Histopathology and classification of renal cell tumors (adenomas, oncocytomas and carcinomas). The basic cytological and histopathological elements and their use for diagnostics

Abstract

The term renal cell tumors (adenomas and carcinomas) subsumes the tumors deriving from the uriniferous tubule epithelium of the kidney. Precise analysis shows that the renal cell tumors display different cell types which build up the individual tumor alone or in combination with each other. Three categories of basic elements are distinguished in the characterization of renal cell tumors: Cytological elements = tumor cell types: Clear, chromophobe, chromophilic (basophilic, eosinophilic), oncocytic, spindle-shaped/pleomorphic. Histological elements = growth patterns: Compact, acinar (nest-like), tubulopapillary (tubular, papillary), cystic. Cytological grading of malignancy: G I, G II, G III; mainly based on the degrees of nuclear atypia. The cytological features are given priority compared to the histological growth forms for classification of renal cell tumors. However, the latter are not to be neglected in the overall evaluation of a tumor. A classification of renal cell tumors is suggested and the result of its application in 510 renal cell carcinomas and oncocytomas is presented. On this basis and in connection with the cytological grading, a more precise prognostic evaluation of the renal cell carcinomas is expected.