*Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada †Department of Pathology and Molecular Medicine, Wellington School of Medicine, University of Otago, Wellington, New Zealand ‡Department of Pathology, Indiana University School of Medicine, Indianapolis, IN Departments of ∥Pathology, Urology and Oncology §§Pathology and Oncology, Johns Hopkins Medical Institutions, Baltimore, MD ††Memorial Sloan Kettering Cancer Centre, NY ‡‡Department of Pathology, in New York University Medical Centre, New York, NY §Department of Oncology and Pathology, Karolinska University Hospital Solna, Stockholm, Sweden ¶Department of Pathology, University Hospital Plzen, Plzen, Czech Republic #Institute of Surgical Pathology, University of Zurich, Switzerland **Section of Pathological Anatomy, Polytechnic University of Medicine, United Hospitals, Ancona, Italy.
Am J Surg Pathol. 2013 Oct;37(10):1469-89. doi: 10.1097/PAS.0b013e318299f2d1.
The classification working group of the International Society of Urological Pathology consensus conference on renal neoplasia was in charge of making recommendations regarding additions and changes to the current World Health Organization Classification of Renal Tumors (2004). Members of the group performed an exhaustive literature review, assessed the results of the preconference survey and participated in the consensus conference discussion and polling activities. On the basis of the above inputs, there was consensus that 5 entities should be recognized as new distinct epithelial tumors within the classification system: tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, clear cell (tubulo) papillary RCC, the MiT family translocation RCCs (in particular t(6;11) RCC), and hereditary leiomyomatosis RCC syndrome-associated RCC. In addition, there are 3 rare carcinomas that were considered as emerging or provisional new entities: thyroid-like follicular RCC; succinate dehydrogenase B deficiency-associated RCC; and ALK translocation RCC. Further reports of these entities are required to better understand the nature and behavior of these highly unusual tumors. There were a number of new concepts and suggested modifications to the existing World Health Organization 2004 categories. Within the clear cell RCC group, it was agreed upon that multicystic clear cell RCC is best considered as a neoplasm of low malignant potential. There was agreement that subtyping of papillary RCC is of value and that the oncocytic variant of papillary RCC should not be considered as a distinct entity. The hybrid oncocytic chromophobe tumor, which is an indolent tumor that occurs in 3 settings, namely Birt-Hogg-Dubé Syndrome, renal oncocytosis, and as a sporadic neoplasm, was placed, for the time being, within the chromophobe RCC category. Recent advances related to collecting duct carcinoma, renal medullary carcinoma, and mucinous spindle cell and tubular RCC were elucidated. Outside of the epithelial category, advances in our understanding of angiomyolipoma, including the epithelioid and epithelial cystic variants, were considered. In addition, the apparent relationship between cystic nephroma and mixed epithelial and stromal tumor was discussed, with the consensus that these tumors form a spectrum of neoplasia. Finally, it was thought that the synovial sarcoma should be removed from the mixed epithelial and mesenchymal category and placed within the sarcoma group. The new classification is to be referred to as the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia.
国际泌尿病理学会肾肿瘤共识会议的分类工作组负责就当前世界卫生组织肾肿瘤分类（2004 年）的新增和变更提出建议。该小组成员进行了详尽的文献回顾，评估了会前调查的结果，并参与了共识会议的讨论和投票活动。基于上述输入，专家组一致认为，在分类系统中应将 5 种实体确认为新的独特上皮性肿瘤：管状囊性肾细胞癌（RCC）、获得性囊性疾病相关 RCC、透明细胞（管状）乳头状 RCC、MiT 家族易位 RCC（特别是 t（6；11）RCC）和遗传性平滑肌瘤病 RCC 综合征相关 RCC。此外，还有 3 种罕见的癌被认为是新兴或暂定的新实体：甲状腺样滤泡性 RCC；琥珀酸脱氢酶 B 缺乏相关 RCC；以及 ALK 易位 RCC。需要进一步报告这些实体，以更好地了解这些极不寻常肿瘤的性质和行为。还有一些新的概念和对现有 2004 年世界卫生组织分类的修改建议。在透明细胞 RCC 组中，多房性透明细胞 RCC 被认为是一种低度恶性潜能的肿瘤。专家组一致认为，乳头状 RCC 的亚型分类具有价值，不应将乳头状 RCC 的嗜酸细胞变体视为一个独立实体。杂交嗜酸细胞嗜铬细胞瘤是一种惰性肿瘤，发生在 3 种情况下，即 Birt-Hogg-Dubé 综合征、肾嗜酸细胞瘤和散发性肿瘤，目前被归入嗜铬细胞瘤 RCC 类别。阐明了与集合管癌、肾髓质癌以及黏液性梭形细胞和管状 RCC 相关的最新进展。在上皮性肿瘤之外，还考虑了对血管平滑肌脂肪瘤的理解的进展，包括上皮样和上皮性囊性变体。此外，还讨论了囊性肾细胞瘤与混合上皮和间质肿瘤之间的明显关系，一致认为这些肿瘤形成了一种肿瘤谱系。最后，认为滑膜肉瘤应从混合上皮和间充质类别中移除，并归入肉瘤组。新的分类被称为国际泌尿病理学会温哥华肾肿瘤分类。
