Handling and Staging of Renal Cell Carcinoma

Autor: John R. Srigley, Cristina Magi-Galluzzi, Asli Yilmaz, Antonio Lopez-Beltran, Omar Hameed, Anne Y. Warren, Jesse K. McKenney, Pedram Argani, Wei Huang, Ruth Birbe, Roberto Orozco, Toyonori Tsuzuki, Edward C. Jones, Gabriella Nesi, Robert W. Allan, Stewart Fleming, Dilek Ertoy Baydar, Anila Abraham, Aysim Ozagari, Victor E. Reuter, Barbara Loftus, Josep Lloreta, Puay Hoon Tan, Jonathan H Shanks, Rodolfo Montironi, Teresa McHale, David G. Bostwick, Laura Irene Jufe, Mathieu Latour, Helen P. Cathro, Peter Bethwaite, Isabel Trias, Yong Mee Cho, Hemamali Samaratunga, Michelle S. Hirsch, Ai Ying Chuang, Masoud Ganji, Maria Merino, Chin Chen Pan, Giovanna A. Giannico, Ondrej Hes, Ming Zhou, Hiroyuki Takahashi, Theo H. van der Kwast, Glen Kristiansen, Semra Olgac, Hiroshi Miyamoto, Masatoshi Kida, Fiona Maclean, Mathilde Sibony, Fadi Brimo, Peter W. Nichols, Katayoon Rezaei, Ulrika Axcrona, Christina Hulsbergen Van De Kaa, Kiril Trpkov, Holger Moch, Lakshmi P. Kunju, Marina Scarpelli, Jonathan I. Epstein, Ruben Ronchetti, Jorge L. Yao, Nilesh S. Gupta, John C. Cheville, Debra L. Zynger, Khalid Ahmed, Louis R. Bégin, James G. Kench, Satish K. Tickoo, Warick Delprado, Rose Miller, Rajal B. Shah, Adeboye O. Osunkoya, Cheng Wang, Claudio Lewin, Daniel M. Berney, Sueli Suzigan, Maria Shevchuk, Sara M. Falzarano, Liang Cheng, Eddie Fridman, Masoumeh Ghayouri, Neriman Gokden, Maria M. Picken, Laurie Russell, Ferran Algaba, Funda Vakar-Lopez, Adebowale J. Adeniran, George J. Netto, Brett Delahunt, Nathalie Rioux-Leclercq, Larry True, Anil V. Parwani, David J. Griffiths, Mahul B. Amin, Martin Susani, David J. Grignon, Ahmed Shabaik, Kathrine Lie, Cynthia Cohen, Constantina Petraki, Fang Ming Deng, Marc Barry, Hedwig Murphy, Kenneth A. Iczkowski, Peter A. Humphrey, Steven S. Shen, Jiaoti Huang, Brian D. Robinson, Zhaoli Lane, Jin Zhao, Marie O'Donnell, Daniel A. Fajardo, Oluwole Fadare, Samson W. Fine, Bhuvana Srinivasan, Andrew Evans, Rafael E. Jimenez, Hikmat Al Ahmadie, Sundus Hussein, Ying-Bei Chen, Athanase Billis, Bungo Furusato, Guido Martignoni, Maria Pyda-Karwicka, Stephen M. Bonsib, Pheroze Tamboli, Joanna Perry-Keene, Stephen Rohan, Henry Crist, Joan Sweet, Tipu Nazeer, John N. Nacey, Lars Egevad
Rok vydání: 2013
Předmět:
Zdroj: American Journal of Surgical Pathology. 37:1505-1517
ISSN: 0147-5185
Popis: The International Society of Urologic Pathology 2012 Consensus Conference on renal cancer, through working group 3, focused on the issues of staging and specimen handling of renal tumors. The conference was preceded by an online survey of the International Society of Urologic Pathology members, and the results of this were used to inform the focus of conference discussion. On formal voting a Z65% majority was considered a consensus agreement. For specimen handling it was agreed that with radical nephrectomy specimens the initial cut should be made along the long axis and that both radical and partial nephrectomy specimens should be inked. It was recommended that sampling of renal tumors should follow a general guideline of sampling 1 block/cm with a minimum of 3 blocks (subject to modification as needed in individual cases). When measuring a renal tumor, the length of a renal vein/caval thrombus should not be part of the measurement of the main tumor mass. In cases with multiple tumors, sampling should include at a minimum the 5 largest tumors. There was a consensus that perinephric fat invasion should be determined by examining multiple perpendicular sections of the tumor/perinephric fat interface and by sampling areas suspicious for invasion. Perinephric fat invasion was defined as either the tumor touching the fat or extending as irregular tongues into the perinephric tissue, with or without desmoplasia. It was agreed upon that renal sinus invasion is present when the tumor is in direct contact with the sinus fat or the loose connective tissue of the sinus, clearly beyond the renal parenchyma, or if there is involvement of any endothelium-lined spaces within the renal sinus, regardless of the size. When invasion of the renal sinus is uncertain, it was recommended that at least 3 blocks of the tumor-renal sinus interface should be submitted. If invasion is grossly evident, or obviously not present (small peripheral tumor), it was agreed that only 1 block was needed to confirm the gross impression. Other recommendations were that the renal vein margin be considered positive only when there is adherent tumor visible microscopically at the actual margin. When a specimen is submitted separately as "caval thrombus, "the recommended sampling strategy is to take 2 or more sections to look for the adherent caval wall tissue. It was also recommended that uninvolved renal parenchyma be sampled by including normal parenchyma with tumor and normal parenchyma distant from the tumor. There was consensus that radical nephrectomy specimens should be examined for the purpose of identifying lymph nodes by dissection/palpation of the fat in the hilar area only; however, it was acknowledged that lymph nodes are found in
Databáze: OpenAIRE
Externí odkaz: