Grade Post Therapy


**Note 1:** Leave post-therapy grade blank when * No neoadjuvant therapy * Clinical or pathological case only * There is only one grade available and it cannot be determined if it is clinical, pathological or post-therapy **Note 2:** Assign the highest grade from the resected primary tumor assessed after the completion of neoadjuvant therapy. **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 * Surgical resection is done after neoadjuvant therapy and grade from the primary site is not documented * Grade checked “not applicable” on CAP Protocol (if available) and no other grade information is available


NAACCR #3845


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
<BLANK> See Note 1