History and General Aspects of Tumor Grading

Abstract

The relationship between tumor morphology and the clinical behavior of tumors has been known for more than a century, and the study of such clinicopathologic correlations could be traced to the teachings of Rudolf Virchow and the scientific beginnings of microscopic pathology. From the historical point of view, however, the first attempts to correlate the microscopic features of tumors with their biology and clinical behavior traditionally are attributed to von Hansemann (1–3). In the 1890s, this German pathologist published his observations on anaplasia and abnormal mitotic figures and first suggested that the biologic and clinical behavior of tumors could be predicted from their microscopic characteristics. His pioneering publications on tumor cell atypia, anaplasia, and asymmetrical mitoses were summarized in a 1897 book, which was so popular that it reappeared 5 years later in a second edition (Figure 1-1). This book, based on meticulous microscopic study of tumors, contains drawings illustrating the author’s views of cancer (Figure 1-2).The clarity of these illustrations is fascinating even today.