ToolsCalculators
Fuhrman Nuclear Grade for Clear Cell Renal Carcinoma
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- The WHO/ISUP grading system (based on nucleolar prominence alone, plus a separate criterion for Grade 4) has largely superseded Fuhrman grading in current pathology reporting.