2009 Update on the Classification of Renal Epithelial Tumors in Adults (original) (raw)
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Pathology of renal cell carcinoma an update
Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology
The classification of kidney tumors in adults expands rapidly with new categories recently incorporated. This will result in the modification of the current 2004 World Health Organization (WHO) classification of the adult renal epithelial neoplasms. Emphasis should be placed in defining risk groups categorized as malignant or benign tumors, including a category of tumors with low malignant potential to accommodate recently recognized categories with extremely good prognosis after surgery. Unusual tumors such as familial renal cell carcinoma (RCC), translocation RCC, renal cell carcinoma after neuroblastoma, tubular mucinous and spindle cell carcinoma, and mixed epithelial and stromal tumors are also presented. A number of recently described entities and morphologic variants of classical categories deserve recognition since they can be important in differential diagnosis. This review emphasizes clinical, pathological and genetic features defining renal epithelial tumors in adults.
An overview of renal cell cancer: Pathology and genetics
Seminars in Cancer Biology, 2013
Renal cell carcinoma is a group of malignancies arising from the epithelium of the renal tubules. The pattern of somatic mutations in kidney tumors has been extensively investigated. In the current 2004 WHO classification, the molecular background of a renal tumor has become, in addition to histopathology, a major criterion for tumor classification. The goal of this review is to discuss morphology and genetics of adult renal epithelial cancer included in the 2004 WHO classification and to mention renal tumor types, which are not considered in the current WHO classification. Further, pathologic considerations with clinical and prognostic implications are provided.
Epithelial tumours of the adult kidney
Virchows Archiv, 1999
The epithelial tumours of the adult kidney, in particular renal cell carcinoma (RCC), are a variety of neoplasms that can be classified by morphology and genotype. Although most are well characterised, typical and less typical tumour variants are recognised. There is evidence to indicate that stage is one of the most important prognostic factors, irrespective of tumour subtype. However, the appropriate handling of nephrectomy specimens is essential for accurate evaluation of diagnostic and prognostic factors in RCC. The problem of how to achieve more objective nuclear grading is still unresolved. The use of diagnostic decision support systems offers the possibility of a flexible approach to this problem, while still utilising morphological criteria. The histopathological analysis remains important, but new techniques of molecular and cell biology will be providing new tools of extraordinary power to sharpen the diagnosis and give it a biological interpretation.
Translational Andrology and Urology
In 1952, renal cell carcinomas had been divided into 2 categories-clear cell or granular celldepending upon their cytoplasmic staining characteristics. In the following years, the inventory of renal epithelial tumors has expanded by the addition of tumors named by their architectural pattern (i.e., papillary RCC, tubulocystic RCC), anatomic location (i.e., collecting duct carcinoma, renal medullary carcinoma), associated diseases (i.e., acquired cystic disease-associated RCCs). With the extensive application of molecular diagnostic techniques, it becomes possible to detect genetic distinctions between various types of renal neoplasm and discover new entities, otherwise misdiagnosed or diagnosed as unclassified RCC. Some tumors such as ALK rearrangement-associated RCC, MiT family translocation renal carcinomas, SDHdeficient renal cancer or FH-deficient RCC, are defined by their molecular characteristics. The most recent World Health Organization (WHO) classification of renal neoplasms account for more than 50 entities and provisional entities. New entities might be included in the upcoming WHO classification. The aim of this review is to summarise and discuss the newly acquired data and evidence on the clinical, pathological, molecular features and on the prognosis of new RCC entities, which will hopefully increase the awareness and the acceptance of these entities among clinicians and improve prognostication for individual patients.
General Overview of Renal Cell Carcinoma with the Evaluation of our cases
Bezmialem Science, 2015
Objective: Renal cell carcinoma (RCC) is the 14 th most common tumor in the world. In 2010, the protocol for the examination of kidney specimens with invasive carcinoma of renal tubular origin was updated. The aim of our study was to review 1-year RCC patients of our hospital according to the new protocol, classification, and staging systems with respect to their morphological and immunohistochemical features. Methods: The medical records of 54 RCC patients between July 2012 and July 2013 were retrospectively reviewed. They were classified according to the WHO 2004 classification system and newly defined subtypes. The following variables were determined in each case: age, sex, histological subtype, stage, and Fuhrman nuclear grade. Results: In our study, 30 (55.6%) men and 24 (44.4%) women were diagnosed with RCC out of 54 patients. The median age was 56 years. In total, 21 patients had (55.2%) right-and 17 had (44.74%) left-sided tumors. Thirty-eight (70.3%) clear cell, 6 (11.1%) papillary, 7 (12.96%) chromophobe, 1 (1.85%) multilocular, 1 (1.85%) unclassified, and 1 (1.85%) tubulocystic RCC were seen. According to primary tumor, 33 (61.1%) pT1, 10 (18.51%) pT2, 9 (16.66%) pT3, and 2 (3.70%) pT4 patients were reported. Chromophobe RCCs were excluded from the Fuhrman grading (G) system; of the remaining 2 (4.17%) were G1, 30 (62.5%) were G2, 13 (27.08%) were G3, and 3 (6.25%) were G4 tumors. Conclusion: Although RCC constitutes the majority of renal tumors, different subtypes are also encountered. In our study, clear cell RCCs were the most common type of tumors consistent with the literature. The remarkable point was that chromophobe RCCs were more frequent in our study. Because of infrequency, more examples are required to distinguish newly defined subtypes.
" Clinicopathological study of adult renal tumours "
Innovative Publication, 2016
Introduction: A wide variety of both benign and malignant tumours arise from different components of the renal parenchyma, notably tubular epithelium. Prognostic markers for Renal cell carcinoma such as tumor stage, grade and necrosis are useful for determining appropriate follow-up and selecting patients for adjuvant therapy. We undertook this study to determine the relative frequencies of different types of adult renal tumours, their clinical, radiological, gross morphological and histopathological features. Our second objective was to evaluate these pathological variables and to establish possible correlations between them. Materials and Methods: A Total of 60 Cases of adult renal neoplasms diagnosed at our institute from June 2007 to June 2014 were reviewed. Age, sex, histologic subtype, pT stage, Fuhrman grade, tumor necrosis were determined in all cases. Results: Among 60 patients, 36 were males and 24 were females. Mean age was 46.5 years. 83.3% tumours were malignant and 16.67%, benign. Among malignant tumours, Renal cell carcinoma (RCC) was the commonest(78.3%). Various subtypes of RCC included: conventional/clear cell RCC (73.2%); papillary, (14.6%); chromophobe (2.4%) and RCC unclassified (1.66%). Other malignant tumours were: leiomyosarcoma (1.66%); spindle cell sarcoma (1.66%); primitive neuroectodermal tumour(1.66%). Benign renal tumours included Angiomyolipoma(10%), oncocytoma(1.66%); metanephric adenoma(1.66%) and renomedullary interstitial tumour (1.66%). Conclusions: RCC was the commonest malignant tumor and conventional/clear cell RCC was the most common subtype. Most of the cases in our study were in grade 2 and stage pT3. Papillary RCC was second most common subtype.Tumor necrosis correlates with higher grade and tumor stage.
Diagnosis and management of renal cell carcinomaA clinical and pathologic study of 309 cases
Cancer, 1971
HE INCIDENCE OF RENAL CELL CARCINOMA T in the United States in 3.5 per 100,000 population per year.19 Grawitz described this tumor in 1883, and observed the striking resemblance of the yellow renal tumor to the adrenal cortex and thus suggested that it might be derived from atlrenal rests.21 Gradually both urologists and pathologists came to the realization that the majority of these renal tumors arise from renal tubular epithelial cells-a fact supported by both light microscopy and electron m i c r o~c o p y .~~~~ Thus, the term renal cell carcinoma or renal cell adenocarcinoma seems most appropriate. These parenchymal tumors, the renal cell carcinomas, constitute approximately 8501, of all primary renal tumors. T h e remaining 15y0 are divided into tumors of the r e n d pelvis and tumors of the renal capsule. This study concerns renal cell carcinoma treated over a 30-year period in a large general hospital. MATERIALS AND METHODS Between 1935 and 1965, 329 patients with renal cell carcinoma were surgically treated at the Massachusetts General Hospital. All patients underwent renal exploration, and all but 10 underwent nephrectomy. Of these 329 patients, 20 could not be traced, and their hospital records were not complete enough to permit accurate evaluation and follow-up. These 20 patients were excluded, leaving 309 patients for evaluation. In these 309 patients, 93 simple nephrectomies were performed, and 203 patients underwent radical nephrectomy, the majority via the thoracoab-~-Presented at the twenty-fourth annual scientific session of the
Pathological and molecular biological aspects of the renal epithelial neoplasms, up-to-date
Pathology International, 2004
Renal neoplasms are not necessarily high in frequency, but they are characteristic in their heterogeneity and occasional association with systemic familial tumor syndromes and phacomatoses (e.g. clear cell renal cell carcinoma and von Hippel-Lindau disease, Wilms tumor and aniridia, genitourinary malformation and mental retardation (so-called, WAGR syndrome), and angiomyolipoma and tuberous sclerosis). Physicians and pathologists should take note of these syndromes and associated renal neoplasms because they have provided important clues to elucidate the mechanism of tumorigenesis concerning cancer-suppressor genes. This review aims to present recent classification of renal parenchymal neoplasms based on their molecular biological characteristics, and future problems yet to be clarified.