The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs—Part B: Prostate and Bladder Tumours

Abstract

It has been 12 yr since the publication of the last World Health Organization (WHO) classification of tumours of the prostate and bladder. During this time, significant new knowledge has been generated about the pathology and genetics of these tumours. Intraductal carcinoma of the prostate is a newly recognized entity in the 2016 WHO classification. In most cases, it represents intraductal spread of aggressive prostatic carcinoma and should be separated from high-grade prostatic intraepithelial neoplasia. New acinar adenocarcinoma variants are microcystic adenocarcinoma and pleomorphic giant cell adenocarcinoma. Modifications to the Gleason grading system are incorporated into the 2016 WHO section on grading of prostate cancer, and it is recommended that the percentage of pattern 4 should be reported for Gleason score 7. The new WHO classification further recommends the recently developed prostate cancer grade grouping with five grade groups. For bladder cancer, the 2016 WHO classification continues to recommend the 1997 International Society of Urological Pathology grading classification. Newly described or better defined noninvasive urothelial lesions include urothelial dysplasia and urothelial proliferation of uncertain malignant potential, which is frequently identified in patients with a prior history of urothelial carcinoma. Invasive urothelial carcinoma with divergent differentiation refers to tumours with some percentage of "usual type" urothelial carcinoma combined with other morphologies. Pathologists should mention the percentage of divergent histologies in the pathology report. PATIENT SUMMARY Intraductal carcinoma of the prostate is a newly recognized entity in the 2016 World Health Organization classification. Better defined noninvasive urothelial lesions include urothelial dysplasia and urothelial proliferation of uncertain malignant potential. v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j AbstractIt has been 12 yr since the publication of the last World Health Organization (WHO) classification of tumours of the prostate and bladder. During this time, significant new knowledge has been generated about the pathology and genetics of these tumours.

Pathology of tumours of the kidney and urinary tract

“…This led to the rather unsatisfactory practice of tumours being described as being grade '1/2' or '2/ 3'. 12 In general application, the large proportion of cases assigned to the grade 2 category represents a heterogeneous group, with some lesions behaving more akin to grade 3 lesions, while others show a more indolent behaviour, similar to grade 1 lesions.…”

Pathohistological diagnosis of prostate cancer

“…Tablica 1 prikazuje patohistološku podjelu tumora prostate u novom izdanju SZO-a -Klasifikacije tumora urinarnog sustava i muških spolnih organa iz 2016 14 . U klasifikaciji se navodi intraduktalni karcinom kao novi entitet.…”

Pelvic Gossypiboma Diagnosed at the Time of Radical Prostatectomy 30 Years after Inguinal Hernioplasty

“…Definitive histopathological analysis revealed a Gleason 4+4, grade group 4 prostatic acinar adenocarcinoma involving the periprostatic tissues and seminal vesicles [8]. Surgical margins, as well as all 28 lymph nodes removed, were negative for malignancy (stage pT3bN0MX).…”

“…Histopathological analysis revealed, according to the recommendations for pathologic evaluation and reporting of carcinoma of the prostate following the WHO 2016 classification [8], a Gleason score 4+4 (grade group 4) prostatic acinar adenocarcinoma involving 6 out of 14 cores, of which 5 on the right side. A whole-body bone scintigraphy and contrast-enhanced CT scan of the thorax, abdomen and pelvis were performed to complete the disease staging.…”