Kidney Tumor

Specimen Type:
Right partial nephrectomy
Left partial nephrectomy
Right radical nephrectomy
Left radical nephrectomy

Tumor Site:
Upper pole
Middle
Lower pole
Not specified

Focality:
Unifocal
Multifocal

Tumor greatest dimension (cm):

Extent of Tumor (Macroscopic/Microscopic):
   Tumor limited to kidney
   Tumor extension into perinephric tissues
   Tumor extension beyond Gerota’s fascia
   Tumor extension into pelvicalyceal system
   Tumor extension into adrenal- direct extension (pT4)
   Tumor extension into adrenal- non-contiguous (pM1)
   Tumor extension into major veins
   Tumor extension into

Histologic Type:
Clear cell (conventional) renal carcinoma
Papillary renal cell carcinoma
Chromophobe renal cell carcinoma
Collecting duct carcinoma
Sarcomatoid carcinoma arising in renal cell carcinoma, subtype , %
Renal cell carcinoma, unclassified
Multilocular clear cell renal cell carcinoma
Renal medullary carcinoma
Translocation carcinoma (Xp11 or others)
Mucinous tubular and spindle cell carcinoma
Tubulocystic renal cell carcinoma
Other (specify):

Sarcomatoid Features:
Not identified
Present, %

Histologic Grade (Fuhrman Nuclear Grade):
Not applicable
G1: Nuclei round, uniform, approximately 10 µ; nucleoli inconspicuous or absent
G2: Nuclei slightly irregular, approximately 15 µ; nucleoli evident
G3: Nuclei very irregular, approximately 20 µ; nucleoli large and prominent
G4: Nuclei bizarre and multilobated, 20 µ or greater, nucleoli prominent, chromatin clumped

Pathologic Staging (pTNM) AJCC 7th edition
Primary Tumor (pT):
pTX: Primary tumor cannot be assessed
pT0: No evidence of primary tumor
pT1: Tumor 7 cm or less in greatest dimension, limited to the kidney
pT1a: Tumor 4 cm or less in greatest dimension, limited to the kidney
pT1b: Tumor more than 4 cm but not more than 7 cm in greatest dimension, limited to the kidney
pT2: Tumor more than 7 cm in greatest dimension, limited to the kidney
pT2a: Tumor more than 7 cm but less than or equal to 10 cm in greatest dimension, limited to the kidney
pT2b: Tumor more than 10 cm, limited to the kidney
pT3: Tumor extends into major veins or perinephric tissues but not into the ipsilateral adrenal gland and not beyond Gerota’s fascia
pT3a: Tumor grossly extends into the renal vein or its segmental (muscle containing) branches, or tumor invades perirenal and/or renal sinus fat but not beyond Gerota’s fascia
pT3b: Tumor grossly extends into the vena cava below the diaphragm
pT3c: Tumor grossly extends into vena cava above diaphragm or invades the wall of the vena cava
pT4: Tumor invades beyond Gerota’s fascia (including contiguous extension into the ipsilateral adrenal gland)

Regional Lymph Nodes (pN):
pNX: Cannot be assessed
pN0: No regional lymph node metastasis (0 / lymph nodes negative for carcinoma)
pN1: Metastasis in regional lymph node(s) ( / positive for metastatic carcinoma)

pM1: Documented metastases or non-contiguous adrenal involvement

Margins:
Cannot be assessed
Margins uninvolved by invasive carcinoma
Margin involved by invasive carcinoma:

Involved margins, if applicable:
   Renal capsular margin (partial nephrectomy only)
   Perinephric fat margin (partial nephrectomy only)
   Renal vein margin
   Gerota’s fascial margin
   Ureteral margin
   Renal parenchymal margin (partial nephrectomy only)
   Other (specify):

Partial nephrectomy:
Distance of carcinoma to parenchymal margin (mm):

Adrenal Gland:
Not present
Uninvolved by tumor
Direct invasion (T3a)
Metastasis (M1)

Venous (Large Vessel) Invasion (V) (excluding renal vein and inferior vena cava):
Absent
Present
Indeterminate

Lymphatic (Small Vessel) Invasion (L):
Absent
Present
Indeterminate

Pathologic Findings in Nonneoplastic Kidney:
   Insufficient tissue (partial nephrectomy specimen with <5 mm of adjacent nonneoplastic kidney)
   No significant pathologic change
   Glomerular disease (specify type):
   Tubulointerstitial disease (specify type):
   Vascular disease (specify type):
   Other (specify):