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Flistological Typing of Bone Tumours FlistologicalTyping of BoneTumours F, Schajowicz In Collaboration with Pathologistsin 9 Countries SecondE,dition With 166Figures, Mostly in Colour Springer-Verlag Berlin Heidelberg NewYork London Paris Tokyo HongKong Barcelona Budapest F.Schajowicz f Head, WHO CollaboratingCentre for the Histological Classificationof Bone Tumours Italian Hospital, Buenos Aires, Argentina andDepartment of Orthopedic Surgery and Pathology St. Louis University Medical Center, St. Louis, Missouri, USA Series Editor L. H. Sobin Head, WHO Collaborating Centre for the International Histological Classificationof Tumours Armed Forces Institute of Pathology,Washington, DC, USA In this series,colour illustrations will be limited in number in order to maintain a reasonablesales price. The printing of additional colour figures was made possible by financial support from Prof. F.J.Martinez-Tello, Madrid, Dr. T.Matsuno, Kita-Ku Sapporo, Prof. Dr. M. Salzer-Kuntschik, Yienna and the following Japanese companies: Daiichi Pharmacological Co., Howmedica, Mitsubishi Yuka Bio-clinical Laboratories Inc., Roussel Morishita KK, Taisho Pharmacological Co. Firstcdition publishcd by WHO in 1972 as No 6 in thc IntcrnationalHistological Classificat ion of Tumours scncs ISBN 3-540-56460-8Springer-Verlag Berlin HeidelbergNewYork ISBN 0-387-56460-8Springer-Verlag NewYork Berlin Heidelberg Library of CongressClatalogrng-in Publication Data Schalowicz.Fnlz Histologicaltyprngofbonetumors/F.Schajowicz.incollaborationwithpathologistsin9countrics 2ndedpcm (lnternationalhrstologlcalclassrticationoftumors)lncludcsbibliographrcalreferencesandrndex ISBN 3-540-56,160-lJ(alk paper) ISBN 0-387-56460-8(alk papcr) I Bones Tumors Histopalhology 2 Bones Tumors Cllassit'ication I litlc II Series:lnternationalhistonalclas- - sification of tumors (Unnumbered) [DNLM: I Bof,c Ncoplasms classrfication 2 Bone Neoplasms pathology WE258S296h19931RC280865318 199361699'271 0014 dc20 DNLM/DLClorLibraryofCongrcss93 17622CIP Thls work is sub]ect to copynght All rights are reservcd whcthcr thc whole or parl of thc material is concerned. spccifi- callythcrightsoftranslahon,repnnring reuscofillustrations,rccitation.broadcasLing.reproductiononmicrolilmorin anyothcrwav.andstoragcindatabanks Duplicationofthispubhcatlonorpartsthereofrspermittcdonl],undcrthepro visionsofthcGermanCopyrightLawofScptcmber9 l965.initscurrentversion,andpermissionforuscmuslalwaysbe obtained from Springcr-Vcrlag Violations arc liablc for proscculion under the German Copyright Law O Spnnger Verlag Berhn Heidelberg 1993 Prinled in Germany Theuseolgcneraldescriptivenames.registerednames.tradcmarks.ctcinthispublicaliondoesnotimpl)'.eveninthcab- senceof a specificstatement. that such names are exempt liom thc rclcvant proteclivc laws and regulalions and thercforc frcc lbr gcncral usc Product liability: Thc publishcrs cannot guarantcc thc accuracy of any information about dosagc and application con- tainedinthisbook lneveryindividualcasethcuscrmustch cksuchinformatlonbyconsultingthcrelcvantlitcraturc Reproduction of Lhefigures: Gustav Dreher GmbH. Sluttgart Typesettrngand printing: Appl. Wemdrng: Binding: SchiifTcr,Griinstadt 21131455 4 3 2 1 0 Prinledonacid keeDaDer Participants Ackerman,L.V., M. D. Department of Pathology,State University of New york at Stony Brook, StonyBrook, New York, USA Adler C. P.,M. D. PathologischesInstitut der Universit?itFreiburg (Ludwig-Aschoff Haus),Freiburg i. Br.,FRG Bertoni,F., M. D. AnatomiaPathologia Malpighi, Bologna, Italy Donato de Pr6spero,J., M. D. DepartamentoPatol6gica Anatomfa, Faculdade de Ciencias Medicasde SantaCasa de S5oPaulo. Brazll Martinez Tello.F.J.. M. D. Hospital"Primero de Octubre,"Departamento de Anatomia Patol6gica,Madrid, Spain Mazabraud,A., M. D. Pavillon Ollier, Hospital Cochin,Paris, France Matsuno,7.,M. D. Departmentof Orthopaedics,Hokkaido UniversitySchool of Medicine,Kita-Ku, Sapporo,Japan Povysil,C., M. D. SecondDepartment of Pathology,Charles University, prague, Czechoslovakia VI Participants Salzer-Kuntschik,M., M. D. Institut fiir PathologischeAnatomie, Vienna,Austria Schajowicz,F, M. D. t Head,WHO CollaboratingCentre forthe Histological Classificationof BoneTumours, Italian Hospital, Buenos Aires, Argentina,andDeparrment of OrthopedicSurgery and Pathology,St. Louis University Medical Center,St. Louis, Missouri.USA Slssorzs.H.4.. M. D. Departmentof Pathology,Hospital for Joint Diseases,Orthopedic Institute, New York, USA, Presentaddress: Histopathology Unit, Imperial CancerResearch Fund Laboratories, Royal Collegeof Surgeonsof England,London, UK Sobin,L. H., M. D. Head,WHO CollaboratingCentre for InternationalHistologica- Classificationof Tumours,Armed ForcesInstitute of Pathology, Washington,DC, USA Unni.K. K.. M.8.. B. S. Department of SurgicalPathology, Mayo Clinic, Rochester, Minnesota.USA General Prefaceto the Series Among the prerequisitesfor comparativestudies of cancerare inter- national agreementon histologicalcriteria for the definition and clas- sificationof cancertypes and a standardizednomenclature. An in- ternationally agreed classificationof tumours, acceptablealike to physicians,surgeons, radiologists, pathologists and statisticians, would enable cancer workers in all parts of the world to compare their findingsand would facilitatecollaboration among them. In a report published in 7952,1a subcommittee of the World Health Organization(WHO) Expert Committee on Health Statistics discussedthe general principles that should govern the statistical classificationof tumours and agreed that, to ensure the necessary flexibility and ease of coding, three separate classificationswere neededaccording to (1) anatomicalsite, (2) histologicaltype, and (3) degreeof malignancy.A classificationaccording to anatomicalsite is availablein the InternationalClassification of Diseases.2 In 1956,the WHO ExecutiveBoard passeda resolution3request- ing the Director-Generalto explore the possibilitythat WHO might organizecentres in variousparts of the world and arrangefor the col- lection of human tissuesand their histological classification.The main purposeof suchcentres would be to develophistological defini- tions of cancertypes and to facilitate the wide adoption of a uniform nomenclature. The resolution was endorsed by the Tenth World Health Assemblyin May 7957.4 I WHO (1952)WHO TechnicalReport Series. No.53, 1952,p 45 2 WHO (1977)Manual of the internationalstatistical classification of diseases. iniuries,and causes of death,1975 version. Geneva 3 wHo (1956)WHO OfficialRecords. No.68, p 14(resolution EB 17.R40) 4 wHo (1957)WHO OfficialRecords. No.79, p467 (resolution WHA 10.18) VIII General Prefaceto the Series Since1958, WHO hasestablished a numberof centresconcerned with this subject.The resultof this endeavourhas been the Interna- tional HistologicalClassification of Tumours,a multivolumedseries whosefirst edition waspublished between 1967 and 1981.The pre- sentrevised second edition aimsto updatethe classification,reflect- ing progressin diagnosisand the relevanceof tumour typesto clinical and epidemiologicalfeatures. Preface to Histological Typittg of Bone Tlrmours.Second Edition The first edition of HistologicalTyping of Bone TumoursI wasthe re- sult of a collaborativeeffort organizedby WHO and carried out by the International Reference/CollaboratingCentre for the Histologi- cal Classificationof Bone Tumours at the Osteo-Articular Pathology Centre,Italian Hospital,Buenos Aires, Argentina.The Centrewas establishedin 1963,and the classificationwas publishedin7972. In order to keepthe classificationup to date,the Centrecirculated a setof revisionproposals to the participantslisted on pagesV andVI. Their reponsesprovided the basisfor a new draft. After further com- municationsamong the participants, the present classification, defini- tionsand explanatory notes were recommended for publication. ProfessorSchajowicz, Head of the WFIO Centre,died suddenly during the final stagesof preparation of the publication. His former pupil and colleague,Dr. H. Gallardo, SpanishHospital, Buenos Aires, Argentina,helped to completethe selectionof illustrations. Dr. K. Shanmugaratnam,Singapore, Head of the WHO Centrefor Upper Respiratory Tract Tumours, and Dr. Sharon Weiss,Ann Ar- bor, Head of the WHO Centrefor Soft TissueTumours, reviewed the final draft of the manuscriptand provided valuablecomments. The histologicalclassification of bonetumours, which appears on pages3-6, containsthe morphology code numbers of the Inter- national Classificationof Diseasesfor Oncology(ICD-O)2 and the SystematizedNomenclature of Medicine(SNOMED).3 I Schajowicz F, Ackerman VL, SissonsHA, Sobin LH, Torloni H (1972) Histo- logical Typing of Bone Tumours. Geneva, World Health Organization (Interna- tional Histological Classificationof Tumours, No. 6) 2 World Health Organization (1990) International Classification of Diseasesfor Oncology. Geneva 3 College of American Pathologists (1982) Systematized Nomenclature of Medicine. Chicago X Preface to Histological Typing of Bone Tumours, Second Edition It will, of course,be appreciatedthat the classificationreflects the present state of knowledge,and modificationsare almost certain to be neededas experience accumulates. Although the presentclassifi- cationhas been adopted by the membersof the group,it necessarily representsa view from which somepathologists may wish to dissent. It is neverthelesshoped that, in the interestsof international cooper- ation, all pathologistswill usethe classificationas put forward. Criti- cism and suggestionsfor its improvementwill be welcomed;these
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