New developments in existing WHO entities and evolving molecular concepts: The Genitourinary Pathology Society (GUPS) update on renal neoplasia.


Journal

Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
ISSN: 1530-0285
Titre abrégé: Mod Pathol
Pays: United States
ID NLM: 8806605

Informations de publication

Date de publication:
07 2021
Historique:
received: 19 10 2020
accepted: 11 02 2021
revised: 11 02 2021
pubmed: 6 3 2021
medline: 27 1 2022
entrez: 5 3 2021
Statut: ppublish

Résumé

The Genitourinary Pathology Society (GUPS) reviewed recent advances in renal neoplasia, particularly post-2016 World Health Organization (WHO) classification, to provide an update on existing entities, including diagnostic criteria, molecular correlates, and updated nomenclature. Key prognostic features for clear cell renal cell carcinoma (RCC) remain WHO/ISUP grade, AJCC/pTNM stage, coagulative necrosis, and rhabdoid and sarcomatoid differentiation. Accrual of subclonal genetic alterations in clear cell RCC including SETD2, PBRM1, BAP1, loss of chromosome 14q and 9p are associated with variable prognosis, patterns of metastasis, and vulnerability to therapies. Recent National Comprehensive Cancer Network (NCCN) guidelines increasingly adopt immunotherapeutic agents in advanced RCC, including RCC with rhabdoid and sarcomatoid changes. Papillary RCC subtyping is no longer recommended, as WHO/ISUP grade and tumor architecture better predict outcome. New papillary RCC variants/patterns include biphasic, solid, Warthin-like, and papillary renal neoplasm with reverse polarity. For tumors with 'borderline' features between oncocytoma and chromophobe RCC, a term "oncocytic renal neoplasm of low malignant potential, not further classified" is proposed. Clear cell papillary RCC may warrant reclassification as a tumor of low malignant potential. Tubulocystic RCC should only be diagnosed when morphologically pure. MiTF family translocation RCCs exhibit varied morphologic patterns and fusion partners. TFEB-amplified RCC occurs in older patients and is associated with more aggressive behavior. Acquired cystic disease (ACD) RCC-like cysts are likely precursors of ACD-RCC. The diagnosis of renal medullary carcinoma requires a negative SMARCB1 (INI-1) expression and sickle cell trait/disease. Mucinous tubular and spindle cell carcinoma (MTSCC) can be distinguished from papillary RCC with overlapping morphology by losses of chromosomes 1, 4, 6, 8, 9, 13, 14, 15, and 22. MTSCC with adverse histologic features shows frequent CDKN2A/2B (9p) deletions. BRAF mutations unify the metanephric family of tumors. The term "fumarate hydratase deficient RCC" ("FH-deficient RCC") is preferred over "hereditary leiomyomatosis and RCC syndrome-associated RCC". A low threshold for FH, 2SC, and SDHB immunohistochemistry is recommended in difficult to classify RCCs, particularly those with eosinophilic morphology, occurring in younger patients. Current evidence does not support existence of a unique tumor subtype occurring after chemotherapy/radiation in early childhood.

Identifiants

pubmed: 33664427
doi: 10.1038/s41379-021-00779-w
pii: S0893-3952(22)00590-7
doi:

Types de publication

Journal Article Practice Guideline

Langues

eng

Sous-ensembles de citation

IM

Pagination

1392-1424

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Auteurs

Kiril Trpkov (K)

Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. kiril.trpkov@albertaprecisionlabs.ca.

Ondrej Hes (O)

Department of Pathology, Charles University in Prague, Faculty of Medicine and University Hospital in Plzen, Plzen, Czech Republic.

Sean R Williamson (SR)

Robert J Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.

Adebowale J Adeniran (AJ)

Department of Pathology, Yale School of Medicine, New Haven, CT, USA.

Abbas Agaimy (A)

Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany.

Reza Alaghehbandan (R)

Department of Pathology, Faculty of Medicine, University of British Columbia, Royal Columbian Hospital, Vancouver, BC, Canada.

Mahul B Amin (MB)

Department of Pathology and Laboratory Medicine and Urology, University of Tennessee Health Science, Memphis, TN, USA.

Pedram Argani (P)

Departments of Pathology and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.

Ying-Bei Chen (YB)

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Liang Cheng (L)

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

Jonathan I Epstein (JI)

Departments of Pathology, Urology and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.

John C Cheville (JC)

Department of Pathology, Mayo Clinic, Rochester, MN, USA.

Eva Comperat (E)

Department of Pathology, Hôpital Tenon, Sorbonne University, Paris, France.

Isabela Werneck da Cunha (IW)

Pathology Department, Rede D'OR-Sao Luiz, Sao Paulo, SP, Brazil.

Jennifer B Gordetsky (JB)

Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.

Sounak Gupta (S)

Department of Pathology, Mayo Clinic, Rochester, MN, USA.

Huiying He (H)

Department of Pathology, Health Science Center, Peking University, Beijing, China.

Michelle S Hirsch (MS)

Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Peter A Humphrey (PA)

Department of Pathology, Yale School of Medicine, New Haven, CT, USA.

Payal Kapur (P)

Departments of Pathology, Urology, Kidney Cancer Program, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Fumiyoshi Kojima (F)

Department of Human Pathology, Wakayama Medical University, Wakayama, Japan.

Jose I Lopez (JI)

Department of Pathology, Cruces University Hospital, Biocruces-Bizkaia Institute, Bizkaia, Spain.

Fiona Maclean (F)

Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
Anatomical Pathology, Douglass Hanly Moir Pathology, Sydney, NSW, Australia.

Cristina Magi-Galluzzi (C)

Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA.

Jesse K McKenney (JK)

Robert J Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.

Rohit Mehra (R)

Department of Pathology and Michigan Center for Translational Pathology, University of Michigan Medical School, Ann Arbor, MI, USA.

Santosh Menon (S)

Department of Surgical Pathology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, India.

George J Netto (GJ)

Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA.

Christopher G Przybycin (CG)

Robert J Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.

Priya Rao (P)

Department of Pathology MD Anderson Cancer Center, Houston, TX, USA.

Qiu Rao (Q)

Department of Pathology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.

Victor E Reuter (VE)

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Rola M Saleeb (RM)

Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.

Rajal B Shah (RB)

Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, TX, USA.

Steven C Smith (SC)

Departments of Pathology and Urology, VCU School of Medicine, Richmond, VA, USA.

Satish Tickoo (S)

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Maria S Tretiakova (MS)

Department of Pathology, University of Washington School of Medicine, Seattle, Washington, USA.

Lawrence True (L)

Department of Pathology, University of Washington School of Medicine, Seattle, Washington, USA.

Virginie Verkarre (V)

Department of Pathology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université de Paris, PARCC, INSERM, Equipe Labellisée par la Ligue contre le Cancer, Paris, France.

Sara E Wobker (SE)

Departments of Pathology and Laboratory Medicine and Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Ming Zhou (M)

Department of Pathology, Tufts Medical Center, Boston, MA, USA.

Anthony J Gill (AJ)

Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Sydney, NSW, Australia.
NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia.

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