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Difference between revisions of "Kidney tumours"
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→Renal cell carcinoma grading
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**Based on nuclear size and shape, chromatin pattern and [[nucleoli|nucleolar size]].<ref name=Ref_GUP282>{{Ref GUP|282}}</ref> | **Based on nuclear size and shape, chromatin pattern and [[nucleoli|nucleolar size]].<ref name=Ref_GUP282>{{Ref GUP|282}}</ref> | ||
**More complicated. | **More complicated. | ||
*''[[ISUP]] grading'':<ref>{{cite journal |author=Delahunt B, Cheville JC, Martignoni G, ''et al.'' |title=The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters |journal=Am. J. Surg. Pathol. |volume=37 |issue=10 |pages=1490–504 |year=2013 |month=October |pmid=24025520 |doi=10.1097/PAS.0b013e318299f0fb |url=}}</ref> | *''[[ISUP]] grading'':<ref name=pmid24025520>{{cite journal |author=Delahunt B, Cheville JC, Martignoni G, ''et al.'' |title=The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters |journal=Am. J. Surg. Pathol. |volume=37 |issue=10 |pages=1490–504 |year=2013 |month=October |pmid=24025520 |doi=10.1097/PAS.0b013e318299f0fb |url=}}</ref> | ||
**Newer and less complicated. | **Newer and less complicated. | ||
**Mostly based on [[nucleoli|nucleolar size]] and to a much lesser degree. on size and morphology | **Mostly based on [[nucleoli|nucleolar size]] and to a much lesser degree. on size and morphology | ||
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===ISUP grading=== | ===ISUP grading=== | ||
Criteria:<ref name=pmid24025520/> | |||
*Grade 1 - nucleoli seen with 40x objective. | *Grade 1 - nucleoli seen with 40x objective. | ||
*Grade 2 - nucleoli seen with 20x objective. | *Grade 2 - nucleoli seen with 20x objective. | ||
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*Grade 4 - extreme nuclear pleomorphism (esp. nuclear enlargement) ''or'' [[renal cell carcinoma with sarcomatoid differentiation|sarcomatoid differentiation]] ([[spindle cell]]s<ref name=pmid15763002/> or rhabdoid cells). | *Grade 4 - extreme nuclear pleomorphism (esp. nuclear enlargement) ''or'' [[renal cell carcinoma with sarcomatoid differentiation|sarcomatoid differentiation]] ([[spindle cell]]s<ref name=pmid15763002/> or rhabdoid cells). | ||
Cavets:<ref name=pmid24025520/> | |||
*Higher grade component trumps lower grade component. | *Higher grade component trumps lower grade component. | ||
**No agreed upon minimum quantity of high grade component for upgrading. | **No agreed upon minimum quantity of high grade component for upgrading. | ||
***37% use 1 field of view with the x10 objective. † | ***37% use 1 field of view with the x10 objective. † | ||
***41% use 1 field of view with the x40 objective. ‡ | ***41% use 1 field of view with the x40 objective. ‡ | ||
*Grading system ''not'' used for ''chromophobe RCC''. | *Grading system ''not'' used for ''[[chromophobe RCC]]''. | ||
** | **The experience with the ''Fuhrman grading'' system showed it is ''not'' prognostic for chromophobe RCC.<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>). | ||
Notes: | |||
*† Suffers from [[IPFitis]]. | *† Suffers from [[IPFitis]]. | ||
*‡ Suffers from [[HPFitis]]. | *‡ Suffers from [[HPFitis]]. | ||