classification of renal cell cancer

Last reviewed 03/2023

Classification

Three main histopathological RCC types have been described in the 2004 WHO classification and modified by International Society of Urological Pathology (ISUP) Vancouver Classification.

  • clear cell (ccRCC)
    • make up about 70% of all cancers of the kidney
    • commonly affects patients in their sixth to seventh decades of life but may occur in all age groups
    • tumor cells have clear cytoplasm and are arranged in compact nests, sheets, alveolar, or acinar structures separated by thin-walled blood vessels

  • papillary (pRCC - type I and II)
    • second most common type of RCC and accounts for 10-15% of RCCs
    • has a better prognosis (5-year survival around 90%)
    • two subtypes are recognised according to histology - type I & type II
      • type 1patients have a better prognosis than type II patients

  • chromophobe (chRCC)
    • accounts for 5% of RCC
    • cells contain largely empty cytoplasm
    • typically have characteristic perinuclear clearing
    • has the lowest risk of developing metastasis

Other renal tumors which include a variety of uncommon, sporadic, and familial carcinomas constitute the remaining 10-15 % of renal cortical tumours.

  • rare tumors of the nephron and collecting system
    • occurs in less than 5% of cases
    • e.g. - collecting duct carcinoma, renal medullary carcinoma, and urothelial carcinoma
    • highly distinct disease entities that bear little resemblance to RCCs.
  • premalignant and benign lesions arising in the kidney
    • include angiomyolipomas, oncocytomas (1,2,3)

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