Grade Pathological


**Note 1:** Pathological grade must not be blank. **Note 2:** Assign the highest grade from the primary tumor. If the clinical grade is the highest grade identified, use the grade that was identified during the clinical time frame for both the clinical grade and the pathological grade. (This follows the AJCC rule that pathological time frame includes all of the clinical time frame information plus information from the resected specimen.) * If a resection is done of a primary tumor and there is no grade documented from the surgical resection, use the grade from the clinical workup * If a resection is done of a primary tumor and there is no residual cancer, use the grade from the clinical workup **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 * No resection of the primary site * Neo-adjuvant therapy is followed by a resection (see post therapy grade) * Clinical case only (see clinical grade) * There is only one grade available and it cannot be determined if it is clinical, pathological, or after neo-adjuvant therapy * Grade checked "not applicable" on CAP Protocol (if available) and no other grade information is available




NAACCR #3844


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