Updated 3 July 2007
Clinico-pathologic Considerations
Most renal tumours in adults are renal cell carcinomas, and discussion elsewhere refers to this histologic type. However it is essential not to overlook the possibility of a more treatable histology in a younger patient or where any atypical clinical features are present. These unusual tumours include:
- Transitional cell carcinomas of renal pelvis
- Lymphomas (see
Lymphoma section of this manual)
- Sarcomas (consider referral to Sarcoma service)
- Adult Wilms' tumour
These tumours require individualized management.
Radical Nephrectomy Specimens Should Include the Following Information:
Gross Description
- The size of the kidney (three dimensions)
- The length of attached ureter
- The size of any tumour mass and the size of any satellite nodules
- The location of any tumour masses
- The relationship to capsule, to the renal pelvis and to the renal vessels
- The presence of tumour within the renal vein
Microscopic Description
- Histologic classification:
clear cell carcinoma |
papillary carcinoma |
chromophobe carcinoma |
oncocytoma |
- Presence or absence of vascular invasion
- The invasion of capsule, renal pelvis, perirenal fat
- The status of all resection margins
- Lymph nodes status
- Fuhrman nuclear grade (1 - Well, 2-3 - Moderate, 4 - Poor)