Pathology of the age of development

DISSCUSED PROBLEMSI. Subject of the pathology of the age of

developmentII. Pediatric neoplasia (neoplasms of the age of

development)(theory and interactive part)

III. Diagnostic methodes used in pathomorphology

(routine stains, immunohistochemistry, molecular biology)

IV. Currently used classification systems (aims, utility, general rules)

V. Summary – pathomorphology of the age of development

Pathology of the age of development

NEW TERMS• solid tumors• small round (blue) cell tumors

(SRCTs)

NEW DIAGNOSTIC METHODES• immunohistochemistry• molecular biology• microarray

Pathology of the age of development

INTERACTIVE PART (for notes)

• Wilms’ tumor

• neuroblastoma

• rhabdomyosarcoma

Pathology of the age of development

NOTES: Acute Leukemias

Symptom

• no matured RBC

• no matured WBC

• no matured platelets

Pathology of the age of development

NOTES: immunohistochemistry

• aim

• utility

• limitations

Pathology of the age of development

NOTES: molecular biology

• aim

• utility

• limitations

Pathology of the age of development

NEW CLASSIFICATION SYSTEMS- UTILITY & RULES

(for notes)1. Rule No 1

2. Rule No 2

3. Rule No 3

4. Rule No 4

5. Rule No 5

Pathology of the age of development

NEW CLASSIFICATION SYSTEMS- UTILITY & RULES

(for notes)New informations:• SIOP• NWTS Differences in treatment rules

(based on protocols for Wilms’ tumor)

Pathology of the age of development

INTERNATIONAL RMS CLASSIFICATION

I. Favorable Prognosis– a. Botryoid type– b. Spindle-cell subtype

II. Intermediate Prognosis– a. Embryonal RMS– b. Pleomorphic RMS

III. Poor Prognosis– a. Alveolar RMS - including solid variant– b. Undifferentiated

Pathology of the age of development• THE REVISED SIOP WORKING CLASSIFICATION OF RENAL

TUMORS OF CHILDHOOD (2001) (FOR PRE-TREATED CASES)

• I. LOW RISK TUMORS– Mesoblastic nephroma– Cystic partially differentiated nephroblastoma– Completely necrotic nephroblastoma

• II. INTERMEDIATE RISK TUMOURS– Nephroblastoma - epithelial type– Nephroblastoma - stromal type– Nephroblastoma - mixed type– Nephroblastoma - regressive type– Nephroblastoma - focal anaplasia NWTS

• III. HIGH RISK TUMOURS– Nephroblastoma - blastemal type– Nephroblastoma - diffuse anaplasia– Clear cell sarcoma of the kidney– Rhabdoid tumor of the kidney

Pathology of the age of development• THE REVISED SIOP WORKING CLASSIFICATION OF RENAL

TUMORS OF CHILDHOOD (2001) (FOR PRIMARY NEPHRECTOMY CASES )

• I. LOW RISK TUMORS– Mesoblastic nephroma– Cystic partially differentiated nephroblastoma

• II. INTERMEDIATE RISK TUMOURS– Non-anaplastic nephroblastoma and its variants– Nephroblastoma - focal anaplasia

• III. HIGH RISK TUMOURS– Nephroblastoma - diffuse anaplasia– Clear cell sarcoma of the kidney– Rhabdoid tumor of the kidney