CA: A Cancer Journal for Clinicians, Vol 21, 162-173, Copyright
© 1971 by American Cancer Society
The Pathology of Tumors, Part One
Lauren V. Ackerman M.D.1 and
Juan Rosai M.D.2
1 Professor of Surgical Pathology and Pathology, Washington University School of Medicine, and Surgical Pathologist, Barnes Hospital and affiliated hospitals, St. Louis, Missouri.
2 Assistant Professor of Pathology, Washington University School of Medicine, and Surgical Pathologist, Barnes Hospital and affiliated hospitals.
The biological behavior of a tumor is the clinician's, patient's, and must be the pathologist's main concern. Predicting this behavior accurately requires clinical as well as microscopic information since the morphology of a tumor may be inconsistent with its true nature. [See Fig. 23. in source pdf.]
The pathologist's final decision should be communicated in terms most useful to the surgeon, avoiding emphasis on subclassifications, except where they are clinically significant, and adapting his terminology so that, in those situations where typing or subtyping may influence the choice of therapy, his recommendations are clear to the surgeon.
Evaluating precancerous conditions and benign tumors that resemble cancer creates special problems for the pathologist. Many conditions previously designated as "precancerous" have, in fact, a very low potential for malignant development and only extreme care in assessing these lesions will prevent unnecessary surgery for a truly benign condition or conservative management of a condition which will inevitably become cancer.
There are a number of lesions, many of which are not even neoplastic, that microscopically resemble cancer. Here again the pathologist must exercise great care that drastic surgery is not performed for a perfectly benign lesion with an ominous appearance, or that treatment of cancer is not delayed.
