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Pathology for Urologists

Clear Cell Renal Cell Carcinoma: Fuhrman Nuclear Grade


Image A
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Image B
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  • Grade 1: round or uniform nuclei; nucleoli not discernible or absent (image A).
  • Grade 2: slightly irregular nuclear contours; nucleoli visible at 400x (image B).

Image C
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Image D
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  • Grade 3: moderately to markedly irregular nuclear contours; nucleoli visible at 100x (image C).
  • Grade 4: multilobular nuclei or bizarre nuclei and large and prominent nucleoli (image D).
  • Grade is based on the highest grade present if heterogenous.
  • Application questionable in other non-clear cell RCC variants.

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