1. Pathology of the age of development DISSCUSED PROBLEMS I. Subject of the pathology of the age of development II. 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

2. Pathology of the age of development NEW TERMS solid tumors small round (blue) cell tumors (SRCTs) NEW DIAGNOSTIC METHODES immunohistochemistry molecular biology microarray

3. Pathology of the age of development INTERACTIVE PART (for notes) Wilms’ tumor neuroblastoma rhabdomyosarcoma

4. Pathology of the age of development NOTES: Acute Leukemias Symptom no matured RBC no matured WBC no matured platelets

5. Pathology of the age of development NOTES: immunohistochemistry aim utility limitations

6. Pathology of the age of development NOTES: molecular biology aim utility limitations

7. 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

8. 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)

9. Pathology of the age of development INTERNATIONAL RMS CLASSIFICATION I. Favorable Prognosis – a. Bo t ryoid 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

10. 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

11. 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