67 years old man Asymptomatic left solid renal tumor of 6 cm.

Presentación del tema: "67 years old man Asymptomatic left solid renal tumor of 6 cm."— Transcripción de la presentación:

1 67 years old man Asymptomatic left solid renal tumor of 6 cm. Radical nephrectomy Clear cell renal cell carcinoma Grade II Fuhrman grading Focal invasion fat tissue sinus Category pT3a

2 UROLOGIST COMMENTS

3 PATHOLOGIST COMMENTS

4 TUMOR-KIDNEY INTERFACE
Tumoral psedocapsule

5 TUMOR-KIDNEY INTERFACE
Tumoral psedocapsule

6 TUMOR-KIDNEY INTERFACE
Tumoral psedocapsule * *

7 TUMOR-CAPSULE INTERFACE
Kidney capsule

8 TUMOR-CAPSULE INTERFACE
Kidney capsule

9 KIDNEY-RENAL SINUS INTERFACE
No Kidney capsule

10 TUMOR-RENAL SINUS INTERFACE

11 RENAL SINUS

12 RENAL SINUS

13 RENAL SINUS

14 RENAL SINUS Vein wall Bonsib. Modern Pathol. 2007; 20: 44

15 RENAL SINUS

16 RENAL SINUS Extrarenal invasion 57% Only Sinus invasion.. 38.6%
Sinus+Capsule inv % Vascular invasion Sinus invasion % Capsule invasion.. 40% Main renal vein 55% Bonsib. Am. J. Surg. Pathol. 2004; 28: 1594

17 without stroma invasion
Vein involvement without stroma invasion 19.5% Bonsib. Am. J. Surg. Pathol. 2004; 28: 1594

18 Sinus invasion and Fuhrman grading Sinus invasion and Tumoral size
Grade % Grade % Sinus invasion and Tumoral size Bonsib. Am. J. Surg. Pathol. 2004; 28: 1594

19 Sinus fat tissue invasion
21% of cases with extra-renal growth Sobrev.5a G M+ Peri-Renal 50.9% 7% % Sinusal. 25.9% 19% % J. Urol 2005; 174: AJSP 2004; 28:

20 ONCOLOGIST COMMENTS

21 63 years old man Asymptomatic rigth solid renal tumor of 7.5 cm. Radical nephrectomy Chromophobe renal cell carcinoma Grade III Fuhrman grading Without invasion Category pT2a

22 UROLOGIST COMMENTS

23 PATHOLOGIST COMMENTS

24 Grados de Fuhrman Carcinomas células claras G1 G2 G3 G4

25 Disease-specific Survival Months from Nephrectomy
GRADOS DE FUHRMAN Carcinomas células claras Rate (%) G1 5 yr 96 10 yr 93 15 yr 83 G2 68 54 44 G3 42 24 Median 41 G4 1 yr 43 2 yr 25 10 11 G1 100% 80% G2 60% Disease-specific Survival G3 40% T 20% G4 0% 60 120 180 Months from Nephrectomy

26 Grados de Fuhrman Carcinomas cromófobos G1 G2 G3 G4

27 Grados de Fuhrman Carcinomas cromófobos

28 Carcinomas cromófobos
Nueva propuesta Carcinomas cromófobos Paner et al. Am. J. Surg. Pathol. 2010; 34: 1233 Grado 1 Con posible “atipia cromófoba” sin anaplasia ni apelotonamiento nuclear

29 Carcinomas cromófobos
Nueva propuesta Carcinomas cromófobos Paner et al. Am. J. Surg. Pathol. 2010; 34: 1233 Grado 2 Variaciones nucleares Apelotonamiento nuclear focal

30 Carcinomas cromófobos
Nueva propuesta Carcinomas cromófobos Paner et al. Am. J. Surg. Pathol. 2010; 34: 1233 Grado 3 Clara anaplasia Sarcomatoide

31 Carcinomas cromófobos
Nueva propuesta Carcinomas cromófobos Paner et al. Am. J. Surg. Pathol. 2010; 34: 1233

32 Carcinomas cromófobos
Nueva propuesta Carcinomas cromófobos Paner et al. Am. J. Surg. Pathol. 2010; 34: 1233

33 Carcinomas cromófobos
Nueva propuesta Carcinomas cromófobos Paner et al. Am. J. Surg. Pathol. 2010; 34: 1233

34 ONCOLOGIST COMMENTS