V.3.5.10 Fuhrman's Grade for Renal Cell Carcinoma

Use these instructions for cases diagnosed on or before 12/31/2013 only.

For cases diagnosed 01/01/2014 forward, see Section V.3.7.5  

January 1, 2004 and Forward

Effective with cases diagnosed January 1, 2004, the priority order for coding grade for renal cell carcinoma (site code C64.9) is as follows:

1. Fuhrman's grade
2. Nuclear grade
3. Terminology (well diff, moderately diff…)
4. Histologic grade (grade I, grade II…)

Fuhrman's grade is based on 3 parameters:

• Nuclear diameter: in microns
• Nuclear outline: regular or irregular
• Nucleoli (visibility): present or not and at what power (low or high power)

Fuhrman's grade (I-IV) is the sum of the points for all 3 parameters.

These prioritization rules do not apply to Wilm's tumor (morphology code 8960).

Note: This grading system is coded in a site-specific factor for the applicable CS schema.

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