Difference between revisions of "Diagnostic size cutoffs"
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[[Image:Lung carcinoid tumourlet - low mag.jpg|thumb|right|A [[carcinoid tumourlet]]; if it were larger it would be a [[carcinoid lung tumour]]. [[H&E stain]].]] | |||
'''Diagnostic size cutoffs''' are cutoffs which (in part) define a [[diagnosis]] and are seen in a number of places in [[pathology]]. They are usually somewhat arbitrary by their nature; however, they often make sense from a biologic big picture/management perspective. It doesn't make sense to treat [[ADH]] and low-grade [[DCIS]] the same, as their behaviour is different. | '''Diagnostic size cutoffs''' are cutoffs which (in part) define a [[diagnosis]] and are seen in a number of places in [[pathology]]. They are usually somewhat arbitrary by their nature; however, they often make sense from a biologic big picture/management perspective. It doesn't make sense to treat [[ADH]] and low-grade [[DCIS]] the same, as their behaviour is different. | ||
In [[pathology]], size matters. With other things equal, in the context of how tumours are currently evaluated, big tumours do worse than small tumours. | ==Rationale== | ||
In [[pathology]], size matters. With other things equal, in the context of how tumours are currently evaluated, big tumours usually do worse than small tumours. | |||
==A table of diagnostic size cutoffs== | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
!Smaller lesion (precursor) | !Smaller lesion (precursor) | ||
| Line 10: | Line 13: | ||
|- | |- | ||
|[[Papillary adenoma of the kidney]] | |[[Papillary adenoma of the kidney]] | ||
|<= | |<=1.5 cm<ref name=pmid26935559>{{Cite journal | last1 = Moch | first1 = H. | last2 = Cubilla | first2 = AL. | last3 = Humphrey | first3 = PA. | last4 = Reuter | first4 = VE. | last5 = Ulbright | first5 = TM. | title = The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours. | journal = Eur Urol | volume = | issue = | pages = | month = Feb | year = 2016 | doi = 10.1016/j.eururo.2016.02.029 | PMID = 26935559 }}</ref> | ||
|[[Papillary renal cell carcinoma]] | |[[Papillary renal cell carcinoma]] | ||
| - | | must be low [[ISUP nucleolar grade]] to call ''papillary adenoma''; cut-off was 0.5 cm in previous WHO GU book<ref>{{Ref WHOGU|28}}</ref> | ||
|- | |- | ||
| [[Atypical alveolar hyperplasia]] | | [[Atypical alveolar hyperplasia]] | ||
| Line 22: | Line 25: | ||
| <2mm | | <2mm | ||
| Low-grade [[ductal carcinoma in situ]] | | Low-grade [[ductal carcinoma in situ]] | ||
| Different criterion for lesions in an [[intraductal papilloma]] | | Different criterion for lesions in an [[intraductal papilloma of the breast]] | ||
|- | |- | ||
| [[Atypical ductal hyperplasia]] in an [[intraductal papilloma]] | | [[Atypical ductal hyperplasia]] in an [[intraductal papilloma of the breast]] | ||
| <3mm | | <3mm | ||
| Low-grade [[ductal carcinoma in situ]] in an intraductal papilloma | | Low-grade [[ductal carcinoma in situ]] in an intraductal papilloma | ||
| Different criterion for lesions '''not''' in an [[intraductal papilloma]] | | Different criterion for lesions '''not''' in an [[intraductal papilloma of the breast]] | ||
|- | |- | ||
| [[Pulmonary carcinoid tumourlet]] | | [[Pulmonary carcinoid tumourlet]] | ||
| < | | <5 mm<ref name=pct_ucsf>URL: [http://pathhsw5m54.ucsf.edu/case7/image75.html http://pathhsw5m54.ucsf.edu/case7/image75.html]. Accessed on: 23 January 2012.</ref><ref name=pmid23205296>{{Cite journal | last1 = He | first1 = P. | last2 = Gu | first2 = X. | last3 = Wu | first3 = Q. | last4 = Lin | first4 = Y. | last5 = Gu | first5 = Y. | last6 = He | first6 = J. | title = Pulmonary carcinoid tumorlet without underlying lung disease: analysis of its relationship to fibrosis. | journal = J Thorac Dis | volume = 4 | issue = 6 | pages = 655-8 | month = Dec | year = 2012 | doi = 10.3978/j.issn.2072-1439.2012.06.11 | PMID = 23205296 }}</ref> | ||
| [[Typical carcinoid lung tumour]] | | [[Typical carcinoid lung tumour]] | ||
| ''Typical carcinoid lung tumour'' '''not''' a cancer | | ''Typical carcinoid lung tumour'' '''not''' a cancer | ||
| Line 49: | Line 52: | ||
{{Reflist|1}} | {{Reflist|1}} | ||
[[Category: | [[Category:Cancer staging]] | ||
Latest revision as of 03:59, 27 May 2016
Diagnostic size cutoffs are cutoffs which (in part) define a diagnosis and are seen in a number of places in pathology. They are usually somewhat arbitrary by their nature; however, they often make sense from a biologic big picture/management perspective. It doesn't make sense to treat ADH and low-grade DCIS the same, as their behaviour is different.
Rationale
In pathology, size matters. With other things equal, in the context of how tumours are currently evaluated, big tumours usually do worse than small tumours.
A table of diagnostic size cutoffs
| Smaller lesion (precursor) | Cutoff value (smaller lesion) | Larger lesion (cancer) | Notes |
|---|---|---|---|
| Papillary adenoma of the kidney | <=1.5 cm[1] | Papillary renal cell carcinoma | must be low ISUP nucleolar grade to call papillary adenoma; cut-off was 0.5 cm in previous WHO GU book[2] |
| Atypical alveolar hyperplasia | <5 mm[3] | Adenocarcinoma in situ of the lung | - |
| Atypical ductal hyperplasia | <2mm | Low-grade ductal carcinoma in situ | Different criterion for lesions in an intraductal papilloma of the breast |
| Atypical ductal hyperplasia in an intraductal papilloma of the breast | <3mm | Low-grade ductal carcinoma in situ in an intraductal papilloma | Different criterion for lesions not in an intraductal papilloma of the breast |
| Pulmonary carcinoid tumourlet | <5 mm[4][5] | Typical carcinoid lung tumour | Typical carcinoid lung tumour not a cancer |
See also
References
- ↑ Moch, H.; Cubilla, AL.; Humphrey, PA.; Reuter, VE.; Ulbright, TM. (Feb 2016). "The 2016 WHO Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours.". Eur Urol. doi:10.1016/j.eururo.2016.02.029. PMID 26935559.
- ↑ The International Agency for Research on Cancer (Author), J. Eble (Editor), J. Epstein (Editor), I. Sesterhenn (Editor), G. Sauter (Editor) (2004). Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs (IARC WHO Classification of Tumours) (1st ed.). Lyon: World Health Organization. pp. 28. ISBN 978-9283224150.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 114. ISBN 978-0781765275.
- ↑ URL: http://pathhsw5m54.ucsf.edu/case7/image75.html. Accessed on: 23 January 2012.
- ↑ He, P.; Gu, X.; Wu, Q.; Lin, Y.; Gu, Y.; He, J. (Dec 2012). "Pulmonary carcinoid tumorlet without underlying lung disease: analysis of its relationship to fibrosis.". J Thorac Dis 4 (6): 655-8. doi:10.3978/j.issn.2072-1439.2012.06.11. PMID 23205296.