Adult Kidney Neoplastic Pathology
A pathologic report for renal tubular cancer nephrectomy specimens should include the following information: type of procedure, specimen laterality, tumor site, tumor size (largest tumor, if multiple), tumor focality, macroscopic extent of tumor, histologic subtype, sarcomatoid features, tumor necrosis (any amount), WHO/ISUP nucleolar/nuclear grade, microscopic tumor extension, margins, lymph-vascular invasion (in addition to invasion of renal vein and its muscle containing segmental branches and inferior vena cava), pathologic staging (pTNM), pathologic findings in nonneoplastic kidney, and other tumors or tumorlike lesions (such as cysts, papillary adenomas).
A pathologic report for renal tubular cancer biopsy specimens should include the following information: type of procedure, specimen laterality, histologic subtype, sarcomatoid features, and WHO/ISUP nucleolar/nuclear grade.
Four major common renal cell tumor subtypes can be distinguished based on morphologic and genetic characteristics [i.e., clear cell renal cell carcinoma (RCC), papillary RCC, chromophobe RCC, and oncocytoma]; WHO/ISUP nucleolar/nuclear grading system is implemented in the first two of the above subtypes.
Based on clinicopathologic findings (such as histologic tumor type, bilateral tumor location, and tumor multifocality), hereditary syndromes (i.e., Birt-Hogg-Dubé, hereditary leiomyomatosis renal cell carcinoma, hereditary papillary renal carcinoma, tuberous sclerosis, and von Hippel-Lindau syndrome) can be suspected and relevant investigation can be proposed. Cytogenetic analysis can confirm the diagnosis of MiTF/TFE family translocation-associated carcinoma.
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