Hes Ondřej
Cesk Patol. 2014;50(4):137-41.
Kidney tumours form a broad spectrum of distinguished histopathological and molecular genetic entities. The last WHO classification is dated to 2004. Current classification has been published in October 2013 by ISUP (International Society of Urological Pathology). There were 5 new epithelials tumours: 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. Another 3 subtypes of RCC were added as "provisional" entities: thyroid-like follicular RCC; succinate dehydrogenase B deficiency-associated RCC; and ALK translocation RCC. Modifications were performed in already existing entities: multicystic clear cell RCC (formerly multilocular cystic RCC) is newly included as a subcategory of clear cell RCC with low malignant potential. Oncocytic papillary RCC (PRCC) has not been recognized as a distinctive subcategory of PRCC yet. Hybrid oncocytic-chromophobe tumour was placed 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, current approach to our understanding of angiomyolipoma, including the epithelioid variant and angiomyolipoma with epithelial cysts was clarified. Cystic nephroma and mixed epithelial and stromal tumour were considered as a spectrum of one entity. Synovial sarcoma was 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.
肾肿瘤构成了一系列具有显著组织病理学和分子遗传学特征的实体。世界卫生组织的上一版分类可追溯到2004年。当前分类由国际泌尿病理学会(ISUP)于2013年10月发布。新增了5种上皮性肿瘤:肾小管囊性肾细胞癌(RCC)、获得性囊性疾病相关性RCC、透明细胞(小管状)乳头状RCC、MiT家族易位性RCC(特别是t(6;11)RCC)以及遗传性平滑肌瘤病RCC综合征相关性RCC。另外3种RCC亚型被列为“暂定”实体:甲状腺样滤泡性RCC;琥珀酸脱氢酶B缺陷相关性RCC;以及ALK易位性RCC。对现有实体进行了修改:多囊性透明细胞RCC(原多房性囊性RCC)新被纳入恶性潜能低的透明细胞RCC亚类。嗜酸性乳头状RCC(PRCC)尚未被视为PRCC的一个独特亚类。混合性嗜酸性细胞-嫌色细胞瘤被归入嫌色性RCC类别。阐述了与集合管癌、肾髓质癌以及黏液性梭形细胞和小管状RCC相关的最新进展。在非上皮性类别中,明确了当前对血管平滑肌脂肪瘤(包括上皮样变体和伴有上皮囊肿的血管平滑肌脂肪瘤)的认识。囊性肾瘤和混合性上皮和间质肿瘤被视为一个实体的不同表现形式。滑膜肉瘤被归入肉瘤组。新分类将被称为国际泌尿病理学会温哥华肾肿瘤分类。
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