Grading of renal cell carcinoma

Brett Delahunt, John Eble, Lars Egevad, Hemamali Samaratunga

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Grading of renal cell carcinoma (RCC) has been recognised as a prognostic factor for almost 100 years. Numerous grading systems have been proposed, initially focusing upon a constellation of cytological features and more recently on nuclear morphology. It has been recommended that grading of RCC should be based upon nucleolar prominence/eosinophilia for grades 1–3, while grade 4 requires nuclear anaplasia (including tumour giant cells, sarcomatoid differentiation and/or rhabdoid morphology). The grading system was adopted formally by the International Society of Urological Pathology (ISUP) and subsequently by the World Health Organisation (WHO), being designated the WHO/ISUP grading classification in the fourth edition of the WHO classification tumours of the urinary system and male genital organs (2016). This grading system has been validated for both clear cell and papillary RCC. Validation studies for chromophobe RCC failed to demonstrate a correlation between grade and outcome for both the superseded Fuhrman grading system and the WHO/ISUP grading classification, and it has been recommended that these tumours not be graded. The WHO/ISUP system has been incorporated into the structured reports of the International Cancer Collaboration on Cancer Reporting for both clear cell and papillary RCC. It is also noted that other types of RCC may be graded, but it must be emphasised in the report that this is for descriptive and diagnostic purposes, and not outcome prediction. More recent studies have shown the incorporation of the presence of tumour necrosis into RCC grading to improve outcome prediction, and this has been validated in several studies.

Original languageEnglish (US)
Pages (from-to)4-17
Number of pages14
JournalHistopathology
Volume74
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Renal Cell Carcinoma
Pathology
Neoplasms
Anaplasia
Male Genitalia
Validation Studies
Eosinophilia
Cell Differentiation
Necrosis

Keywords

  • grading
  • International Society of Urological Pathology
  • prognosis
  • renal neoplasia

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Delahunt, B., Eble, J., Egevad, L., & Samaratunga, H. (2019). Grading of renal cell carcinoma. Histopathology, 74(1), 4-17. https://doi.org/10.1111/his.13735

Grading of renal cell carcinoma. / Delahunt, Brett; Eble, John; Egevad, Lars; Samaratunga, Hemamali.

In: Histopathology, Vol. 74, No. 1, 01.01.2019, p. 4-17.

Research output: Contribution to journalReview article

Delahunt, B, Eble, J, Egevad, L & Samaratunga, H 2019, 'Grading of renal cell carcinoma', Histopathology, vol. 74, no. 1, pp. 4-17. https://doi.org/10.1111/his.13735
Delahunt B, Eble J, Egevad L, Samaratunga H. Grading of renal cell carcinoma. Histopathology. 2019 Jan 1;74(1):4-17. https://doi.org/10.1111/his.13735
Delahunt, Brett ; Eble, John ; Egevad, Lars ; Samaratunga, Hemamali. / Grading of renal cell carcinoma. In: Histopathology. 2019 ; Vol. 74, No. 1. pp. 4-17.
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