Assessment of tumour-associated necrosis provides prognostic information additional to World Health Organization/International Society of Urological Pathology grading for clear cell renal cell carcinoma

2018 ◽  
Vol 74 (2) ◽  
pp. 284-290 ◽  
Author(s):  
Julien Dagher ◽  
Brett Delahunt ◽  
Nathalie Rioux-Leclercq ◽  
Lars Egevad ◽  
Geoff Coughlin ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
World Health Organization ◽  
Cell Carcinoma ◽  
International Society ◽  
Renal Cell ◽  
Clear Cell ◽  
World Health ◽  
Prognostic Information ◽  
Cell Renal Cell Carcinoma ◽  
Health Organization

Clear cell renal cell carcinoma: validation of World Health Organization/International Society of Urological Pathology grading

2017 ◽  
Vol 71 (6) ◽  
pp. 918-925 ◽  
Author(s):  
Julien Dagher ◽  
Brett Delahunt ◽  
Nathalie Rioux-Leclercq ◽  
Lars Egevad ◽  
John R Srigley ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
World Health Organization ◽  
Cell Carcinoma ◽  
International Society ◽  
Renal Cell ◽  
Clear Cell ◽  
World Health ◽  
Cell Renal Cell Carcinoma ◽  
Health Organization

scholarly journals Comparing World Health Organization/International Society of Urological Pathology Grading and Fuhrman Grading with the Prognostic Value of Nuclear Area in Patients with Renal Cell Carcinoma

Uro ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 2-13
Author(s):  
Maj Rabjerg ◽  
Oke Gerke ◽  
Birte Engvad ◽  
Niels Marcussen
Keyword(s):  
Renal Cell Carcinoma ◽  
World Health Organization ◽  
Cell Carcinoma ◽  
International Society ◽  
Renal Cell ◽  
World Health ◽  
Nuclear Area ◽  
Prognostic Information ◽  
Cancer Specific Survival ◽  
Health Organization

This study was undertaken to compare Fuhrman grading with World Health Organization/International Society of Urological Pathology (WHO/ISUP) grading and stereologically measured nuclear area in patients with Clear Cell Renal Cell Carcinoma (ccRCC) or Papillary Renal Cell Carcinoma (PRCC) and to evaluate the independent predictive value of Fuhrman, WHO/ISUP and stereologically measured nuclear area combined with necrosis in a series of patients with ccRCC in relation to cancer-specific survival. In all, 124 cases of ccRCC and PRCC were included. All slides were blindly scored by two trained pathologists according to the Fuhrman and WHO/ISUP grading systems. Nuclear measurements were performed on digitally scanned slides in Visiopharm® and correlated to survival. Analysis of ccRCC and PRCC cases showed that application of WHO/ISUP grading resulted in a significant downgrading of cases from G2 to G1, when comparing with Fuhrman grading. Neither of these patients experienced progression. Cancer specific survival estimates in 101 ccRCC patients showed that WHO/ISUP grading was slightly superior in predicting cancer-specific survival. Novel models included WHO/ISUP grading and mean nuclear area (MNA) each of which combined with necrosis. Both demonstrated an increased ability to predict cancer-specific survival. The study demonstrates that WHO/ISUP grading provides superior prognostic information compared to Fuhrman grading and stereologically measured nuclear area. Necrosis in combination with either WHO/ISUP grading or MNA adds additional prognostic information.

scholarly journals Morphologic, Molecular, and Taxonomic Evolution of Renal Cell Carcinoma: A Conceptual Perspective With Emphasis on Updates to the 2016 World Health Organization Classification

2016 ◽  
Vol 140 (10) ◽  
pp. 1026-1037 ◽  
Author(s):  
Aaron M. Udager ◽  
Rohit Mehra
Keyword(s):  
Renal Cell Carcinoma ◽  
World Health Organization ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Elongation Factor ◽  
World Health ◽  
World Health Organization Classification ◽  
Anaplastic Lymphoma ◽  
Diagnosis And Classification ◽  
Health Organization

Molecular and morphologic interrogation has driven a much-needed reexamination of renal cell carcinoma (RCC). Indeed, the recently released 2016 World Health Organization classification now recognizes 12 distinct RCC subtypes, as well as several other emerging/provisional RCC entities. From a clinical perspective, accurate RCC classification may have important implications for patients and their families, including prognostic risk stratification, targeted therapeutics selection, and identification for genetic testing. In this review, we provide a conceptual framework for approaching RCC diagnosis and classification by categorizing RCCs as tumors with clear cytoplasm, papillary architecture, and eosinophilic (oncocytic) cytoplasm. The currently recognized 2016 World Health Organization classification for RCC subtypes is briefly discussed, including new diagnostic entities (clear cell papillary RCC, hereditary leiomyomatosis and RCC-associated RCC, succinate dehydrogenase–deficient RCC, tubulocystic RCC, and acquired cystic disease–associated RCC) and areas of evolving RCC classification, such as transcription elongation factor B subunit 1 (TCEB1)–mutated RCC/RCC with angioleiomyoma-like stroma/RCC with leiomyomatous stroma, RCC associated with anaplastic lymphoma receptor tyrosine kinase (ALK) gene rearrangement, thyroidlike follicular RCC, and RCC in neuroblastoma survivors. For each RCC subtype, relevant clinical, molecular, gross, and microscopic findings are reviewed, and ancillary studies helpful for its differential diagnosis are presented, providing a practical approach to modern RCC classification.

scholarly journals Multilocular Cystic Renal Cell Carcinoma: A Rare Entity with Review of Literature

2014 ◽  
Vol 6 (01) ◽  
pp. 050-052 ◽  
Author(s):  
Shailja Puri Wahal ◽  
Kavita Mardi
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Who Classification ◽  
Clear Cell ◽  
World Health ◽  
Renal Tumors ◽  
Cystic Nephroma ◽  
Cell Renal Cell Carcinoma ◽  
Cystic Renal Cell Carcinoma

ABSTRACTMultilocular cystic renal cell carcinoma (MCRCC) represents a rare variant of clear cell renal cell carcinoma (RCC). MCRCC has been recognized as a separate subtype of RCC in the 2004 World Health Organization (WHO) classification of adult renal tumors. MCRCC is diagnosed on the basis of strict histological criteria according to 2004 WHO classification. The chief differentials diagnosis to be considered include cystic nephroma, cystic clear cell carcinoma, clear cell papillary renal cell carcinoma and tubulocystic carcinoma. Only few cases of MCRCC are reported in literature. This case is being highlighted for its rarity and so as to avoid a misdiagnosis as conventional RCC.

scholarly journals WHO/ISUP grading of clear cell renal cell carcinoma and papillary renal cell carcinoma; validation of grading on the digital pathology platform and perspectives on reproducibility of grade

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lisa Browning ◽  
Richard Colling ◽  
Clare Verrill
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Digital Pathology ◽  
Papillary Renal Cell Carcinoma ◽  
World Health Organisation ◽  
World Health ◽  
Cell Renal Cell Carcinoma ◽  
Kappa Agreement

Abstract Background There are recognised potential pitfalls in digital diagnosis in urological pathology, including the grading of dysplasia. The World Health Organisation/International Society of Urological Pathology (WHO/ISUP) grading system for renal cell carcinoma (RCC) is prognostically important in clear cell RCC (CCRCC) and papillary RCC (PRCC), and is included in risk stratification scores for CCRCC, thus impacting on patient management. To date there are no systematic studies examining the concordance of WHO/ISUP grading between digital pathology (DP) and glass slide (GS) images. We present a validation study examining intraobserver agreement in WHO/ISUP grade of CCRCC and PRCC. Methods Fifty CCRCCs and 10 PRCCs were graded (WHO/ISUP system) by three specialist uropathologists on three separate occasions (DP once then two GS assessments; GS1 and GS2) separated by wash-out periods of at least two-weeks. The grade was recorded for each assessment, and compared using Cohen’s and Fleiss’s kappa. Results There was 65 to 78% concordance of WHO/ISUP grading on DP and GS1. Furthermore, for the individual pathologists, the comparative kappa scores for DP versus GS1, and GS1 versus GS2, were 0.70 and 0.70, 0.57 and 0.73, and 0.71 and 0.74, and with no apparent tendency to upgrade or downgrade on DP versus GS. The interobserver kappa agreement was less, at 0.58 on DP and 0.45 on GS. Conclusion Our results demonstrate that the assessment of WHO/ISUP grade on DP is noninferior to that on GS. There is an apparent slight improvement in agreement between pathologists on RCC grade when assessed on DP, which may warrant further study.

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