La classificazione anatomo-patologica
del carcinoma del rene
M.P. Gardiman (Padova)
DIPARTIMENTO DI MEDICINA - DIMED UNITA’ OPERATIVA COMPLESSA ANATOMIA PATOLOGICA GENERALE E
CITOPATOLOGIA
DIRETTORE: PROF. MASSIMO RUGGE
WHO 2004 WHO 2016
2013
nuove entità e acquisizione di nuove conoscenze riguardanti la morfologia, la ICH, la biologia molecolare dei vari istotipi di CCR
2016 WHO
classification of
Urogenital Tumours
2004
MEST
MEST
PROPOSED NEW EPITHELIAL NEOPLASMS
Hereditary leiomyomatosis and renal cell carcinoma (RCC) syndrome–associated RCC Succinate dehydrogenase–deficient renal cell carcinoma
Tubulocystic renal cell carcinoma
Acquired cystic disease–associated renal cell carcinoma Clear cell papillary renal cell carcinoma
Germline mutation in SDH (SDHB > SDHA)
SDHB
vacuoli
inclusioni
CK7 +
sec.Fuhrman decorso indolente e una buona prognosi
racemasi + / CK7 e CAIX neg.
Spectrum of patterns in variable proportions, branched papillary structures , acinar structures and areas indistinguishable from clear cell RCC
EMERGING/PROVISIONAL NEW TUMOR ENTITIES
Thyroid-like follicular RCCs
RCCs associated with ALK gene rearrangements
2013 ISUP Vancouver classification
thyroid-like follicular RCCs
Thyroid-like follicular carcinoma
Thyroid-like follicular carcinomas of the kidney are negative for thyroid transcription factor 1 (TTF-1)
ALK rearrangement-associated RCC
Grading
The tumour grade is
assigned according to the highest grade cells present, rather
than the most predominant.
Pathological tumour stage (TNM)
L’invasione del seno renale definita come
invasione del grasso o del tessuto connettivo o degli spazi vascolari del seno renale rappresenta la principale via di diffusione extrarenale del CCR
The presence of renal sinus invasion has been shown to be associated with more aggressive tumour behaviour than perinephric fat invasion
The nature of the invasive edge, whether pushing or infiltrative, has been shown to have prognostic significance,
with 3-year survival rates of 75% and 27%, respectively, although specification of the growth pattern is not currently a required item for pathology reports
