Grade Clinical


**Note 1:** Clinical grade must not be blank. **Note 2:** Assign the highest grade from the primary tumor assessed during the clinical time frame. **Note 3:** Codes 1-4 take priority over codes A-D. **Note 4:** The Fuhrman grade is no longer used for coding grade for Kidney cancers. The WHO/ISUP grade is now used. If the Fuhrman grade is documented, code 9. **Note 5:** Code 9 when * Grade from primary site is not documented * Clinical workup is not done (for example, cancer is an incidental finding during surgery for another condition) * Grade checked “not applicable” on CAP Protocol (if available) and no other grade information is available **Note 6:** If there is only one grade available and it cannot be determined if it is clinical, pathological, or after neo-adjuvant therapy, assign as a clinical grade and code unknown (9) for pathological grade, and blank for post-therapy grade.




NAACCR #3843


Code Description
1 G1: Nucleoli absent or inconspicuous and basophilic at 400x magnification
2 G2: Nucleoli conspicuous and eosinophilic at 400x magnification, visible but not prominent at 100x magnification
3 G3: Nucleoli conspicuous and eosinophilic at 100x magnification
4 G4: Marked nuclear pleomorphism and/or multinucleate giant cells and/or rhabdoid and/or sarcomatoid differentiation
A Well differentiated
B Moderately differentiated
C Poorly differentiated
D Undifferentiated, anaplastic
9 Grade cannot be assessed (GX); Unknown