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Amended classification of renal tumours 2013 (International Society of Urological Pathology Vancouver Classification of Renal Neoplasia)


Authors: Milan Hora 1;  Tomáš Ürge 1;  Kristýna Kalusová 1;  Michal Michal 2;  Zdeněk Chudáček 3;  Jiří Ferda 4;  Ondřej Hes 2
Authors‘ workplace: Urologická klinika LF UK a FN, Plzeň 1;  Šiklův patologicko-anatomický ústav LF UK a FN, Plzeň 2;  Radiodiagnostické oddělení FN, Plzeň 3;  Klinika zobrazovacích metod FN, Plzeň 4
Published in: Ces Urol 2014; 18(1): 9-20
Category: Review article

Overview

Introduction:
Kidney tumours form a broad spectrum of histopathological entities. The last WHO classification was formulated in 2004. An actualized version was published in October 2013 by International Society of Urological Pathology. We present a summary of the substantial changes made, from the clinician’s point of view.

Overview:
Five epithelial tumours: tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, clear cell (tubulo) papillary RCC, MiT family translocation RCCs (in particular t(6;11) RCC), and hereditary leiomyomatosis RCC syndrome-associated RCC, were added to the classification. In addition, three RCCs, thyroid-like follicular RCC; succinate dehydrogenase B deficiency-associated RCC; and ALK translocation RCC, were added as provisional entities. Some modifications were made in existing entities: Multicystic clear cell RCC (formerly multilocular cstic RCC) has been logically included into a subcategory of clear CRCC, as a tumour with low malignant potential. Oncocytic papillary RCC (PRCC) wasn’t accepted as a distinctive subcategory of PRCC. Hybrid oncocytic chromophobe tumour, which exists in 3 clinical and pathological forms; Birt-Hogg-Dubé Syndrome, renal oncocytosis, and as a sporadic neoplasm, was classified within the chromophobe RCC category. Recent new findings related to RC origin; collecting duct carcinoma, renal medullary carcinoma, and mucinous spindle cell and tubular RCC, were included. New insights into angiomyolipoma, including the epithelioid and epithelial cystic variants, were summarized as well. Cystic nephroma, and mixed epithelial and stromal tumour, were combined into one category. Synovial sarcoma was placed within the sarcoma group. The new classification is referred to as the International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia.

Conclusion:
Urologists should be educated in ISUP Vancouver Classification of Renal Neoplasia, as it contains a lot of substantial changes compared to the 2004 WHO classification and we predict that it will become a basis for the new WHO classification.

Key words:
renal tumours, classification.


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Labels
Paediatric urologist Nephrology Urology
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