Histological Typing Of Tumours Of The Exocrine Pancreas

In Collaboration with Pathologists in 7 Countries

The classification of tumors is important for understanding tumor histogenesis, for predicting prognosis, for differential diagnosis, and for recommending appropriate therapy. Since 1836, when pancreatic cancer was first described, progress has been made in pancreatic cancer morphology, and a number of classifications have been proposed. All of these classifications are mainly based on morphological characteristics. Some are too detailed to be of practical use while others are more pragmatic. Some of the inherent problems in the previous classifications included difficulties in obtaining an adequate number of pan creatic tumors for examination and insufficient clinical data and follow-up. With the increasing incidence of pancreatic cancer in many parts of the world during the past six decades, and with the availability of more tumors to patho logists, advances have been made in pancreatic tumor studies. Classifications by Cubilla and Fitzgerald and by Kloppel, which are generally similar, mostly considered prominent morphological features and their histogenesis. These pathology-oriented classifications, although complete, were not practical from the standpoint of clinicians concerned with the prognosis of individual tumors.

Although this second edition retains the concise format of the first edition, the number of tumours described has increased considerably, especially in the melanocytic, adnexal, fibrous tissue and lymphoid neoplasms. Care has been taken to avoid needless subclassification, so as to limit the expansion of categories to those fulfilling demonstrable histological criteria. The commentaries remain succint whilst including the major diagnostic points, with reference to relevant immunohistochemical features. All the illustrations have been changed since the first edition. Of particular importance is the fact that close collaboration with the authors of the AFIP Atlas of Tumor Pathology on Melanocytic and Non-melanocytic Tumors of the Skin ensures a consistent approach to the classification.

Although the histological typing of ovarian tumours is the focus of this volume, other aspects of investigation of a specimen of ovarian tumour are also important. Some of these aspects are mentioned in the text or illustrated. They include tumour grading, which is impor­ tantprognostically and therapeutically for certain types ofovarian tu­ mour, quantification ofcomponents in mixed tumours and evaluation of the stroma of certain tumours that are associated with endocrine function. Grading methodologies have varied from one tumour type to another and from one group of investigators to another for the same type of tumour. Because a standard internationally recognized grading methodology has not been established, no specific guidance is presented in this volume. Nevertheless, grading by any generally acceptable method should be incorporated in the diagnosis whenever appropriate. The clinical and pathological classification of the extent of tu­ mour growth (staging) should be taken into account for the purposes of treatment and prognosis. The TNlV1/FIGO system is therefore in­ cluded (p. 45). Histological Classification of Ovarian Tumours 1 Surface Epithelial-Stromal Tumours 1. 1 Serous tumours 1. 1. 1 Benign 1 1. 1. 1. 1 Cystadenoma 8441/0 Papillary cystadenoma 8460/0 1. 1. 1. 2 Surface papilloma . . . . . . . . . . . . . . . . . . . . . . . . 8461/0 1. 1. 1. 3 Adenofibroma; cystadenofibroma . . . . . 9014/0 1. 1. 2 Of borderline malignancy (of low malignant potential) 2 1. 1. 2. 1 Cystic tumour 8442/1 Papillary cystic tumour . . . . . . . . . . . . . . . . . . . . 846211 Surface papillary tumour. . . . . . . . . . . . . . . . . . . 8463/1 1. 1. 2. 2 1. 1. 2. 3 Adenofibroma; cystadenofibroma 9014/1 1. 1.

"The WHO Classification of Tumours of the Digestive System presented in this book reflects the views of a Working Group that convened for an Editorial and Consensus Conference at the International Agency for Research on Cancer (IARC), Lyon, December 10-12, 2009"--P. [5].