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Classification of renal cell cancer

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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)

Reference:


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