Pathology

Abstract

A checklist based approach to reporting the relevant pathologic details of renal cell carcinoma resection specimens improves the completeness of the report. Karyotypic evaluation of renal neoplasms has refined but also complicated their classification. The number of diagnostic possibilities has increased and the importance of distinguishing different tumor types has been underscored by dramatic variation in prognosis and the development of targeted therapies for specific subtypes. The increasing number of recognized renal neoplasms has implications for handling renal resection specimens. Furthermore, the prognostic significance of other features of renal neoplasms related to grade and stage has been demonstrated. This guideline for the handling of renal resection specimens will focus on problem areas in the evolving practice of diagnosis, grading, and staging of renal neoplasms. The accompanying checklist will serve to ensure that all necessary details of the renal resection specimen are included in the surgical pathology report. Editorial CommentThe reporting of renal cell carcinoma is facilitated by the provision of a checklist to insure that pathologists provide all of the essential information to enable clinicians to optimize patient care. The checklist includes the gross description and the diagnostic information:1. Gross description. Includes how the specimen is received, how the specimen is identified, the type of nephrectomy (total or partial), the length of ureters and the description of other structures. The tumor description includes the site within the kidney, the size in 3 dimensions, the gross characteristics (color, consistency and degree of heterogeneity, the relationship to the perinephric soft tissue with emphasis to the renal sinus fat, renal vein invasion, adrenal invasion, lymph nodes, and other findings (hydronephrosis, pyelonephritis, etc.) 2. Diagnostic information. Includes the histologic type according to the World Health Organization 2004 classification (1): clear cell carcinoma, multilocular cystic carcinoma, papillary carcinoma, mucinous tubular and spindle carcinoma, collecting duct carcinoma, medullary carcinoma, translocation carcinomas (includes Xp11 and 6:11