Skip to main content

Adult Kidney Neoplastic Pathology

  • Chapter
  • First Online:
  • 1062 Accesses

Abstract

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.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   99.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Algaba F (2013) Immunohistochemistry in renal cell carcinoma. What’s new?-What’s new in uropathology? Handout. Working group symposium. 25th European Congress of Pathology. ESP

    Google Scholar 

  • Algaba F, Akaza H, Lopez-Beltran A, Martignoni G et al (2011) Current pathologic keys of renal cell Carcinoma. Eur Urol 60(4):634–643

    Article  PubMed  Google Scholar 

  • Armstrong AJ, Halabi S, Eisen T et al (2016) Everolimus versus sunitinib for patients with metastatic non-clear cell renal cell carcinoma (ASPEN): a multicentre, open-label, randomised phase 2 trial. Lancet Oncol 17:378–388

    Article  CAS  PubMed  Google Scholar 

  • Bissler JJ, Kingswood JC, Radzikowska E et al (2016) Everolimus for renal angiomyolipoma in patients with tuberous sclerosis complex or sporadic lymphangioleiomyomatosis: extension of a randomized controlled trial. Nephrol Dial Transplant 31(1):111–119

    Article  CAS  PubMed  Google Scholar 

  • Campbell S, Lane B (2012) Malignant renal tumors. In: Kavoussi L, Novick A, Partin A, Peters C (eds) Campbell-Walsh urology, 10th edn. Saunders, Philadelphia, pp 1413–1474

    Chapter  Google Scholar 

  • Cheville JC, Lohse CM, Sukov WR et al (2012) Chromophobe renal cell carcinoma: the impact of tumor grade on outcome. Am J Surg Pathol 36:851–856

    Article  PubMed  Google Scholar 

  • Choueiri TK, Escudier B, Powles T et al (2015) Cabozantinib versus everolimus in advanced renal-cell carcinoma. N Engl J Med 373:1814–1823

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Choueiri TK, Escudier B, Powles T et al (2016) Cabozantinib versus everolimus in advanced renal cell carcinoma (METEOR): final results from a randomised, open label, phase 3 trial. Lancet Oncol 17:917–927

    Article  CAS  PubMed  Google Scholar 

  • Cindolo L, de la Taille A, Schips L et al (2005) Chromophobe renal cell carcinoma: comprehensive analysis of 104 cases from multicenter European database. Urology 65(4):681–686

    Article  PubMed  Google Scholar 

  • Clague J, Lin J, Cassidy A et al (2009) Family history and risk of renal cell carcinoma: results from a case-control study and systematic meta-analysis. Cancer Epidemiol Biomark Prev 18(3):801–807

    Article  Google Scholar 

  • Crépel M, Jeldres C, Perrotte P et al (2010) Nephron-sparing surgery is equally effective to radical nephrectomy for T1BN0M0 renal cell carcinoma: a population-based assessment. Urology 75:271–275

    Article  PubMed  Google Scholar 

  • Eble JN (1998) Angiomyolipoma of kidney. Semin Diagn Pathol 15(1):21–40

    PubMed  CAS  Google Scholar 

  • Escudier B, Eisen T, Stadler WM et al (2007a) Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med 356:125–134

    Article  CAS  PubMed  Google Scholar 

  • Escudier B, Pluzanska A, Koralewski P et al (2007b) Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: a randomised, double-blind phase III trial. Lancet 370:2103–2111

    Article  PubMed  Google Scholar 

  • Escudier B, Porta C, Schmidinger M et al (2016) Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow up. Ann Oncol 27(Suppl.5):v58–v68

    Article  CAS  PubMed  Google Scholar 

  • Heng DY, Xie W, Regan MM et al (2009) Prognostic factors for overall survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted agents: results from a large, multicenter study. J Clin Oncol 27:5794–5799

    Article  CAS  PubMed  Google Scholar 

  • Heng DY, Xie W, Regan MM et al (2013) External validation and comparison with other models of the International Metastatic Renal- Cell Carcinoma Database Consortium prognostic model: a population-based study. Lancet Oncol 14:141–148

    Article  PubMed  PubMed Central  Google Scholar 

  • Hes O, Petersson F, Kuroda N et al (2013) Renal hybrid oncocytic/chromophobe tumors- A review. Histol Histopathol 28:1257–1264

    PubMed  Google Scholar 

  • Hock LM, Lynch J, Balaji KC (2002) Increasing incidence of all stages of kidney cancer in the last 2 decades in the United States: an analysis of surveillance, epidemiology and end results program data. J Urol 167(1):57–60

    Article  PubMed  Google Scholar 

  • Hudes G, Carducci M, Tomczak P et al (2007) Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med 356:2271–2281

    Article  CAS  PubMed  Google Scholar 

  • Jayson M, Sanders H (1998) Increased incidence of serendipitously discovered renal cell carcinoma. Urology 51:203–205

    Article  CAS  PubMed  Google Scholar 

  • Junker K, Ficarra V, Kwon ED et al (2012) Potential role of genetic markers in the management of kidney cancer. Eur Urol 63(2):333–340

    Article  CAS  PubMed  Google Scholar 

  • Kantarjian HM, Wolff RA (eds) (2010) The MD Anderson manual of medical oncology Chapter 35, 3rd edn. McGraw-Hill Medical, New York, p 916

    Google Scholar 

  • Konety B, Vaena D, Williams R (2013) Renal parenchymal neoplasms. In: McAninch J, Lue T (eds) Smith and Tanagho’s general urology, 18th edn. McGraw-Hill, New York, pp 330–340

    Google Scholar 

  • Levi F, Ferlay J, Galeone C et al (2008) The changing pattern of kidney cancer incidence and mortality in Europe. BJU Int 101(8):949–958

    Article  PubMed  Google Scholar 

  • Ljungberg B (2016) Renal cell carcinoma. In: European Association of Urology Guidelines. European Association of Urology. Available via https://uroweb.org/guideline/renal-cell-carcinoma. Accessed 26 Feb 2017

  • Magi-Galluzzi C, Zhou M (2010) Ureter, urinary bladder and kidney chapter 10. In: Gattuso P, Reddy VB, David O, Spitz DJ, Haber MH (eds) Differential diagnosis in surgical pathology, 2nd edn. Saunders, Elsevier, Philadelphia, pp 487–538

    Chapter  Google Scholar 

  • Margulis V, Matin S, Wood C (2012) Benign renal tumors. In: Kavoussi L, Novick A, Partin A, Peters C (eds) Campbell-Walsh urology, 10th edn. Saunders, Philadelphia, pp 1496–1501

    Google Scholar 

  • Miller BA, Scoppa SM, Feuer EJ (2006) Racial/ethnic patterns in lifetime and age-conditional risk estimates for selected cancers. Cancer 106(3):670–682

    Article  PubMed  Google Scholar 

  • Moch H, Humphrey PA, Ulbright TM, Reuter VE (eds) (2016) WHO classification of tumours of the urinary system and male genital organs. IARC, Lyon

    Google Scholar 

  • Motzer RJ, Hutson TE, Tomczak P et al (2007) Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med 356:115–124

    Article  CAS  PubMed  Google Scholar 

  • Motzer RJ, Escudier B, Oudard S et al (2008) Efficacy of everolimus in advanced renal cell carcinoma: a double-blind, randomised, placebo-controlled phase III trial. Lancet 372:449–456

    Article  CAS  PubMed  Google Scholar 

  • Motzer RJ, Hutson TE, Cella D et al (2013) Pazopanib versus sunitinib in metastatic renal cell carcinoma. N Engl J Med 369:722–731

    Article  CAS  PubMed  Google Scholar 

  • Motzer RJ, Barrios CH, Kim TM et al (2014a) Phase II randomized trial comparing sequential first-line everolimus and second-line sunitinib versus first-line sunitinib and second-line everolimus in patients with metastatic renal cell carcinoma. J Clin Oncol 32:2765–2772

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Motzer RJ, Porta C, Vogelzang NJ et al (2014b) Dovitinib versus sorafenib for third-line targeted treatment of patients with metastatic renal cell carcinoma: an open-label, randomised phase 3 trial. Lancet Oncol 15:286–296

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Motzer RJ, Escudier B, McDermott DF et al (2015) Nivolumab versus everolimus in advanced renal-cell carcinoma. N Engl J Med 373:1803–1813

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Mues AC, Palacios JM, Haramis G et al (2010) Contemporary experience in the management of angiomyolipoma. J Endourol 24(11):1883–1886

    Article  PubMed  Google Scholar 

  • Murphy WM, Grignon DJ, Perlman EJ (2004) Tumors of the kidney, bladder and related urinary structures AFIP Atlas of Tumor Pathology Series 4, Washington

    Google Scholar 

  • Murray TE, Doyle F, Lee M (2015) Transarterial embolization of angiomyolipoma: a systematic review. J Urol 194(3):635–639

    Article  PubMed  Google Scholar 

  • Novara G, Ficarra V, Antonelli A et al (2010) Validation of the 2009 TNM version in a large multi-institutional cohort of patients treated for renal cell carcinoma: are further improvements needed? Eur Urol 58:588–595

    Article  PubMed  Google Scholar 

  • Ouzaid I, Autorino R, Fatica R et al (2014) Active surveillance for renal angiomyolipoma: outcomes and factors predictive of delayed intervention. BJU Int 114(3):412–417

    PubMed  Google Scholar 

  • Oxley JD, Sullivan J, Mitchelmore A et al (2007) Metastatic renal oncocytoma. J Clin Pathol 60(6):720–722

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Paner GP, Turk TM, Clark JI, Lindgren V, Picken MM (2005) Passive seeding in metanephric adenoma: a review of pseudometastatic lesions in perinephric lymph nodes. Arch Pathol Lab Med 129(10):1317–1321

    PubMed  Google Scholar 

  • Paner GP, Amin MB, Alvarado-Cabrero I et al (2010) A novel tumor grading scheme for chromophobe renal cell carcinoma: prognostic utility and comparison with Fuhrman nuclear grade. Am J Surg Pathol 34:1233–1240

    Article  PubMed  Google Scholar 

  • Pignot G, Elie C, Conquay S et al (2007) Survival analysis of 130 patients with papillary renal cell carcinoma: prognostic utility of type 1 and type 2 subclassification. Urology 69:230–235

    Article  PubMed  Google Scholar 

  • Poulakis V, Witsch U, de Vries R et al (2003) Quality of life after surgery for localized renal cell carcinoma: comparison between radical nephrectomy and nephron-sparing surgery. Urology 62:814–820

    Article  PubMed  Google Scholar 

  • Przybycin CG, McKenney JK, Reynolds JP et al (2014) Rhabdoid differentiation is associated with aggressive behavior in renal cell carcinoma: a clinicopathologic analysis of 76 cases with clinical follow-up. Am J Surg Pathol 38(9):1260–1265

    PubMed  Google Scholar 

  • Ramon J, Rimon U, Garniek A et al (2009) Renal angiomyolipoma: long-term results following selective arterial embolization. Eur Urol 55(5):1155–1161

    Article  PubMed  Google Scholar 

  • Rini BI, Campbell SC, Escudier B (2009) Renal cell carcinoma. Lancet 373:1119–1132

    Article  CAS  PubMed  Google Scholar 

  • Rini BI, Escudier B, Tomczak P et al (2011) Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): a randomised phase 3 trial. Lancet 378:1931–1939

    Article  CAS  PubMed  Google Scholar 

  • Romis L, Cindolo L, Patard JJ et al (2004) Frequency, clinical presentation and evolution of renal oncocytomas: Multicentric experience from a European database. Eur Urol 45:53–57

    Article  PubMed  Google Scholar 

  • Ross H, Martignoni G, Argani P (2012) Renal cell carcinoma with clear cell and papillary features. Arch Pathol Lab Med 136:391–399

    Article  PubMed  Google Scholar 

  • Sheth S, Scatarige JC, Horton KM et al (2001) Current concepts in the diagnosis and management of renal cell carcinoma: role of multidetector ct and three-dimensional CT. Radiographics 21:S237–S254

    Article  PubMed  Google Scholar 

  • Srigley JR, Delahunt B, Eble JN et al (2013) The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. Am J Surg Pathol 37:1469–1489

    Article  PubMed  Google Scholar 

  • Sternberg CN, Davis ID, Mardiak J et al (2010) (2010) Pazopanib in locally advanced or metastatic renal cell carcinoma: results of a randomized phase III trial. J Clin Oncol 28:1061–1068

    Article  CAS  PubMed  Google Scholar 

  • Störkel S, Eble JN, Adlakha K et al (1997) Classification of renal cell carcinoma: Workgroup No. 1. Union Internationale Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC). Cancer 80(5):987–989

    Article  PubMed  Google Scholar 

  • Sukov WR, Lohse CM, Leibovich BC et al (2012) Clinical and pathological features associated with prognosis in patients with papillary renal cell carcinoma. J Urol 187(1):54–59

    Article  PubMed  Google Scholar 

  • Tannir NM, Jonasch E, Albiges L et al (2016) Everolimus versus sunitinib prospective evaluation in metastatic non-clear cell renal cell carcinoma (ESPN): a randomized multicenter phase 2 trial. Eur Urol 69:866–874

    Article  CAS  PubMed  Google Scholar 

  • Toro JR, Glenn G, Duray P et al (1999) Birt-Hogg-Dubé syndrome: A novel marker of kidney neoplasia. Arch Dermatol 135:1195–1202

    PubMed  CAS  Google Scholar 

  • Truong LD, Shen SS (2011) Immunohistochemical diagnosis of renal neoplasms. Arch Pathol Lab Med 135:92–109

    PubMed  Google Scholar 

  • Urge T, Hes O, Ferda J et al (2010) Typical signs of oncocytic papillary renal cell carcinoma in everyday clinical praxis. World J Urol 28:513–517

    Article  CAS  PubMed  Google Scholar 

  • Van Poppel H, Da Pozzo L, Albrecht W et al (2011) A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol 59:543–552

    Article  PubMed  Google Scholar 

  • Vera-Badillo FE, Conde E, Duran I (2012) Chromophobe renal cell carcinoma: a review of an uncommon entity. Int J Urol 19:894–900

    Article  CAS  PubMed  Google Scholar 

  • Volpe A, Novara G, Antonelli A et al (2012) Chromophobe renal cell carcinoma (RCC): oncological outcomes and prognostic factors in a large multicentre series. BJU Int 110:76–83

    Article  PubMed  Google Scholar 

  • Wang H-Y, Mills SE (2005) KIT and RCC are useful in distinguishing chromophobe renal cell carcinoma from the granular variant of clear cell renal cell carcinoma. Am J Surg Pathol 29(5):640–646

    Article  PubMed  Google Scholar 

  • Zhou M, Magi-Galluzzi C (2007) Genitourinary pathology, foundations in diagnostic pathology. Churchill Livingstone, Philadelphia

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Karatrasoglou, E.A., Lazaris, A.C., Spapis, V., Zouki, D.N. (2018). Adult Kidney Neoplastic Pathology. In: Lazaris, A. (eds) Clinical Genitourinary Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-72194-1_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72194-1_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72193-4

  • Online ISBN: 978-3-319-72194-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics