In the assessment of a patient with renal cell carcinoma (RCC), the Fuhrman nuclear grading system has been largely replaced by which classification endorsed by the International Society of Urological Pathology (ISUP)?
- A TNM 8th edition staging with size thresholds
- B Leibovich score for metastatic risk
- C WHO/ISUP grading system (nucleolar grade 1–4) ✓
- D SSIGN score incorporating stage, size, and necrosis
Correct answer: C. WHO/ISUP grading system (nucleolar grade 1–4)
Explanation
The WHO/ISUP nucleolar grading system has replaced the Fuhrman system for clear cell and papillary RCC grading. Grade 1 = inconspicuous nucleoli at 400x; Grade 2 = visible nucleoli at 400x; Grade 3 = prominent nucleoli at 100x; Grade 4 = extreme nuclear pleomorphism or sarcomatoid/rhabdoid differentiation. This grading is more reproducible and better correlates with outcome than the original Fuhrman system.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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