The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia

John R. Srigley (Lead / Corresponding author), Brett Delahunt, John N. Eble, Lars Egevad, Jonathan I. Epstein, David Grignon, Ondrej Hes, Holger Moch, Rodolfo Montironi, Satish K. Tickoo, Ming Zhou, Pedram Argani, ISUP Renal Tumor Panel

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    Abstract

    The classification working group of the International Society of Urological Pathology consensus conference on renal neoplasia was in charge of making recommendations regarding additions and changes to the current World Health Organization Classification of Renal Tumors (2004). Members of the group performed an exhaustive literature review, assessed the results of the preconference survey and participated in the consensus conference discussion and polling activities. On the basis of the above inputs, there was consensus that 5 entities should be recognized as new distinct epithelial tumors within the classification system: tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, clear cell (tubulo) papillary RCC, the MiT family translocation RCCs (in particular t(6;11) RCC), and hereditary leiomyomatosis RCC syndrome-associated RCC. In addition, there are 3 rare carcinomas that were considered as emerging or provisional new entities: thyroid-like follicular RCC; succinate dehydrogenase B deficiency-associated RCC; and ALK translocation RCC. Further reports of these entities are required to better understand the nature and behavior of these highly unusual tumors. There were a number of new concepts and suggested modifications to the existing World Health Organization 2004 categories. Within the clear cell RCC group, it was agreed upon that multicystic clear cell RCC is best considered as a neoplasm of low malignant potential. There was agreement that subtyping of papillary RCC is of value and that the oncocytic variant of papillary RCC should not be considered as a distinct entity. The hybrid oncocytic chromophobe tumor, which is an indolent tumor that occurs in 3 settings, namely Birt-Hogg-Dubé Syndrome, renal oncocytosis, and as a sporadic neoplasm, was placed, for the time being, within the chromophobe RCC category. Recent advances related to collecting duct carcinoma, renal medullary carcinoma, and mucinous spindle cell and tubular RCC were elucidated. Outside of the epithelial category, advances in our understanding of angiomyolipoma, including the epithelioid and epithelial cystic variants, were considered. In addition, the apparent relationship between cystic nephroma and mixed epithelial and stromal tumor was discussed, with the consensus that these tumors form a spectrum of neoplasia. Finally, it was thought that the synovial sarcoma should be removed from the mixed epithelial and mesenchymal category and placed within the sarcoma group. The new classification is to be referred to as the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia.
    Original languageEnglish
    Pages (from-to)1469-89
    Number of pages21
    JournalAmerican Journal of Surgical Pathology
    Volume37
    Issue number10
    DOIs
    Publication statusPublished - Oct 2013

    Fingerprint

    Renal Cell Carcinoma
    Pathology
    Kidney
    Neoplasms
    Leiomyomatosis
    Synovial Sarcoma
    Angiomyolipoma
    Medullary Carcinoma
    Succinate Dehydrogenase
    Sarcoma
    Thyroid Gland
    Adenocarcinoma

    Keywords

    • Humans
    • Kidney Neoplasms
    • Societies, Medical

    Cite this

    Srigley, J. R., Delahunt, B., Eble, J. N., Egevad, L., Epstein, J. I., Grignon, D., ... ISUP Renal Tumor Panel (2013). The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. American Journal of Surgical Pathology, 37(10), 1469-89. https://doi.org/10.1097/PAS.0b013e318299f2d1
    Srigley, John R. ; Delahunt, Brett ; Eble, John N. ; Egevad, Lars ; Epstein, Jonathan I. ; Grignon, David ; Hes, Ondrej ; Moch, Holger ; Montironi, Rodolfo ; Tickoo, Satish K. ; Zhou, Ming ; Argani, Pedram ; ISUP Renal Tumor Panel. / The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. In: American Journal of Surgical Pathology. 2013 ; Vol. 37, No. 10. pp. 1469-89.
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    abstract = "The classification working group of the International Society of Urological Pathology consensus conference on renal neoplasia was in charge of making recommendations regarding additions and changes to the current World Health Organization Classification of Renal Tumors (2004). Members of the group performed an exhaustive literature review, assessed the results of the preconference survey and participated in the consensus conference discussion and polling activities. On the basis of the above inputs, there was consensus that 5 entities should be recognized as new distinct epithelial tumors within the classification system: tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, clear cell (tubulo) papillary RCC, the MiT family translocation RCCs (in particular t(6;11) RCC), and hereditary leiomyomatosis RCC syndrome-associated RCC. In addition, there are 3 rare carcinomas that were considered as emerging or provisional new entities: thyroid-like follicular RCC; succinate dehydrogenase B deficiency-associated RCC; and ALK translocation RCC. Further reports of these entities are required to better understand the nature and behavior of these highly unusual tumors. There were a number of new concepts and suggested modifications to the existing World Health Organization 2004 categories. Within the clear cell RCC group, it was agreed upon that multicystic clear cell RCC is best considered as a neoplasm of low malignant potential. There was agreement that subtyping of papillary RCC is of value and that the oncocytic variant of papillary RCC should not be considered as a distinct entity. The hybrid oncocytic chromophobe tumor, which is an indolent tumor that occurs in 3 settings, namely Birt-Hogg-Dub{\'e} Syndrome, renal oncocytosis, and as a sporadic neoplasm, was placed, for the time being, within the chromophobe RCC category. Recent advances related to collecting duct carcinoma, renal medullary carcinoma, and mucinous spindle cell and tubular RCC were elucidated. Outside of the epithelial category, advances in our understanding of angiomyolipoma, including the epithelioid and epithelial cystic variants, were considered. In addition, the apparent relationship between cystic nephroma and mixed epithelial and stromal tumor was discussed, with the consensus that these tumors form a spectrum of neoplasia. Finally, it was thought that the synovial sarcoma should be removed from the mixed epithelial and mesenchymal category and placed within the sarcoma group. The new classification is to be referred to as the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia.",
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    Srigley, JR, Delahunt, B, Eble, JN, Egevad, L, Epstein, JI, Grignon, D, Hes, O, Moch, H, Montironi, R, Tickoo, SK, Zhou, M, Argani, P & ISUP Renal Tumor Panel 2013, 'The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia', American Journal of Surgical Pathology, vol. 37, no. 10, pp. 1469-89. https://doi.org/10.1097/PAS.0b013e318299f2d1

    The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. / Srigley, John R. (Lead / Corresponding author); Delahunt, Brett; Eble, John N.; Egevad, Lars; Epstein, Jonathan I.; Grignon, David; Hes, Ondrej; Moch, Holger; Montironi, Rodolfo; Tickoo, Satish K.; Zhou, Ming; Argani, Pedram; ISUP Renal Tumor Panel.

    In: American Journal of Surgical Pathology, Vol. 37, No. 10, 10.2013, p. 1469-89.

    Research output: Contribution to journalArticle

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