Pathology of tumours of the urinary tract (original) (raw)

Attention is called to the difference between the pathologist's and the radiologist's point of view. The reasons for this difference are discussed with special emphasis on renal tumours. Classification of renal tumours. The first main groups are innocent and malignant. Are these really clear-cut or do they blend into one another ? The commoner innocent renal tumours are adenoma, fibroma, myoma, lipoma, and angioma. These are rarely of any clinical importance but adenoma is a possible source of hypernephroma. AMany elaborate classifications of cancer of the kidney have been proposed but the following four groups are sufficient for most purposes: Carcinoma, hypernephroma, sarcoma, and teratoid tumours. Much the commonest malignant renal tumour in adults is the hypernephroma, thought by Grawitz and others to be derived from ectopic adrenal rests. There is still no agreement concerning their origin but three views are held at the present time : (a) All are carcinoma of renal tubules. (b) Some are derived from renal tubules and some from ectopic adrenal. (c) All are formed from adrenal tissue. These views are discussed with special reference to material in St. Mary's Hospital Museum, and it is suggested that the first view is the most probable although the second cannot be excluded. The teratoid tumours are the commonest in infants and swine. The differences between them and hypernephromata are described. The renal pelvis, ureter, and bladder all have tumours of the same type and can conveniently be considered together. Connective tissue tumours, both innocent and malignant, are very rare. Papilloma and carcinoma are rare in the pelvis and ureter, but commoner in the bladder. The relation between these two tumours is discussed. REsuME.-L'auteur attire l'attention sur la difference entre les points de vue pathologique et radiologique, et en discute les causes, mentionnant en particulier les tumeurs du rein. Classification des tumeurs du rein. Les deux groupes principaux sont les tumeurs benignes et les tumeurs malignes. Ces groupes sont-ils vraiment distincts, ou se fondent-ils l'un dans l'autre ? Les tumeurs b6nignes les plus fr6quentes sont les ad6nomes, les fibromes, les myomes, les lipomes et les angiomes. Elles ont rarement une importance clinique, quoique l'adenome peut etre le point de depart d'un hypernephrome. Beaucoup de classifications 6labor6es des cancers du rein ont ete proposees, mais les quatre groupes suivants suffisent pour la plupart des cas: le carcinome, l'hypernephrome, le sarcome et les tumeurs teratoides. Chez les adultes, la tumeur maligne de beaucoup la plus fr6quente est l'hypern6phrome, que Grawitz, entre autres, a consider6 comme d6riv6 de restes ectopiques de glande surr6nale. Les auteurs ne s'accordent pas encore sur l'origine de ces tumeurs, mais trois opinions sont tenues aujourd'hui: (a) elles sont toujours des carcinomes des tubules r6nales, (b) quelques-unes derivent des tubules r6nales et d'autres de restes surr6naux, (c) elles derivent toujours du tissu surrenal. Ces opinions sont discutees ici avec allusion speciale au mat6riel du musee de l'H6pital de St. Mary. L'auteur suggere que la premiere theorie est la plus probable, mais que la seconde possibilite ne peut pas etre exclue. Chez les nourrissons et le porc les tumeurs les plus frequentes sont les tumeurs teratoides. L'auteur decrit les differences entre ces tumeurs et les hypernephromes. Le bassinet, l'uretere SEPT.-RAD. 1