Abstract

Introduction: There has been much interest in the morphologic subtypes of adult renal epithelial neoplasia

in the last years. Knowledge of the specific morphologic and cytogenetic characteristics has led to the

integration of this information into the classification systems. Renal cell carcinomas are classified as clear cell

(conventional), papillary, chromophobe, and unclassified subtypes, and collecting duct carcinoma in the recent

World Health Organization 2004 classification system. Genetic changes in the development of each of these

histologic subtypes are generally unique to each tumor type, and may be useful for molecular diagnosis of

renal primary or metastatic tumors.

A prognostic marker ideally should have high specificity, sensitivity, and reproducibility, well supported

in the literature, and used regularly to manage patients. They should be clinically relevant and have an

independent prognostic significance. In this regard, the pathologic prognostic markers in renal cell carcinomas

are pathological stage, grade, and histopathologic type. Besides these parameters, a wide variety of anatomic,

microscopic, cytogenetic, and molecular markers have been evaluated and given promising information. But,

these data have not been fully proven and supported by clinicopathologic studies.

Identification of genetic anomalies may lead to more accurate diagnosis in renal tumors and the

corporation of this data a decision tree structured from clinical, anatomic, pathologic criteria, and molecular

marker expression may help to better prognostic evaluation and planning therapy, individually.