD, PhD

344 Hamartoma

Steven Christopher Smith, MD, PhD

Urothelial Neoplasms, General

346 Overview of Urinary Bladder Neoplasms

Hikmat Al-Ahmadie, MD

Flat Urothelial Lesions

350 Urothelial Carcinoma In Situ

Steven Christopher Smith, MD, PhD

358 Flat Urothelial Lesions Other Than Carcinoma In Situ

Steven Christopher Smith, MD, PhD

UROTHELIAL NEOPLASMS, NONINVASIVE

362 Atypical Urothelial Proliferations, Flat and Tented Type (Formerly Flat and Papillary Hyperplasia)

Jatin S. Gandhi, MD and Mahul B. Amin, MD

364 Urothelial Papilloma

Steven Christopher Smith, MD, PhD

370 Papillary Urothelial Neoplasm of Low Malignant Potential

Steven Christopher Smith, MD, PhD

374 Low-Grade Papillary Urothelial Carcinoma

Hikmat Al-Ahmadie, MD

378 High-Grade Papillary Urothelial Carcinoma

Hikmat Al-Ahmadie, MD

384 Inverted Urothelial Neoplasia

Steven Christopher Smith, MD, PhD

Urothelial Neoplasms, Invasive

394 Invasive Urothelial Carcinoma

Hikmat Al-Ahmadie, MD

404 Urothelial Carcinoma, Subtypes and Divergent Differentiation

Steven Christopher Smith, MD, PhD

Glandular Lesions

426 Cystitis Cystica et Glandularis

Hikmat Al-Ahmadie, MD

430 Villous Adenoma

Hikmat Al-Ahmadie, MD

432 Invasive Adenocarcinoma

Hikmat Al-Ahmadie, MD

438 Clear Cell Adenocarcinoma

Hikmat Al-Ahmadie, MD

Squamous Lesions

444 Squamous Proliferations Other Than Carcinoma

Hikmat Al-Ahmadie, MD

448 Invasive Squamous Cell Carcinoma

Hikmat Al-Ahmadie, MD

Mesenchymal Lesions

454 Myofibroblastic Proliferations

Steven Christopher Smith, MD, PhD

462 Smooth Muscle Tumors

Steven Christopher Smith, MD, PhD

470 Rhabdomyosarcoma

Steven Christopher Smith, MD, PhD

476 Other Mesenchymal Tumors

Steven Christopher Smith, MD, PhD

Other Tumors of Urinary Bladder

484 Paraganglioma

Steven Christopher Smith, MD, PhD

492 Metastatic/Secondary Involvement of Bladder

Steven Christopher Smith, MD, PhD

Diverticula of Urinary Tract

500 Diverticula

Hikmat Al-Ahmadie, MD and Mahul B. Amin, MD

504 Diverticular-Associated Neoplasia

Hikmat Al-Ahmadie, MD and Mahul B. Amin, MD

URETHRA

508 Inflammatory Lesions of Urethra

Steven Christopher Smith, MD, PhD

512 Carcinoma of Urethra

Steven Christopher Smith, MD, PhD

516 Other Tumors and Tumor-Like Lesions of Urethra

Steven Christopher Smith, MD, PhD

URETER

520 Urothelial Carcinoma of Ureter

Hikmat Al-Ahmadie, MD

524 Other Tumors and Tumor-Like Lesions of Ureter

Hikmat Al-Ahmadie, MD

RENAL PELVIS

530 Urothelial Carcinoma of Renal Pelvis

Hikmat Al-Ahmadie, MD

540 Other Tumors and Tumor-Like Lesions of Renal elvis

Hikmat Al-Ahmadie, MD

Urachs

546 Urachal Remnants

Steven Christopher Smith, MD, PhD

548 Tumors of Urachus

Steven Christopher Smith, MD, PhD

Immunohistochemical Profiles for Tumors Involving Urinary Bladder

554 Immunohistochemistry, Urinary Tract

Steven Christopher Smith, MD, PhD

SECTION 3: PROSTATE GLAND AND SEMINAL VESICLE

Introduction and Overview

562 Classification of Prostate Tumors and Tumor-Like Lesions

Gladell P. Paner, MD, (BS) MT

564 General Concepts, Prostate

Gladell P. Paner, MD, (BS) MT

570 Microanatomy and Zonal Variations

Gladell P. Paner, MD, (BS) MT

580 Imaging Considerations for Pathologists

Steven Christopher Smith, MD, PhD

NONNEOPLASTIC LESIONS

584 Prostatitis

Steven Christopher Smith, MD, PhD

588 Prostate Hyperplasia

Gladell P. Paner, MD, (BS) MT

596 Adenosis

Hikmat Al-Ahmadie, MD and Mahul B. Amin, MD

600 Atrophy and Its Patterns

Gladell P. Paner, MD, (BS) MT

606 Hyperplasia of Mesonephric Remnants

Steven Christopher Smith, MD, PhD

610 Verumontanum Mucosal Gland Hyperplasia

Gladell P. Paner, MD, (BS) MT and Deepika Sirohi, MD

612 Nephrogenic Adenoma (Metaplasia) of Prostatic Urethra

Gladell P. Paner, MD, (BS) MT

PUTATIVE PREMALIGNANT LESIONS AND LESIONS FALLING SHORT OF MALIGNANT DIAGNOSIS

620 Prostatic Intraepithelial Neoplasia

Hikmat Al-Ahmadie, MD and Mahul B. Amin, MD

Prostate Neoplasms

630 General Concepts, Prostate Carcinoma

Steven Christopher Smith, MD, PhD

638 Acinar Adenocarcinoma

Gladell P. Paner, MD, (BS) MT

656 Acinar Adenocarcinoma Subtypes and Patterns

Gladell P. Paner, MD, (BS) MT

668 Atypical Small Acinar Proliferations

Steven Christopher Smith, MD, PhD

674 Intraductal Proliferations and Ductal Carcinoma

Hikmat Al-Ahmadie, MD and Mahul B. Amin, MD

682 Ductal Adenocarcinoma

Gladell P. Paner, MD, (BS) MT

690 Urothelial Carcinoma Involving Prostate Gland

Steven Christopher Smith, MD, PhD

696 Prostate Carcinoma With Neuroendocrine Differentiation

Steven Christopher Smith, MD, PhD

704 Adenoid Cystic (Basal Cell) Carcinoma of Prostate

Steven Christopher Smith, MD, PhD

710 Sarcomatoid Carcinoma of Prostate

Steven Christopher Smith, MD, PhD

716 Carcinomas With Squamous Differentiation

Gladell P. Paner, MD, (BS) MT

722 Cystic Epithelial Tumors of Prostate

Gladell P. Paner, MD, (BS) MT