Background & Purpose Registry Personnel What is the Registry? What the Registry provides? What the Registry Wants? Enroll Basic Facts about PPB PPB Types: I, II & III Signs and Symptoms Age at Diagnosis / Gender / Laterality Prognosis Metastasis PPB Critical Issues Constitutional / Syndrome & Familial Disease Registry Personnel Radiography Surgery Pathology PPB Types: I, II & III Progression of Type Type I Pathology Diagnosis and Differential Diagnosis Type II & III Pathology Diagnosis and Differential Diagnosis Differentiation from Adult Pulmonary Blastoma Immunohistochemistry Ultrastructural Findings Fine Needle Aspiration Cytology Pathology of Metastases Recommended Path Studies Special Studies/Tumor Cytogenetics Pathology Consultation Recommendations Staging Treatment Lung Cysts Type I Type II and III Recurrences & Metastases Stem Cell Therapy Surveillance Appendix/Data Resources Forms, Schemas, and Roadmaps Consultation Enroll Now Basics of PPB What Causes PPB? Different Types of PPB Treatment Surgery Chemotherapy Radiation Therapy Does PPB Spread? Recurrence/Relapse Family/Genetic Issues Who Should Treat PPB? What Can Families Do? Enroll Now Definitions/Glossary Genetic Study/Tissue Bank For Families For Pathologists For Pediatric Oncologists, Data Managers, and Other Physical Caregivers All Forms Pathology Review and Tissue Submission Forms Parental Authorization Chemotherapy Schemas and Roadmaps

Constitutional & Familial Issues: Genetics of PPB: A Very Rare Disease: Enrolling Patients in the Registry Cerebral Metastases in PPB Genetic Study of PPB PPB Associated with Cystic Nephroma and Other Renal Tumors Type I PPB: Treatment Issues Type II and III THERAPY RECOMMENDATION CHANGE 04/09/2010 2010 PPB FAMILY WEEKEND IN WASHINGTON DC 02/15/2007 THERAPY CHANGE: PPB Types II and III 11/15/2006 PPB, Cystic Nephroma & Small Bowel Polyps 10/01/2005 Genetic Study in PPB - PPB Tissue Bank

Immunohistochemistry Immunoperoxidase stains demonstrate a consistent pattern of antigen expression in PPB but such staining, in general, adds little to the diagnostic assessment obtained by standard histologic studies. Muscle specific actin and desmin are consistently positive in the obvious rhabdomyoblasts and also decorate to a lesser degree the small primitive cells in the cambium layer zones. Blastematous islands occasionally show weak staining for muscle specific actin. Vimentin stains the rhabdomyoblastic cells, cartilage, fibrosarcoma, or fibrous histiocytoma-like foci, and focally decorates blastematous islands. Weak neuron-specific enolase staining of blastematous areas is rarely seen. S-100 protein staining is confined to areas of conspicuous cartilaginous differentiation, and cytokeratin staining is limited to the epithelium of the cystic spaces or entrapped respiratory or mesothelial elements.

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