ToolsCalculators
Fuhrman Nuclear Grade for Clear Cell Renal Carcinoma
Histologic nuclear grade and prognostic implication in clear cell RCC.
Fuhrman Nuclear Grade for Clear Cell Renal Carcinoma
Predominant nuclear grade on light microscopy
ResultGrade 1
Well differentiated; the most favourable nuclear grade. Grade is assigned from the least differentiated (worst) focus present.
- Fuhrman nuclear grade
- Grade 1 of 4
When to use
- Grading resected clear cell renal cell carcinoma to inform prognosis and follow-up intensity.
Formula
Categorical assessment of nuclear diameter, nuclear-outline irregularity, and nucleolar prominence in the least-differentiated tumour focus; Grade 4 additionally requires bizarre/multilobed nuclei or sarcomatoid differentiation.
Pearls and pitfalls
- Originally validated only in clear cell RCC; not recommended for chromophobe RCC.
- The WHO/ISUP grading system (based on nucleolar prominence alone, plus a separate criterion for Grade 4) has largely superseded Fuhrman grading in current pathology reporting.