Selected Common Diagnostic Problems in Urologic Pathology: Perspectives From a Large Consult Service in Genitourinary Pathology

SPECIAL ISSUE–INSIGHTS AND CONTROVERSIES IN UROLOGIC PATHOLOGY

Selected Common Diagnostic Problems in Urologic Pathology: Perspectives From a Large Consult Service in Genitourinary Pathology

Fadi Brimo, MD; Jonathan I. Epstein, MD

From the Departments of Pathology and Urology, McGill University Health Center, Montréal, Quebec, Canada (Dr Brimo); and the Departments of Pathology, Urology, and Oncology, Johns Hopkins Hospital Medical Institutions, Baltimore, Maryland (Dr Epstein).

The authors have no relevant financial interest in the products or companies described in this article.

Reprints: Jonathan I Epstein, MD, Department of Pathology, The Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287, (e-mail: jepstein@jhmi.edu).

Context.—Several common differential diagnoses are encountered in urologic pathology, frequently causing patient referrals for a second opinion.

Objectives.—To review 3 common differential diagnoses encountered in a large consultation service in genitourinary pathology, including partial atrophy versus prostatic acinar adenocarcinoma, oncocytoma versus chromophobe renal cell carcinoma, and urothelial carcinoma in situ versus normal urothelium and reactive atypia. We will discuss the detailed, morphologically distinctive features and the usefulness of immunohistochemistry.

Data Sources.—Personal experience and review of the current literature.

Conclusions.—Careful morphologic assessment and awareness of diagnostic pitfalls are fundamental in reaching a definitive diagnosis in most cases. Immunohistochemistry is useful but should be used only in conjunction with the morphologic impression.

Accepted: May 13, 2011;

College of American Pathologist

Original Web: http://www.archivesofpathology.org/doi/full/10.5858/arpa.2011-0187-RA?=

Descarga formato PDF – Free Article: http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2011-0187-RA

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