J Clin Pathol 65:106-113 doi:10.1136/jclinpath-2011-200339
  • Original article

Handling and reporting of nephrectomy specimens for adult renal tumours: a survey by the European Network of Uropathology

Editor's Choice
  1. Lars Egevad12
  1. 1Department of Pathology, Fundacion Puigvert-University Autonomous, Barcelona, Spain
  2. 2Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
  3. 3Department of Molecular Oncology, Barts Cancer Institute, London, UK
  4. 4Service d'anatomie et cytologie pathologiques, Hopital Foch, Paris, France
  5. 5Department of Pathology, Hôpital Pitié-Salpêtrière, Paris, France
  6. 6Department of Pathology, University Hospital of Wales, Cardiff, UK
  7. 7Institute of Pathology, University Hospital Bonn, Germany
  8. 8Unit of Anatomic Pathology, Cordoba University Medical School, Cordoba, Spain
  9. 9Anatomia Patologica, Department of Pathology and Diagnostics, University of Verona, Italy
  10. 10Institute for Surgical Pathology, University Hospital, Zurich, Switzerland
  11. 11Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region, Ancona, Italy
  12. 12Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Professor Lars Egevad, Department of Pathology, Radiumhemmet P1:02, Karolinska University Hospital, Stockholm 17176, Sweden; lars.egevad{at}
  • Accepted 27 August 2011
  • Published Online First 30 September 2011


Aim To collect information on current practices of European pathologists for the handling and reporting of nephrectomy specimens with renal tumours.

Methods and Results A questionnaire was circulated to the members of the European Network of Uropathology, which consists of 343 pathologists in 15 European countries. Replies were received from 48% of members. These replies indicated that nephrectomy specimens are most often received in formalin. Lymph nodes are found in less than 5% of nephrectomy specimens. All respondents give an objective measure of tumour size, most commonly in three diameters. The most common method to search for capsule penetration is to slice tissue outside the tumour perpendicularly into the tumour. The most common sampling algorithm from tumours greater than 2 cm is one section for every centimetre of maximum tumour diameter. Most respondents use the 2004 WHO renal tumour classification although only slightly over half consider small papillary tumours malignant if the diameter is greater than 5 mm. The Fuhrman grading system is widely used. Almost all use immunohistochemistry for histological typing in some cases, while only 7% always use it. The most utilised special stains are CK7 (95%), CD10 (93%), vimentin (86%), HMB45 (68%), c-kit (61%) and Hale's colloidal iron (52%). Only 18% use other ancillary techniques for diagnosis in difficult cases.

Conclusions While most pathologists appear to follow published guidelines for reporting renal carcinoma, there is still a need for the development of consensus and further standardisation of practice for contentious areas of specimen handling and reporting.


  • The first two authors contributed equally to the study.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.