Renal Cell Neoplasia

2003 WHO Classification



Papillary Adenoma





Clear cell Renal cell carcinoma

Multiolocular clear cell renal cell carcinoma

Papillary Renal cell carcinoma

Type 1

Type 2

Chromophobe Renal cell carcinoma


Eosinophilic variant

Carcinoma of collecting duct of Bellini

Renal meduallry carcinoma

Xp11 Translocation carcinoma

Carcinoma associated with Neuroblastoma

Mucinous tubular and spindle cell carcinoma

Renal cell carcinoma, Unclassified


The 2003 Classification recognized the connection of Metanephric adenoma with metanephric adenofibroma and metanephric stromal tumor and that there is no evidence of their origin from renal tubular epithelium by placing them in a category of Metanephric Neoplasia.


1997 Consensus Classification

Benign Neoplasms

Papillary Adenoma


Metanephric Adenoma


Malignant Neoplasms

Conventional(Clear Cell) carcinoma

Papillary carcinoma

Chromophobe carcinoma

Collecting duct carcinoma

Renal cell carcinoma, NOS



Renal cell carcinoma: Fuhrman Nuclear Grading


Grade 1 - Round, uniform nuclei approximately 10 microns in diameter (RBC is 6 microns) with minute or absent nucleoli

Grade 2 - Slightly irregular contours and diameters of approximately 15 microns with nucleoli visible at 400x

Grade 3 - Moderately to markedly irregular nuclear contours and diameters of approximately 20 microns with large nucleoli visible at 100x

Grade 4 - Nuclei similar to those of grade 3 but also multilobular or multiple nuclei or bizarre nuclei and heavy clumps of chromatin