Today's pathologists, in practice and in training, all face a similar challenge: too much to learn but too little time. When the decision comes to buying a textbook, pathologists want one that is comprehensive yet easy to read and features many good images.A\This book fits the bill. It has a unique format. Rather than combining many topics into one lengthy chapter that readers have to wade through, each chapter covers one specific disease entity or diagnostic issue, such as staging and grading. Each chapter provides excellent images of gross and microscopic pathology, along with highly templated and bulleted text. The clinical, pathologic, immunohistochemical, and molecular features of each disease entity are succinctly discussed and up to date. Emphasis is placed on the pathologic features and diagnostic criteria. Pertinent differential diagnoses are provided, along with diagnostically important clinical, gross, microscopic, and immunohistochemical clues.A\A book is only as good as its writers. We are very fortunate to have assembled a team of internationally known surgical pathologists who not only understand the issues practicing pathologists face in their daily work but also have a vision for the future of genitourinary pathology.A\Acknowledgments:We are enormously grateful to the contributors of this book. They spent countless hours out of their very busy schedules to make this textbook possible. We thank Margaret LaPlaca for her secretarial assistance. We also want to thank our publisher, Elsevier, and executive content strategist, William Schmitt, for his support and encouragement during the production of this book. A special thanks is given to Katie DeFrancesco, our content development specialist at Elsevier, for her patience and persistence in keeping this book on track. Ming Zhou, MD, PhD; George J. Netto, MD; Jonathan I. Epstein, MD

A.NONNEOPLASTIC DISEASE OF THE PROSTATE 1

Anatomy and Histology of the Prostate 2

Seminal VesicJe/Ejaculatory Duct 7

Cowper Gland 10

Benign Prostatic Hyperplasia 12

Acute Inflammation of the Prostate 15

Chronic Inflammation of the Prostate 17

Nonspecific Granulomatous Prostatitis 19

Postbiopsy Cranuloma 21

Prostatic Xanthoma 22

Granulomatous Inflammation of Infectious Etiology 23

Simple Atrophy 25

Cystic Atrophy 26

Postatrophy Hyperplasia 27

Partial Atrophy 29 Adenosis 31

Sclerosing Adenosis 33

Clear Cell Cribriform Hyperplasia 36

Hyperplasia of Mesonephric Remnants 38

Basal Cell Hyperplasia 40

Urothelial Metaplasia 43

Squamous Metaplasia 44

Mucin Cell Metaplasia 45

Neuroendocrine Cells Involving the Prostate 46

Verumontanum Mucosal Gland Hyperplasia 48

Prostatic Infarct 49

B.NEOPLASTIC DISEASE OF THE PROSTATE 51

Prostatic Intraepithelial Neoplasia 52

Intraductal Carcinoma of the Prostate 55

Prostatic Carcinoma, Usual Variant 57

Prostatic Carcinoma, Atrophic Variant 64

Prostatic Carcinoma, Foamy Gland Variant 66

Prostatic Carcinoma, Pseudohyperplastic Variant 68

Prostatic Adenocarcinoma, Mutinous Variant 71

Prostatic Ductal Adenocarcinoma, PIN-Like 73

Sarcomatoid Carcinoma 76

Pleomorphic Giant Cell Carcinoma of the Prostate 78

Lymphoepithelioma-Like Carcinoma of the Prostate 80

Prostate Carcinoma With Squamous Differentiation 81

Ductaf Adenocarcinoma 83

Small Cell Carcinoma 86

Basal Cell Adenoma 88

Basal Cell Carcinoma 90

Urothelial Carcinoma 92

Prostatic Stromal Tumors of Uncertain Malignant Potential 94

Prostatic Stromal Sarcoma 97

Atypical Glands Suspicious for Carcinoma 99

High-Grade Prostatic Intraepithelial Neoplasia With Adjacent Atypical Glands 102 Radiation-Induced Changes 104

Hormonal Ablation-Induced Changes 107

Cryoablation Therapy-Induced Changes 110

Immunohistochemical Work-Up of Prostate Carcinoma 113

Gleason Grading of Prostate Carcinoma 116

Prostate Cancer Staging in Radical Prostatectomy 120

Work-Up of "Vanishing" Cancer in Radical Prostatectomy 124

Nonprostatic Adenocarcinoma Involving the Prostate 125

C.SEMINAL VESICLES 127

Anatomy and Histology of Seminal Vesicles 128

Amyloidosis 131

D.NONNEOPLASTIC DISEASE OF THE URINARY BLADDER 133

Anatomy and Histology of the Urinary Bladder 134

von Brunn Nests 136

Cystitis Cystica et Glandularis 137

Squamous Metaplasia 139

Intestinal Metaplasia 140

Nephrogenic Metaplasia/Adenoma 141

Polypoid and Papillary Cystitis 144

Follicular Cystitis 146

Giant Cell Cystitis 147

Interstitial Cystitis/Painful Bladder Syndrome 148

Eosinophilic Cystitis 149

Infectious Cystitis 150

Malakoplakia 153

Granulomatous Cystitis After Bacillus Calmette-Guerin Therapy 154

Radiation Cystitis 155

Chemotherapy-Induced Cystitis 157

Endometriosis of the Bladder 159

Bladder Endocervicosis 161

Bladder Exstrophy 162

Urachal Anomaly 163

Bladder Diverticulum 164

Ectopic Prostate Tissue 166

E.NEOPLASTIC DISEASE OF THE URINARY BLADDER 167

Papillary Urothelial Hyperplasia 168

Reactive Urothelial Atypia 170

Urothelial Atypia of Unknown Significance 172

Urothelial Dysplasia 173

Urothelial Carcinoma in Situ 174

Urothelial Papilloma 176

Inverted Papilloma 178

Papillary Urothelial Neoplasm of Low Malignant Potential 187

Low-Grade Papillary Urothelial Carcinoma 182

High-Grade Papillary Urothelial Carcinoma 184

Invaaive Urothelial Carcinoma 186

Urothelial Carcinoma With Inverted Growth Pattern 189

Urothelial Carcinoma With Squamous Differentiation 190

Urothelial Carcinoma With Villoglandular Differentiation 191

Urothelial Carcinoma, Micropapillary Variant 193

Urothelial Carcinoma, Microcystic Variant 196

Urothelial Carcinoma, Lymphoepithelioma-Like Carcinoma Variant 198

Urothelial Carcinoma, Clear Cell (Glycogen-Rich) Variant 200

Urothelial Carcinoma, Lipoid Cell Variant 201

Urothelial Carcinoma With Syncytiotrophoblastic Giant Cells 202

Urothelial Carcinoma With Rhabdoid Differentiation 204

Urothelial Carcinoma Similar to Giant Ceil Tumor of Bone 205

Small Cell Carcinoma 207

Large Cell Undifferentiated Carcinoma 209

Urothelial Carcinoma With Unusual Stromal Reactions 211

Urothelial Carcinoma With Sarcomatoid Differentiation 212

Villous Adenoma 215

Adenocarcinoma 217

Clear Cell Adenocarcinoma 219

Urachal Adenocarcinoma 221

Squamous Ceil Carcinoma 223

Paraganglioma 226

Staging of Urothelial Carcinoma 228

Secondary Spread of Prostate Carcinoma to the Bladder 229

Secondary Adenocarcinoma Involving the Bladder, Other Than Prostatic Carcinoma 231

F.NONNEOPLASTIC DISEASE OF THE KIDNEY 235

Anatomy of the Kidney 236

Renal Dysplasia 237

Autosomal Recessive Polycystic Kidney Disease 239

Autosomal Dominant Polycystic Kidney Disease 240

Medullary Spongy Kidney 242

Acquired Cystic Kidney Disease 243

Simple Cortical Cyst 244

Acute Pyelonephritis 245

Chronic Nonobstructive Pyelonephritis 247

Chronic Obstructive Pyelonephritis 249

Xanthogranulomatous Pyelonephritis 251

Renal Papillary Necrosis 253

Benign Nephrosclerosis 254

Malignant Nephrosclerosis 256

Acute Tubular Necrosis 258

Acute Interstitial Nephritis 260

Infectious Interstitial Nephritis 262

G.NEOPLASTIC DISEASE OF THE KIDNEY 265

Papillary Adenoma 266

Oncocytoma 267

Clear Cell Renal Cell Carcinoma 270

Multilocular Cystic Renal Cell Carcinoma 273

Papillary Renal Cell Carcinoma 274

Chromophotae Renal Cell Carcinoma 278

Collecting Duct Carcinoma 280

Renal Medullary Carcinoma 282

Renal Cell Carcinoma Associated With Neuroblastoma 284

Renal Cell Carcinoma Associated With Xp11.2 Translocation and TFE3 Gene Fusions 285

Mucinous Tubular and Spindle Cell Carcinoma 287

Renal Cell Carcinoma, Unclassified Type 289

Tubulocystic Carcinoma 291

Renal Cell Carcinoma Associated With Acquired Cystic Renal Diseases 293

Renal Cell Carcinoma With Sarcomatoid Differentiation 295

Thyroid Follicular Carcinoma-Like Renal Cell Carcinoma 297

Clear Cell Tubufopapillary Renal Cell Carcinoma 298

Renal Cell Carcinoma With Leiomyomatous Stroma 300

Metanephric Adenoma 302

Metanephric Stromal Tumor 304

Wilms Tumor 306

Nephrogenic Rests and Nephroblastomatosis 309

Congenital Mesoblastic Nephroma (CMN) 310

Rhabdoid Tumor of the Kidney 312

Clear Cell Sarcoma of the Kidney 314

Ossifying Renal Tumor of Infancy 316

Angiomyolipoma 317

Epithelioid Angiomyol ipoma 319

Juxtaglomerular Cell Tumor 322

Renal Medullary Fibroma (Renomedullary Interstitial Cell Tumor) 323

Cystic Nephroma and Mixed Epithelial and Stromal Tumor of the Kidney 324

Primary Renal Synovial Sarcoma 326

Renal Carcinoid Tumor 328

Fuhrman Grading System for Renal Cell Carcinoma 330

Staging of Renal Cell Carcinoma 332

Renal Cell Carcinoma in von Hippel-Lindau Disease 334

Renal Cell Neoplasms in Birt-Hogg-Dube Syndrome 335

Hereditary Leiomyomatosis and Renal Cell Carcinoma Syndrome 337

Renal Tumors in Tuberous Sclerosis 338

H.RENAL PELVIS AND URETER 339

Proliferative Ureteritis, Including Florid von Brunn Nests and Ureteropyelitis Cystica et Glandularis 340

Ureteropelvic Junction Obstruction 342

Idiopathic Retroperitoneal Fibrosis 344

Fibrocpithelial Polyp of the Ureter and Renal Pelvis 345

Ureteral Urothelial Carcinoma and Staging 346

Staging for Pelvic Urothelial Carcinoma 347

I.NONNEOPLASTIC DISEASE OF THE TESTIS 349

Anatomy and Histology 350

Cryptorchidism 352

Testiculosplenic Fusion 355

Adrenal Cortical Rests 357

Spermatic Cord Torsion and Testicular Infarction 358

Testicular Microlithiasis 359

Vasculitis 360

Male Infertility Work-Up 362

Maturation Arrest 363

Hypospermatogenesis 364

Germ Cell Aplasia, Sertoli Cell-Only Syndrome 365

Excurrent Duct Obstruction 366

Prepubertal Gonadotropin Deficiency 367

Postpubertal Gonadotropin Deficiency 368

Viral Orchitis 369

Granulomatous Orchiepididymitis 370

Nonspecific Granulomatous Orchitis 372

Congenital Adrenal Hyperplasia 373

Androgen Insensitivity Syndrome 375

Klinefelter Syndrome 376

Testicular Tumor of the Adrenogenital Syndrome 377

Embryonic Testicular Regression 379

Gonadal Dysgenesis 380

J.NEOPLASTIC DISEASE OF THE TESTIS 383

Testicular Intratubular Germ Cell Neoplasia, Unclassified 384

Seminoma 386

Spermatocytic Seminoma 390

Embryonal Carcinoma 391

Yolk Sac Tumor 394

Teratoma 397

Mixed Germ Cell Tumor 399

Teratoma With Somatic-Type Malignancies 401

Testicular Carcinoid Tumor 403

Dermoid Cyst 405

Epidcrmoid Cyst 406

Choriocarcinoma 407

Leydig Cell Tumor 408

Sertoli Cell Tumor 410

Sclerosing Sertoli Cell Tumor 413

Large Cell Calcifying Sertoli Cell Tumor 414

Granulosa Cell Tumor 416

Juvenile Granulosa Cell Tumor 418

Fibrothecoma 420

Stromal Tumor of the Testis, Unclassified Type 421

Gonadoblastoma 423

Testicular Lymphoma 425

Ovarian Epithelial-Type Testicular Tumors 427

Tumors of the Rete Testis 430

Testicular Cancer Staging 432

K.SPERMATIC CORD AND TESTICULAR ADNEXA 433

Appendix Testis 434

Appendix Epididymis 435

Glandular Inclusions in Inguinal Herniorrhaphy Specimens 436

Hydrocefe 437

Spermatocele 439

Vasitis Nodosa 440

Sperm Granuloma 441

Adenomatoid Tumor 442

Fibrous Pseudotumor 444

Paratesticular Idiopathic Smooth Muscle Hyperplasia 445

Papillary Cystadenoma of the Epididymis 446

Paratesticular Lipoma 447

Paratesticular Liposarcoma 448

Paratesticular Rhabdomyosarcoma 449

Leiomyoma of the Spermatic Cord and Testicular Adnexa 451

Paratesticular Leiomyosarcoma 452

Aggressive Angiomyxoma of the Male Genital Region 453

Cellular Angiofibroma 454

Malignant Mesothelioma, Paratesticular 456

Ovarian-Type Epithelial Tumors 458

Epithelial Tumors of the Rete Testis 460

L.DISEASE OF THE PENIS, URETHRA, AND SCROTUM 463

Fibroepithelial Polyp of the Urethra 464

Urethral Caruncle 466

Urethral Diverticulum 467

Urethral Stricture 468

Polypoid Urethritis 469

Condyloma Acuminatum 470

Prostatic-Type Urethral Polyp 471

Urethral Urothelial Carcinoma Associated With Bladder Urothelial Carcinoma 472

Primary Urethral Carcinoma 473

Urethral Adenocarcinoma 474

Clear Cell Adenocarcinoma of the Urethra 476

Zoon Balanitis 477

Lichen Sclerosus et Atrophicus (Balanitis Xerotica Obliterans) 478

Pseudoepitheliomatous Keratotic Micaceous Balanitis 480

Peyronie Disease 481

Squamous Hyperplasia of the Penis 482

Penile Intraepithelial Neoplasia, Including Bowen Disease, Erythroplasia of Queyrat and Bowenoid Papulosis 483

Squamous Cell Carcinoma of the Penis, Usual Type 485

Basaloid Squamous Cell Carcinoma 487

Penile Warty (Condylomatous) Carcinoma 489

Squamous Cell Carcinoma, Verrucous 490

Squamous Cell Carcinoma, Papillary 492

Squamous Cell Carcinoma, Pseudohyperplastic Nonverruciform 494

Sarcomatiod (Spindle Cell) Squamous Cell Carcinoma of the Penis 496

Adenosquamous Cell Carcinoma 498

Mixed Carcinomas of the Penis 499

Penile Basal Cell Carcinoma 500

Extramammary Paget Disease of Penis and Scrotum 501

Merkel Cell Carcinoma of the Genitourinary Tract 504

Sclerosing Lipogranuloma 506

Scrotal Calcinosis 507

Genital Melanosis and Lentiginosis 508

Primary Melanoma of the Genitourinary System 509

Staging for Penile Squamous Cell Carcinoma 510

Staging for Urethral Carcinoma 511

M.SOFT TISSUE TUMORS AND LYMPHOMAS 513

Inflammatory Myofibroblastic Tumor of the Bladder 514

Leiomyoma of the Bladder 516

Leiomyosarcoma of the Bladder 517

Solitary Fibrous Tumor 519

Gastrointestinal Stromal Tumor of the Genitourinary Tract 520

Lymphomas of the Genitourinary Organs 522

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