The International Society of Urological Pathology (ISUP) Vancouver classification of renal neoplasia

John R. Srigley, Brett Delahunt, John N. Eble, Lars Egevad, Jonathan I. Epstein, David Grignon, Ondrej Hes, Holger Moch, Rodolfo Montironi, Satish K. Tickoo, Ming Zhou, Pedram Argani, Anila Abraham, Adebowale Adeniran, Khalid Ahmed, Hikmat Al Ahmadie, Ferran Algaba, Robert Allan, Mahul Amin, Ulrika AxcronaMarc Barry, Dilek Baydar, Louis Bégin, Dan Berney, Peter Bethwaite, Athanase Billis, Ruth Birbe, Stephen Bonsib, David Bostwick, Fadi Brimo, Helen Cathro, Ying Bei Chen, Liang Cheng, John Cheville, Yong Mee Cho, Ai Ying Chuang, Cynthia Cohen, Henry Crist, Warick Delprado, Fang Ming Deng, Andrew Evans, Oluwole Fadare, Daniel Fajardo, Sara Falzarano, Samson Fine, Stewart Fleming, Eddie Fridman, Bungo Furusato, Masoud Ganji, Masoumeh Ghayouri, Giovanna Giannico, Neriman Gokden, David Griffiths, Nilesh Gupta, Omar Hameed, Michelle Hirsch, Jiaoti Huang, Wei Huang, Christina Hulsbergen Van De Kaa, Peter Humphrey, Sundus Hussein, Kenneth Iczkowski, Rafael Jimenez, Edward Jones, Laura Irene Jufe, James Kench, Masatoshi Kida, Glen Kristiansen, Lakshmi Priya Kunju, Zhaoli Lane, Mathieu Latour, Claudio Lewin, Kathrine Lie, Josep Lloreta, Barbara Loftus, Antonio Lopez-Beltran, Fiona Maclean, Cristina Magi-Galluzzi, Guido Martignoni, Teresa McHale, Jesse McKenney, Maria Merino, Rose Miller, Hiroshi Miyamoto, Hedwig Murphy, John Nacey, Tipu Nazeer, Gabriella Nesi, George Netto, Peter Nichols, Marie O'Donnell, Semra Olgac, Roberto Orozco, Adeboye Osunkoya, Aysim Ozagari, Chin Chen Pan, Anil Parwani, Joanna Perry-Keene, Constantina Petraki, Maria Picken, Maria Pyda-Karwicka, Victor Reuter, Katayoon Rezaei, Nathalie Rioux-Leclercq, Brian Robinson, Stephen Rohan, Ruben Ronchetti, Laurie Russell, Hemamali Samaratunga, Marina Scarpelli, Ahmed Shabaik, Rajal Shah, Jonathan Shanks, Steven Shen, Maria Shevchuk, Mathilde Sibony, Bhuvana Srinivasan, Martin Susani, Sueli Suzigan, Joan Sweet, Hiroyuki Takahashi, Pheroze Tamboli, Puay Hoon Tan, Isabel Trias, Kiril Trpkov, Larry True, Toyonori Tsuzuki, Funda Vakar-Lopez, Theo Van Der Kwast, Cheng Wang, Anne Warren, Jorge Yao, Asli Yilmaz, Jin Zhao, Debra Zynger

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858 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1469-1489
Number of pages21
JournalAmerican Journal of Surgical Pathology
Issue number10
StatePublished - Oct 2013

All Science Journal Classification (ASJC) codes

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine


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