Eble JN, Sauter G, Epstein JI and Sesterhenn IA (eds):

Pathology and Genetics, Tumors of the Urinary System and Male Genital Organs, 359 pp, Lyon, France, World Health Organization, International Agency for Research on Cancer, 2004 ($75).

Tumors of the Urinary System and Male Genital Organs is a new addition to the series of WHO ‘blue books’ dealing with the classification of tumors. I am sure that it will be welcomed by pathologists worldwide in the same way as its predecessors.

Similar in form and layout to other books of the series, this book is a very attractive and nicely produced paperback. It comprises five major sections, each subdivided into a number of subsets and short chapters pertaining to tumors of the kidney, the urinary system, the prostate, the testis and paratesticular tissues, and the penis. Each section begins with the latest WHO classification of tumors at the respective anatomic site, and also includes a brief TNM classification. The data on each tumor type are presented systematically, in a standardized manner and are accompanied by citation from the most recent literature. The text is succinct, well written and meticulously edited. Even though the emphasis is on the histopathology of tumors, selected epidemiologic, clinical, genetic, immunohistochemical and ultrastructural data are also given when necessary. The contributors and editors deserve to be congratulated for compressing so many facts into so few pages and making the text so readable. Furthermore, praise should go to the entire group on their team effort, for eliminating the trivia and concentrating on the important aspects of urogenital oncology, and for choosing the most relevant and up-to-date publications for reference. The illustrations are almost invariably first class and are used effectively to reinforce the salient points in the text. The tables are also very useful.

One of the most notable novelties in this book is probably the classification of noninvasive urothelial neoplasms. This new WHO classification replaces the commonly used three-tier grading scheme (papillary carcinomas, grade I, II, III). Instead, the tumors are classified as papillary urothelial neoplasm of low malignant potential (PUNLMP), low-grade noninvasive papillary urothelial carcinoma, and high-grade noninvasive papillary urothelial carcinoma. The validity of this grading system is supported by genetic and clinical follow-up studies. This two-tier grading of carcinomas avoids the use of the more ambiguous ‘grade II’ in the old grading scheme. The diagnostic criteria of all these categories are clearly defined in the text and supplemented by a very useful flow chart.

The spectrum of kidney tumors was expanded by new entities, such as mucinous tubular spindle cell carcinoma. It is a low-grade polymorphic renal epithelial neoplasm with mucinous tubular and spindle cell features. The sarcomatoid renal cell carcinoma is categorized under unclassified renal cell carcinoma because it is not viewed as a type per se, but rather as a high-grade carcinoma arising in another tumor type.

Consistent use of a well-recognized tumor classification and uniform diagnosis of tumors between institutions are crucial for good patient care, but also for comparative clinical and pathological studies. This book, published at a very reasonable price, should be central in the diagnoses and management of urinary tract tumors on a daily basis. This book should be an essential reading for pathology and urology residents, and should be used by practicing pathologists, urologists and oncologists as well.