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Difference between revisions of "Kidney tumours"
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→Grading RCC
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*The system was validated for clear cell RCC. | *The system was validated for clear cell RCC. | ||
*Fuhrman nuclear grade is '''not''' prognostic in ''chromophobe RCC'' and should not be used in that context.<ref name=pmid17527087>{{Cite journal | last1 = Delahunt | first1 = B. | last2 = Sika-Paotonu | first2 = D. | last3 = Bethwaite | first3 = PB. | last4 = McCredie | first4 = MR. | last5 = Martignoni | first5 = G. | last6 = Eble | first6 = JN. | last7 = Jordan | first7 = TW. | title = Fuhrman grading is not appropriate for chromophobe renal cell carcinoma. | journal = Am J Surg Pathol | volume = 31 | issue = 6 | pages = 957-60 | month = Jun | year = 2007 | doi = 10.1097/01.pas.0000249446.28713.53 | PMID = 17527087 }}</ref> | *Fuhrman nuclear grade is '''not''' prognostic in ''chromophobe RCC'' and should not be used in that context.<ref name=pmid17527087>{{Cite journal | last1 = Delahunt | first1 = B. | last2 = Sika-Paotonu | first2 = D. | last3 = Bethwaite | first3 = PB. | last4 = McCredie | first4 = MR. | last5 = Martignoni | first5 = G. | last6 = Eble | first6 = JN. | last7 = Jordan | first7 = TW. | title = Fuhrman grading is not appropriate for chromophobe renal cell carcinoma. | journal = Am J Surg Pathol | volume = 31 | issue = 6 | pages = 957-60 | month = Jun | year = 2007 | doi = 10.1097/01.pas.0000249446.28713.53 | PMID = 17527087 }}</ref> | ||
*Anything with [[spindle cell]]s<ref name=pmid15763002/> or rhabdoid cells should make one think grade 4, as it is likely a ''[[renal cell carcinoma with sarcomatoid differentiation]]''. | |||
===Criteria & grades=== | ===Criteria & grades=== | ||
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*Grade 3: [[nucleoli]] seen easily (key feature). | *Grade 3: [[nucleoli]] seen easily (key feature). | ||
*Grade 4: prominent pleomorphism (key feature), hyperchromasia, [[macronucleoli]]. | *Grade 4: prominent pleomorphism (key feature), hyperchromasia, [[macronucleoli]]. | ||
**[[Spindle cell]]s<ref name=pmid15763002/> or rhabdoid cells also make something grade 4 (see ''[[renal cell carcinoma with sarcomatoid differentiation]]''). | |||
Note: | |||
*Most tumours are grade 2 & 3. | |||
===Fuhrman grading in short=== | ===Fuhrman grading in short=== | ||
*1 vs. 2: grade 2 has granular chromatin, grade 2 has nucleoli visible @ 20x objective.<ref>AE. June 2010.</ref> | *1 vs. 2: grade 2 has granular chromatin, grade 2 has nucleoli visible @ 20x objective.<ref>AE. June 2010.</ref> | ||
*2 vs. 3: grade 3 has nucleoli @ 10x objective. | *2 vs. 3: grade 3 has nucleoli @ 10x objective. | ||
*3 vs. 4: grade 4 has pleomorphism/hyperchromasia. | *3 vs. 4: grade 4 has pleomorphism/hyperchromasia (or spindle cells or rhabdoid cells). | ||
==Clear cell renal cell carcinoma== | ==Clear cell renal cell carcinoma== | ||