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.pdfTumours oftheLung,ClasificationPleura,WHO Thymus
IARC
World Health Organization Classification of Tumours
Pathology & Genetics
Tumours of the Lung, Pleura,
Thymus and Heart
Edited by William D. Travis, Elizabeth Brambilla,
H. Konrad Müller-Hermelink and Curtis C. Harris
Previous volumes in this series
Kleihues P., Cavenee W.K. (Eds.): |
Hamilton S.R., Aaltonen L.A. (Eds.): |
Jaffe E.S., Harris N.L., Stein H., |
World Health Organization |
World Health Organization |
Vardiman J.V. (Eds.): World Health |
Classification of Tumours. |
Classification of Tumours. |
Organization Classification ofTumours. |
Pathology and Genetics of |
Pathology and Genetics of Tumours |
Pathology and Genetics ofTumours of |
Tumours of the Nervous System. |
of the Digestive System. |
Haematopoietic and LymphoidTissues. |
IARC Press: Lyon 2000 |
IARC Press: Lyon 2000 |
IARC Press: Lyon 2001 |
ISBN 92 83 22409 4 |
ISBN 92 83 22410 8 |
ISBN 92 83 22411 6 |
Fletcher C.D., Unni K.K., |
Tavassoli F.A., Devilee P. (Eds.): |
Eble J.N., Sauter G., Epstein J.E., |
Mertens F. (Eds.): World Health |
World Health Organization |
Sesterhenn I.A. (Eds.): World Health |
Organization Classification of Tumours. |
Classification of Tumours. |
Organization Classification of Tumours. |
Pathology and Genetics of Tumours of |
Pathology and Genetics of Tumours of |
Pathology and Genetics of Tumours of |
Soft Tissue and Bone. |
the Breast and Female Genital Organs |
the Urinary System and Male Genital |
IARC Press: Lyon 2002 |
IARC Press: Lyon 2003 |
Organs. |
ISBN 92 832 2413 2 |
ISBN 92 832 2412 4 |
IARC Press: Lyon 2004 |
|
|
ISBN 92 832 2415 9 |
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World Health Organization Classification of Tumours
WHO |
OMS |
International Agency for Research on Cancer (IARC)
Pathology and Genetics of
Tumours of the Lung, Pleura,
Thymus and Heart
Edited by
William D. Travis
Elisabeth Brambilla
H. Konrad Müller-Hermelink
Curtis C. Harris
IARCPress
Lyon, 2004
World Health Organization Classification of Tumours
Series Editors Paul Kleihues, M.D.
Leslie H. Sobin, M.D.
Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart
Editors |
William D. Travis, M.D. |
|
Elisabeth Brambilla, M.D. |
|
H. Konrad Müller-Hermelink, M.D. |
|
Curtis C. Harris, M.D. |
Coordinating Editors |
Wojciech Biernat, M.D. |
|
Janice Sych, Ph.D. |
Editorial Assistants |
Stéphane Sivadier |
|
Agnès Meneghel |
|
Voichita Meyronein |
Layout |
Vanessa Meister |
|
Marlen Grassinger |
|
Sibylle Söring |
Illustrations |
Thomas Odin |
Printed by |
Team Rush |
|
69603 Villeurbanne, France |
Publisher |
IARCPress |
|
International Agency for |
|
Research on Cancer (IARC) |
|
69008 Lyon, France |
This volume was produced in collaboration with the
International Academy of Pathology (IAP)
and the
International Association for the Study of Lung Cancer (IASLC)
The WHO Classification of Tumours of Lung, Thymus and Heart presented in this book reflects the views of a Working Group that convened for an Editorial and Consensus Conference in Lyon, France, March 12-16, 2003.
Members of the Working Group are indicated in the List of Contributors on page 289.
Published by IARC Press, International Agency for Research on Cancer, 150 cours Albert Thomas, F-69008 Lyon, France
© International Agency for Research on Cancer, 2004. Reprinted 2007.
Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved.
The International Agency for Research on Cancer welcomes
requests for permission to reproduce or translate its publications, in part or in full. Requests for permission to reproduce figures or charts from this publication should be directed to
the respective contributor (see section Source of Charts and Photographs).
The designations used and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the
World Health Organization concerning the legal status of any country, territory, city, or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the World Health Organization in preference to others
of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
The authors alone are responsible for the views expressed in this publication.
Enquiries should be addressed to the
Communications Unit, International Agency for Research on Cancer, 69008 Lyon, France, which will provide the latest information on any changes made to the text and plans for new editions.
Format for bibliographic citations:
Travis W.D., Brambilla E., Muller-Hermelink H.K., Harris C.C. (Eds.): World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. IARC Press: Lyon 2004
IARC Library Cataloguing in Publication Data
Pathology and genetics of tumours of the lung, pleura, thymus and heart / editors W.D. Travis… [et al.]
(World Health Organization classification of tumours ; 7)
1. Lung neoplasms - genetics 2. Lung neoplasms - pathology
3. Pleura neoplasms - genetics 4. Pleura neoplasms, - pathology 5. Thymus neoplasms - genetics 6. Thymus neoplasms - pathology 7. Heart neoplasms – genetics 8. Heart neoplasms - pathology
I. Travis William D. II. Series
ISBN 92 832 2418 3 (NLM Classification: WJ 160)
Contents
1 Tumours of the lung |
9 |
WHO and TNM classifications |
10 |
Introduction |
12 |
Epidemiology and etiology |
12 |
Clinical features and staging |
16 |
Concept of pulmonary neuroendocrine tumours |
19 |
Genetic and molecular alterations |
21 |
Genetic susceptibility |
24 |
Malignat epithelial tumours |
26 |
Squamous cell carcinoma |
26 |
Small cell carcinoma |
31 |
Adenocarcinoma |
35 |
Mixed subtype |
37 |
Acinar adenocarcinoma |
37 |
Papillary adenocarcinoma |
38 |
Bronchioloalveolar adenocarcinoma |
38 |
Solid adenocarcinoma |
38 |
Fetal adenocarcinoma |
40 |
Mucinous (colloid) adenocarcinoma |
40 |
Mucinous cystadenocarcinoma |
40 |
Signet ring adenocarcinoma |
40 |
Clear cell adenocarcinoma |
40 |
Large cell carcinoma |
45 |
Large cell neuroendocrine carcinoma |
47 |
Basaloid carcinoma |
48 |
Lymphoepithelioma-like carcinoma |
48 |
Clear cell carcinoma |
48 |
Rhabdoid phenotype |
48 |
Adenosquamous carcinoma |
51 |
Sarcomatoid carcinoma |
53 |
Pleomorphic carcinoma |
55 |
Spindle cell carcinoma |
55 |
Giant cell carcinoma |
55 |
Carcinosarcoma |
56 |
Pulmonary blastoma |
56 |
Carcinoid tumour |
59 |
Typical carcinoid |
59 |
Atypical carcinoid |
59 |
Salivary gland tumours |
63 |
Mucoepidermoid carcinoma |
63 |
Adenoid cystic carcinoma |
65 |
Epithelial-myoepithelial carcinoma |
67 |
Preinvasive epithelial lesions |
68 |
Squamous dysplasia and carcinoma in situ |
68 |
Atypical adenomatous hyperplasia |
73 |
Diffuse idiopathic pulmonary neuroendocrine |
76 |
cell hyperplasia |
|
Benign epithelial lesions |
78 |
Papilloma |
78 |
Squamous cell papilloma |
78 |
Glandular papilloma |
80 |
Mixed papilloma |
81 |
Alveolar adenoma |
82 |
Papillary adenoma |
84 |
Adenomas of salivary gland type |
85 |
Mucous gland adenoma |
85 |
Pleomorphic adenoma |
86 |
Mucinous cystadenoma |
87 |
Lymphoid / histiocytic tumours |
88 |
MALT lymphoma |
88 |
Diffuse large B-cell lymphoma |
91 |
Lymphomatoid granulomatosis |
92 |
Pulmonary Langerhans cell histiocytosis |
95 |
Mesenchymal tumours |
97 |
Epithelioid haemangioendothelioma / |
|
angiosarcoma |
97 |
Pleuropulmonary blastoma |
99 |
Chondroma |
101 |
Congenital peribronchial |
|
myofibroblastic tumour |
102 |
Diffuse pulmonary lymphangiomatosis |
104 |
Inflammatory myofibroblastic tumour |
105 |
Lymphangioleiomyomatosis |
107 |
Pulmonary vein sarcoma |
108 |
Pulmonary artery sarcoma |
109 |
Synovial sarcoma |
111 |
Miscellaneous tumours |
113 |
Hamartoma |
113 |
Sclerosing haemangioma |
115 |
Clear cell tumour |
118 |
Teratoma |
119 |
Intrapulmonary thymoma |
120 |
Melanoma |
121 |
Metastases to the lung |
122 |
2 Tumours of the pleura |
125 |
WHO and TNM classifications |
126 |
Mesothelioma |
128 |
Epithelioid mesothelioma |
132 |
Sarcomatoid mesothelioma |
133 |
Desmoplastic mesothelioma |
133 |
Biphasic mesothelioma |
134 |
Well differentiated papillary mesothelioma |
135 |
Localized malignant mesothelioma |
136 |
Adenomatoid tumour |
136 |
Lymphomas |
137 |
Primary effusion lymphoma |
137 |
Pyothorax-associated lymphoma |
138 |
Mesenchymal tumours |
141 |
Epithelioid haemangioendothelioma / |
|
angiosarcoma |
141 |
Synovial sarcoma |
141 |
Solitary fibrous tumour |
142 |
Calcifying tumour |
143 |
Desmoplastic small round cell tumour |
144 |
3 Tumours of the thymus |
145 |
WHO and TNM classifications |
146 |
Tumours of the Thymus: Introduction |
148 |
Thymomas |
152 |
Type A |
154 |
Type AB |
157 |
Type B1 |
159 |
Type B2 |
161 |
Type B3 |
164 |
Micronodular thymoma |
167 |
Metaplastic thymoma |
169 |
Microscopic thymoma |
171 |
Sclerosing thymoma |
171 |
Lipofibroadenoma |
171 |
Thymic carcinomas |
172 |
Squamous cell carcinoma |
172 |
Basaloid carcinoma |
175 |
Mucoepidermoid carcinoma |
176 |
Lymphoepithelioma-like carcinoma |
177 |
Sarcomatoid carcinoma |
179 |
Clear cell carcinoma |
182 |
Papillary adenocarcinoma |
183 |
Non-papillary adenocarcinoma |
184 |
Carcinoma with t(15;19) translocation |
185 |
Undifferentiated carcinoma |
187 |
Thymic neuroendocrine tumours |
188 |
Typical carcinoid |
191 |
Atypical carcinoid |
191 |
Large cell neuroendocrine carcinoma |
193 |
Small cell neuroendocrine carcinoma |
193 |
Combined thymic epithelial tumours |
196 |
Germ cell tumours of the mediastinum |
198 |
Seminoma |
202 |
Embryonal carcinoma |
205 |
Yolk sac tumour |
207 |
Choriocarcinoma |
209 |
Teratoma |
210 |
Mixed germ cell tumours |
213 |
GCT with somatic type malignancy |
216 |
GCT with haematologic malignancies |
219 |
Lymphomas of the mediastinum |
221 |
Primary large B-cell lymphoma |
222 |
Thymic MALT lymphoma |
225 |
Precursor T-lymphoblastic lymphoma / |
|
leukaemia |
227 |
Anaplastic large T-cell lymphoma |
229 |
Hodgkin lymphoma |
230 |
Grey zone lymphoma Hodgkin / NHL |
233 |
Histiocytic tumours |
234 |
Dendritic cell tumours |
236 |
Myeloid sarcoma and extramedullary AML |
238 |
Soft tissue tumours of the mediastinum |
239 |
Thymolipoma |
239 |
Mediastinal lipoma |
240 |
Liposarcoma |
240 |
Solitary fibrous tumour |
241 |
Rhabdomyosarcoma |
242 |
Synovial sarcoma |
244 |
Vascular neoplasms |
244 |
Leiomyomatous tumours |
244 |
Neurogenic tumours |
245 |
Ectopic thyroid tumours |
246 |
Ectopic parathyroid tumours |
246 |
Metastases to the mediastinum |
247 |
4 Tumours of the heart |
249 |
WHO classification |
250 |
Introduction |
251 |
Benign tumours with myocyte differentiation |
254 |
Rhabdomyoma |
254 |
Histiocytoid cardiomyopathy |
256 |
Hamartoma of mature cardiac myocytes |
258 |
Adult cellular rhabdomyoma |
259 |
Benign tumours of pluripotent mesenchyme |
260 |
Cardiac myxoma |
260 |
Papillary fibroelastoma |
263 |
Haemangioma |
266 |
Benign tumours with myofibroblastic |
|
differentiation |
268 |
Cardiac fibroma |
268 |
Inflammatory myofibroblastic tumour |
270 |
Cardiac lipoma |
271 |
Cystic tumour of atrioventricular node |
272 |
Cardiac sarcomas |
273 |
Angiosarcoma |
273 |
Epithelioid haemangioendothelioma |
275 |
Pleomorphic malignant fibrous histiocytoma / |
|
unidifferentiated pleomorphic sarcoma |
276 |
Fibrosarcoma and myxosarcoma |
277 |
Rhabdomyosarcoma |
278 |
Leiomyosarcoma |
280 |
Synovial sarcoma |
280 |
Cardiac lymphomas |
282 |
Metastatic tumours to the heart |
284 |
Pericardial tumours |
285 |
Solitary fibrous tumour |
285 |
Malignant mesothelioma |
286 |
Germ cell tumours |
287 |
Metastatic pericardial tumours |
287 |
Contributors |
299 |
Source of charts and photographs |
304 |
References |
306 |
Subject index |
353 |