Abstract
The International Society of Urological Pathology 2012
Consensus Conference made recommendations regarding classification,
prognostic factors, staging, and immunohistochemical
and molecular assessment of adult renal tumors. Issues relating to
prognostic factors were coordinated by a workgroup who identified
tumor morphotype, sarcomatoid/rhabdoid differentiation, tumor
necrosis, grading, and microvascular invasion as potential prognostic
parameters. There was consensus that the main morphotypes
of renal cell carcinoma (RCC) were of prognostic significance, that
subtyping of papillary RCC (types 1 and 2) provided additional
prognostic information, and that clear cell tubulopapillary RCC
was associated with a more favorable outcome. For tumors
showing sarcomatoid or rhabdoid differentiation, there was consensus
that a minimum proportion of tumor was not required for
diagnostic purposes. It was also agreed upon that the underlying
subtype of carcinoma should be reported. For sarcomatoid carcinoma,
it was further agreed upon that if the underlying carcinoma
subtype was absent the tumor should be classified as a grade
4 unclassified carcinoma with a sarcomatoid component. Tumor
necrosis was considered to have prognostic significance, with assessment
based on macroscopic and microscopic examination of
the tumor. It was recommended that for clear cell RCC the
amount of necrosis should be quantified. There was consensus
that nucleolar prominence defined grades 1 to 3 of clear cell and
papillary RCCs, whereas extreme nuclear pleomorphism or sarcomatoid
and/or rhabdoid differentiation defined grade 4 tumors.
It was agreed upon that chromophobe RCC should not be graded.
There was consensus that microvascular invasion should not be
included as a staging criterion for RCC
Consensus Conference made recommendations regarding classification,
prognostic factors, staging, and immunohistochemical
and molecular assessment of adult renal tumors. Issues relating to
prognostic factors were coordinated by a workgroup who identified
tumor morphotype, sarcomatoid/rhabdoid differentiation, tumor
necrosis, grading, and microvascular invasion as potential prognostic
parameters. There was consensus that the main morphotypes
of renal cell carcinoma (RCC) were of prognostic significance, that
subtyping of papillary RCC (types 1 and 2) provided additional
prognostic information, and that clear cell tubulopapillary RCC
was associated with a more favorable outcome. For tumors
showing sarcomatoid or rhabdoid differentiation, there was consensus
that a minimum proportion of tumor was not required for
diagnostic purposes. It was also agreed upon that the underlying
subtype of carcinoma should be reported. For sarcomatoid carcinoma,
it was further agreed upon that if the underlying carcinoma
subtype was absent the tumor should be classified as a grade
4 unclassified carcinoma with a sarcomatoid component. Tumor
necrosis was considered to have prognostic significance, with assessment
based on macroscopic and microscopic examination of
the tumor. It was recommended that for clear cell RCC the
amount of necrosis should be quantified. There was consensus
that nucleolar prominence defined grades 1 to 3 of clear cell and
papillary RCCs, whereas extreme nuclear pleomorphism or sarcomatoid
and/or rhabdoid differentiation defined grade 4 tumors.
It was agreed upon that chromophobe RCC should not be graded.
There was consensus that microvascular invasion should not be
included as a staging criterion for RCC
| Original language | English |
|---|---|
| Pages (from-to) | 1490–1504 |
| Number of pages | 15 |
| Journal | American Journal of Surgical Pathology |
| Volume | 37 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - Oct 2013 |
Keywords
- pathology
- kidney
- renal cell carcinoma
- tumor