Updates in the WHO Classification of Adult Renal Neoplasia Including Differential Diagnoses and Diagnostic Pitfalls

 

In 2022, a new version of the WHO's Urinary and Male Genital Tumours was published. In this new edition, a contemporary classification for renal tumors included 1) a new subgrouping of tumors (i.e., “molecularly defined,” “oncocytic,” and “other” categories), 2) the official inclusion of three new renel cell carcinoma (RCC) subtypes, 3) downgrading of one tumor type from carcinoma to benign, 4) the elimination of so-called type I and type I papillary RCCs, and 5) a new list of emerging entities that require additional evidence prior to inclusion as distinct subtypes. These new WHO changes, as well as corresponding diagnostic criteria, differential diagnoses, ancillary studies, molecular alterations, and potential diagnostic pitfalls will be discussed.

Originally published on December 4, 2023

Lecture Presenter

Michelle S. Hirsch, MD, PhD

Michelle S. Hirsch, MD, PhD

Chief, Genitourinary Pathology
Brigham and Women's Hospital
Associate Professor of Pathology
Harvard Medical School

Dr. Hirsch is originally from Northern California but moved to Boston more than 30 years ago to obtain her PhD in anatomy and cell biology and her MD from Boston University. She then completed an anatomic pathology residency at Brigham and Women’s Hospital (BWH) in Boston, followed by both women’s and perinatal pathology and genitourinary (GU) pathology fellowships. Dr. Hirsch joined the staff at BWH in 2003, was appointed chief of the GU pathology division in 2010, and has been an associate professor of Pathology at Harvard Medical School since 2012. Dr. Hirsch has served as president of the New England Society of Pathology and was a previous member of the USCAP education committee. Her research focuses on biomarkers in the GU and GYN tracts, with an emphasis on kidney and testicular tumors. She has nearly 200 published manuscripts, reviews, editorials, and chapters (in toto). Dr. Hirsch is passionate about teaching and mentoring.

Objectives

After this presentation, participants will be able to:

  • Discuss the new and emerging entities in the WHO classification of adult renal epithelial tumors
  • Describe morphologic features to form a differential diagnosis for adult renal epithelial tumor subtypes
  • Utilize ancillary studies to more accurately diagnose adult renal epithelial tumor subtypes
  • Describe (a subset of) kidney tumors that are associated with familial syndromes
  • Recognize pitfalls/outliers in renal epithelial tumor diagnoses

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories