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Citation:
Weerakkody Y, Sharma R, Fuhrman grade of renal cell carcinoma. Reference article, Radiopaedia.org (Accessed on 11 Oct 2024) https://doi.org/10.53347/rID-192659
The Fuhrman grade, or Fuhrman nuclear grade, is a pathological grading system used in determining aggressiveness in renal cell carcinoma. It is mainly based on size of the nucleoli and the morphology of the nucleoli.
It is graded into 4 categories:
grade 1: inconspicuous nucleoli at ×400 magnification and basophilic (low-grade)
grade 2: clearly visible nucleoli at ×400 magnification and eosinophilic (low-grade)
grade 3: clearly visible nucleoli at ×100 magnification (high grade)
grade 4: extreme pleomorphism or rhabdoid and/or sarcomatoid morphology (high grade and most aggressive)
Some studies have demonstrated the Fuhrman grade to be an independent predictor of survival 3.
History and etymology
It is named after Susan Fuhrman who initially described in 1982 1.
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1. Fuhrman S, Lasky L, Limas C. Prognostic Significance of Morphologic Parameters in Renal Cell Carcinoma. Am J Surg Pathol. 1982;6(7):655-64. doi:10.1097/00000478-198210000-00007 - Pubmed
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2. Sun R, Zhao S, Jiang H et al. Imaging Tool for Predicting Renal Clear Cell Carcinoma Fuhrman Grade: Comparing R.E.N.A.L. Nephrometry Score and CT Texture Analysis. Biomed Res Int. 2021;2021:1821876. doi:10.1155/2021/1821876 - Pubmed
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3. Qayyum T, McArdle P, Orange C et al. Reclassification of the Fuhrman Grading System in Renal Cell Carcinoma-Does It Make a Difference? SpringerPlus. 2013;2(1):378. doi:10.1186/2193-1801-2-378 - Pubmed
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4. Luo S, Wei R, Lu S et al. Fuhrman Nuclear Grade Prediction of Clear Cell Renal Cell Carcinoma: Influence of Volume of Interest Delineation Strategies on Machine Learning-Based Dynamic Enhanced CT Radiomics Analysis. Eur Radiol. 2021;32(4):2340-50. doi:10.1007/s00330-021-08322-w - Pubmed
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