Cancer Grading Manual

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Cancer Grading Manual

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Cancer Grading Manual

Edited by

Ivan Damjanov,

MD, PhD

Professor of Pathology

The University of Kansas School of Medicine Kansas City, Kansas

Fang Fan,

MD, PhD

Assistant Professor of Pathology

The University of Kansas School of Medicine Kansas City, Kansas

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Ivan Damjanov, MD, PhD Fang Fan, MD, PhD

Professor of Pathology Assistant Professor of Pathology

The University of Kansas The University of Kansas

School of Medicine School of Medicine

Kansas City, Kansas Kansas City, Kansas

Library of Congress Control Number: 2006923814

ISBN-10: 0-387-33750-4 ISBN-13: 978-0387-33750-0

e-ISBN-10: 0-387-33751-2 e-ISBN-13: 978-0387-33751-7 Printed on acid-free paper.

All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden.

The use in this publication of trade names, trademarks, service marks and similar terms, even if they are not identiﬁed as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights.

While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.

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Preface

The grading and staging of tumors are routinely performed during the work-up of most patients who have cancer. Whereas the staging of tumors relies on a wealth of clinical, intraoperative, or radiologic data, tumor grading remains in the domain of pathologists—hence, the idea to compile a book for our colleagues in diagnostic surgical pathology and their residents.

Like most surgical pathologists, we grade and stage tumors every day, and the assigned values are included in the ﬁnal pathology reports. During the sign-out, we use the AJCC Cancer Staging Handbook or TNM Atlas: Illustrated Guide to the TNM Classiﬁcation of Malignant Tumors. As strange as it might sound, although many textbooks contain instructions on how to grade tumors, there is no concise,

“ready-to-use,” practice-oriented manual on the microscopic grading of tumors.

Confronted with the perceived need for such a book (and especially encouraged by our residents), we undertook the task of extracting the pertinent facts from books, monographs, and seminal papers and presenting them in a concise form. Since pathology is a visual discipline, the publisher allowed us to liberally use color microphotographs whenever needed to make a point, and thus produce an illustrated manual that could be applied in the daily practice of surgical pathology without the need to resort to other books. We thank the publisher for this support.

From now on, our residents will no longer need to ask us which book they should use for grading tumors. We hope that other practicing surgical pathologists will ﬁnd the book useful as well, and keep it as a companion to their favorite tumor staging manual.

In preparing this book, we have consulted a number of leading textbooks of surgical pathology, monographs prepared by the experts of the World Health Organi- zation, and tumor atlases published by the Armed Forces Institute of Pathology.

Readers interested in these sources, as well the recent comprehensive, seminal articles, will ﬁnd them listed as references at the end of each chapter. While there is nothing new in this compilation, it is the ﬁrst to present these data in such a con- densed form, illustrated with so many color images.

We have concentrated on tumors that are common, and thus have omitted some of the less common neoplasms and some of the neoplastic diseases that are in the domain of subspecialties of pathology (most notably hematology). We have not included the grading of some common inﬂammatory non-neoplastic diseases, such as chronic hepatitis or lupus nephritis. We hope that readers will not mind, but if you feel that some omissions are unpardonable, we would love to hear from you.

Comments and suggestions for improvements, updates, or revisions are welcome.

Ivan Damjanov, MD, PhD Fang Fan, MD, PhD v

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Contributors

Rachel Careccia, MD

Assistant Professor of Pathology, Department of Pathology, Wake Forest Univer- sity Baptist Medical Center, Winston-Salem, NC, USA

Carlos Cerruto, MD

Assistant Professor of Pathology, Department of Pathology, Wake Forest Univer- sity Baptist Medical Center, Winston-Salem, NC, USA

Karen L. Chang, MD

Pathologist, Department of Pathology, City of Hope National Medical Center Duarte, CA, USA

Gregorio Chejfec, MD

Professor of Pathology, Department of Pathology, University of Illinois School of Medicine, Chicago, IL, USA

Ivan Damjanov, MD, PhD

Professor of Pathology, Department of Pathology, The University of Kansas School of Medicine, Kansas City, KS, USA

Fang Fan, MD, PhD

Assistant Professor of Pathology, Director of Cytology, Department of Pathology, The University of Kansas School of Medicine, Kansas City, KS, USA

Nina Gale, MD

Professor and Chair, Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

John F. Fetsch, MD

Staff Pathologist, Armed Forces Institute of Pathology, Washington, DC, USA

Zoran Gatalica, MD, DSc

Professor of Pathology, Director of Surgical Pathology, Creighton University School of Medicine, Omaha, NE, USA

Grace Guzman, MD

Assistant Professor of Pathology, Department of Pathology, University of Illinois School of Medicine, Chicago, IL, USA

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x Contributors

M. Joe Ma, MD, PhD

Department of Pathology, Florida Hospital Orlando, Orlando, FL, USA

Cesar Moran, MD

Professor of Pathology, University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA

Markku Miettinen, MD

Staff Pathologist, Director of Soft Tissue Pathology, Armed Forces Institute of Pathology Washington, DC, USA

Gregor Mikuz, MD

Professor and Chair, Institute of Pathology, University of Innsbruck School of Medicine, Innsbruck, Austria

Asraa Namiq, MD

Assistant Professor of Pathology, Department of Pathology, The University of Kansas School of Medicine, Kansas City, KS, USA

Omar P. Sangüeza, MD

Professor of Pathology, Department of Pathology, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA

Saul Suster, MD

Professor of Pathology and Vice-Chair, Director of Anatomic Pathology, Depart- ment of Pathology, Ohio State University School of Medicine, Columbus, OH, USA

Ossama Tawﬁk, MD, PhD

Professor of Pathology, Director of Anatomic and Surgical Pathology, Department of Pathology, The University of Kansas School of Medicine, Kansas City, KS, USA

Patricia A. Thomas, MD

Professor of Pathology and Chair, Associate Dean, Department of Pathology, The University of Kansas School of Medicine, Kansas City, KS, USA

Lawrence M. Weiss, MD

Chairman, Department of Pathology, City of Hope National Medical Center, Duarte, CA, USA

Nina Zidar, MD

Professor of Pathology, Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

Cancer Grading Manual