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The last WHO expert workgroup recommended abandoning the distinction between potentially malignant lesions and conditions. The term to use is "potentially malignant disorders". Leukoplakia is the most common of these disorders, while erythroplakia is rather rare. The diagnosis is still made by excluding other documented white or red lesions. Despite progress in molecular biology, no marker allows predicting malignant transformation. These lesions are treated surgically with or without dysplasia. It is unknown if this surgery can really prevent transformation into squamous cell carcinoma. The potential malignancy of oral lichen planus is still debated. The risk of malignant transformation is lower than that of leukoplakia. No treatment may prevent this. Other potentially malignant conditions such as oral submucous fibrosis, actinic cheilitis, lupus, and immunodeficiency are rare., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Hepatocellular carcinogenesis is usually the result of a muti-step process. It begins with an exposure to various risk factors; followed by the development of a chronic hepatitis and cirrhosis that is a pre-neoplastic step; and finally after the occurrence of an hepatocellular carcinoma (HCC), different molecular events control aggressiveness of the tumors. The aim of this work was to identify in the international context, forces and priorities of the fundamental and translational HCC research.

Vulvar cancer is a rare disease and its screening is depending on the quality and the relevance of our clinical examination. Incidence of vulvar cancer and especially precancerous lesions, vulvar intraepithelial neoplasias (VIN), increased during these last years. The new terminology of vulvar intraepithelial neoplasia will help us to identify high risk groups which could develop a cancer: usual and differentiated VIN. An early diagnosis is essential to propose an adequate treatment. Management is a major point according to the rising incidence of these lesions in younger women. Until we can observe a benefit from the vaccination against human papillomavirus, we must increase the quality of screening by a careful examination of the vulva.

As a consequence of increased screening mammography, preinvasive breast lesions represent a growing percentage of breast pathology diagnoses. Intraductal epithelial proliferations of the breast are, at present, classified into three groups: usual epithelial hyperplasia, atypical ductal hyperplasia and ductal carcinoma in situ. The boundary between those two last entities is not clearly defined on a morphological point of view although the clinical management is different. Columnar atypical lesions or flat atypical hyperplasia, frequently observed near microcalcifications, are not homogeneously managed. Lobular lesions are classified under the category of lobular neoplasia which avoid interobserver variability. Molecular biology data and immunoprofiles isolate different lobular phenotypes and link them to invasive cancer. The different systems of classifications of those different entities, the most recent molecular biology datas, controversies and consensus are described in this manuscript.

Tumour classification systems provide the foundation for tumour diagnosis and patient therapy and a critical basis for epidemiological and clinical studies. This updated classification was developed with the aim to adhere to the principles of reproducibility, clinical significance, and simplicity in order to minimize the number of unclassifiable lesions. Major changes in the revised classification as compared to the previous one (WHO 1981) include the addition of two pre-invasive lesions to squamous dysplasia and carcinoma in situ: atypical adenomatous hyperplasia (AAH) and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia. Another change is the subclassification of adenocarcinoma: the definition of bronchioloalveolar carcinoma has been restricted to non-invasive tumours. There has been substantial evolution of concepts in neuroendocrine lung tumour classification. Large cell neuroendocrine carcinoma (LCNEC) is now recognized as a histologically high-grade non-small cell carcinoma showing histopathological features of neuroendocrine differentiation as well as immunohistochemical neuroendocrine markers. The large cell carcinoma class has been enriched with several variants, including the large cell neuroendocrine carcinoma and the basaloid carcinoma, both of which have a poor prognosis. Finally, a new class has been defined called carcinoma with pleomorphic, sarcomatoid, or sarcomatous elements, which gathers a number of proliferations characterized by a spectrum of epithelial to mesenchymal differentiation. Immunohistochemistry and electron microscopy are invaluable techniques for diagnosis and subclassification, but our intention was to render the classification simple and practical to every surgical laboratory so that most lung tumours can be classified by light microscopic criteria.

Objectives: We analyzed data in the literature in comparison with experience at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of la Salpêtrière Hospital on precancerous lesions of the oral mucosa, in order to establish definitions and describe epidemiological, clinical, histological findings as well as natural history and treatment outcome., Material and Methods: Three literature sources were analyzed: Medline and Current Contents searches, books and references listed in articles. The following key words were used and classed into three groups; 1) oral mucosa, epidemiology, precancerous lesions, malignant transformation, dysplasia, leucoplakia, oral lichen planus, erythroplasia, verrucous, cheilitis, candidosis, immunodepression, 2) oral mucosa, tumor markers, carcinogens, keratin, keratinocytes, gene, nuclear proteins, p53 protein, Ki-67 antigen, 3) oral mucosa, therapy, prevention, nutrients. The period chosen ran from 1980 to 1998. This automatic literature search was completed by systematic manual search of summaries in specialized journals published in 1997-1998. The lists of references in the identified articles were consulted and furnished the principal publications concerning precancerous lesions of the buccal mucosa. In all 383 references were selected and analyzed by level of scientific proof. Among these 135 are cited in the text. If data in the literature were insufficient, the physicians at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of La Salpêtrière Hospital were consulted to provide their experience-based recommendations., Results and Discussion: Clear and practical definitions drawn from current knowledge were adopted. Precancerous lesions were distinguished from precancerous states. Precancerous lesions included chronic lesions of the oral cavity on which cancer of the oral cavity is known to develop. These were: leucoplakia, oral lichen planus, erythroplasia, papillomatous lesions, actinic cheilitis, submucosal fibrosis, keratotic candidosis, and tertiary syphilis. The precancerous states included cancers occasionally observed in the oral cavity: immunodepression and Plummer Vinson syndrome were analyzed. Epidemiological, clinical, histological, and evolutive data as well as therapeutic strategies were described. A decisional algorithm was elaborated for leucoplakia. The text was enriched with images available in the Department., Conclusion: Precancerous lesions of the oral mucosa offer a particularly interesting area of research for understanding the process of cancer formation and its prevention. The level of scientific proof available in the large majority of the published reports is low. Few recent publications provide relevant data. In practice, the experience in the management of cancer and precancerous lesions of the oral mucosa accumulated over the last 40 years at the Department of Cancer and Oral pathology of the Stomatology and Maxillo-Facial Surgery division of la Salpêtrière Hospital provides an invaluable source of information.

For a few years, many descriptions and studies have been published regarding precancerous nodular liver lesions. As a result, several terms and classifications have been proposed leading to poor reproducibility. In 1995, an International Working Party defined nodular lesions called low grade and high grade dysplastic nodules. A good correlation between clinical, radiological and pathological lesions was then obtained. This article summarizes the histopronostic features of the nodules observed in cirrhotic liver, and attempts to specify the diagnostic criteria to distinguish dysplastic from regenerative macronodules and hepatocellular carcinomas.

This paper is an attempt to evaluate the role of diagnostic and therapeutic tools to define differentiated thyroid carcinoma. At the beginning of the last century, physicians described its clinical feature: hard and invasive goiter arising after 25 and leading to death. In 1860, the surgical revolution encouraged the surgeons of goiter to treat thyroid cancer: simple goiter was viewed as precancer. From 1880, cell and tumor theories led pathologists to define microscopically thyroid cancer. In 1920, they demonstrated that the two most constant indications of thyroid epithelial malignancy were invasion of the blood vessels and distant metastasis. In 1930, radiotherapists introduced the concept of prognostic classification which combines histological criteria and patient survival for thyroid cancer. From 1940, the medical use of radioiodine led to distinguish two groups of thyroid tumors: those which are able to concentrate radioiodine and those which are not. Physicians, specialised in thyroid endocrinology, established the rules of thyroid cancer treatment. Our purpose is to analyse the epistemological and historical context of this pathology definition.

The management of lesions of the oral mucosa requires precise knowledges and expertise in clinical care. This review article summarise the principles of the most validated therapeutical features about lesions of the oral mucosa. Global management procedures are described. Therapeutic modalities involving drugs, surgery, radiotherapy, chemotherapy, immunotherapy, electrotherapy, gene therapy and photodynamic therapy are detailed as well.

Unlabelled: Excisions with histological examination were performed in 227 cases of breast microcalcifications without palpable tumor. 99 benign lesions, 27 borderline lesions and 101 carcinomas, 58 of them in situ, were found. Different radiological parameters were studied in relation to histological results: According to the morphology of the calcifications, a classification of 5 types was made. Type 1: annular: 100 per cent were benign lesions. Type 2: regularly punctiform: 22 per cent were malignant lesions. Type 3: too fine for precizing the shape: 40 per cent were malignant lesions. Type 4: irregularly punctiform: 66 per cent were malignant lesions. Type 5: vermicular: 100 per cent of the lesions were malignant. The number of calcifications was higher in carcinomas and 56 per cent of the lesions with more than 30 calcifications were malignant. Close grouping: when there were more than 10 calcifications within a 5 mm diameter area, 57 per cent of malignant lesions were found. Several clusters: 70 per cent were correlated with malignant lesions. Uneven sizes: no signification., Location: the rare retroareolar location correlated with benign lesions in 64 per cent of the cases. Furthermore, the malignant lesions were rare (24%) in women under 40 years of age. For these young women, the authors suggest to directly excise the most suspicious microcalcifications as based on the factors of suspicion and to simply follow the other cases.

A group of senior Pathologists engaged in review work on international randomized trials for the W.H.O and/or the E.O.R.T.C., propose a new simplified classification of melanocytic lesions with an intra-epidermal component, applicable in routine. This classification attempts to introduce standards to permit morphological identification of a large group of intra-epidermal melanocytic proliferations with three classes of atypia (slight, mild, severe) and group of malignant melanomas especially those without dermal invasion. The new definitions and objective criteria (at cytological and architectural level) of diagnosis are given with examples of equivalence between some established entities and this new universal terminology.