Difference between revisions of "Clear cell renal cell carcinoma"
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The '''synoptic report''' should include:<br>Specimen: | The '''synoptic report''' should include:<br>Specimen: | ||
*'''Procedure''': Total or partial nephrectomy | *'''Procedure''': Total or partial nephrectomy |
Revision as of 20:55, 1 December 2020
Author:
Mikael Häggström [note 1]
Clear cell renal cell carcinoma (CCRCC):
Contents
Gross processing
As per: Kidney with tumor
Microscopic examination
CCRCC typically shows cells in nests or solid pattern, and a delicate branching fibrovascular network.[1]
Differential diagnosis: Kidney with tumor
If unsure, useful immunohistochemistry markers that are positive in CCRCC are vimentin, EMA, keratin, CD10, Pax2, RCC, CAIX (circumferential membranous).[1]
Grading
CCRCCs are graded by the ISUP/WHO as follows:[2][3]
- Grade 1: Inconspicuous and basophilic nucleoli at ×400 magnification
- Grade 4: Extreme pleomorphism or rhabdoid and/or sarcomatoid morphology
Microscopy report
There should preferably be a free text report and a synoptic report, the free text report including:
- Diagnosis of clear cell renal cell carcinoma
- Greatest dimension (from grossing)
- ISUP/WHO grade
- Radicality
Example:
Kidney, left, partial nephrectomy:
|
Synoptic report
The synoptic report should include:
Specimen:
- Procedure: Total or partial nephrectomy
- Laterality: Left or right
Tumor
- Histologic type: Such as clear cell renal cell carcinoma (without further specification)
- Histologic grade
- Tumor size: From gross description
- Tumor focality: Unifocal or multifocal
- Tumor extension: Such as tumor limited to kidney
- Sarcomatoid features: Identified or not identified
- Rhabdoid features: Identified or not identified
- Tumor necrosis: Identified or not identified
Margins
- Margin involvement: Involved by invasive carcinoma (and in which direction), or negative for malignancy
- Margins type(s): Generally renal parenchymal margin if partial nephrectomy
Staging
- Regional lymph nodes: Involved by invasive carcinoma (and how many), or "no lymph nodes submitted or found"
- Pathologic stage classification (by pTNM, AJCC 8th Edition):
- Primary tumor (pT)
- Regional lymph nodes (pN): Such as pNX if no lymph nodes submitted or found
Any pathologic findings in non-neoplastic kidney
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ 1.0 1.1 Sirohi, Deepika; Smith, Steven C.; Agarwal, Neeraj; Maughan, Benjamin L. (2018). "Unclassified renal cell carcinoma: diagnostic difficulties and treatment modalities ". Research and Reports in Urology Volume 10: 205–217. doi: . ISSN 2253-2447.
- ↑ YiFen Zhang. What is the ISUP/WHO grading system for renal cell carcinoma (RCC)?. Medscape. Updated: Jul 02, 2019
- ↑ Moch, H. (2016). "WHO-ISUP-Graduierungssystem für Nierenkarzinome ". Der Pathologe 37 (4): 355–360. doi: . ISSN 0172-8113.
Image sources