HF01-12: A History of Renal Tumors Through the Pages of Robbins Pathology and Campbell's Urology
Friday, May 3, 2024 3:49 PM to 3:54 PM · 5 min. (US/Central)
206
Abstract
History of Urology Forum
Information
Full Abstract and Figures
Author Block
Jennifer B Gordetsky, Jeffrey A Stump*, Jonathan C Craig, Aida Valencia, Nashville, TN
Introduction
We investigated the history of the classification of renal tumors, researching how and when its changing landscape was reflected in medical textbooks with a focus on Robbins Pathology and Campbell's Urology.
Methods
Landmark articles on renal neoplasia available in PubMed were evaluated. Textbooks including Robbins Pathology, Campbell’s Urology, and other popular texts were reviewed for the incorporation of scientific discoveries.
Results
A timeline of discoveries is presented in Figure 1. Information in medical textbooks lagged scientific discoveries. Case reports of renal tumors were described in the 1800s, yet in the textbook “Pathology and Morbid Anatomy” (1889), “carcinomata” of the kidney are absent. In 1926, “Young’s Practice of Urology” states, “...the greatest uncertainty reigns as to the histogenesis of these tumors, and competent pathologists have described them as sarcoma, hypernephroma, angiosarcoma, endothelioma, and carcinoma”. The original term “hypernephroma” (1894) designated these tumors as adrenal in origin, a theory rejected in a scientific literature review published in 1936. The 1st edition of Campbell (1954) and Robbins (1957) question but do not completely reject the adrenal origin theory. Electron microscopy definitively proved renal cell origin in 1959. In 1976, papillary renal cell carcinoma (RCC) was recognized as a separate entity from clear cell RCC. Campbell separates out "papillary adenocarcinoma" from "classic hypernephroma" in 1979. In 1984 Robbins recognized that most tumors were “clear cell” and associated with VHL. Campbell first mentioned VHL in 1992. Pathologic-based classification occurred in both texts in the late 1990s; Robbins specifying clear cell, papillary, and chromophobe as subtypes, and Campbell using chromophobe, adenocarcinoma NOS (clear/granular), and collecting duct carcinoma. Campbell finally abandoned “hypernephroma” completely in the 10th edition (2011), citing the 2004 WHO, which classified RCC as a group of different tumor subtypes based on molecular studies.
Conclusions
Histology, immunohistochemistry, and molecular techniques revolutionized our understanding of renal tumors. As we continue this journey, Dr. Young’s comment holds true; competent pathologists will continue to describe renal tumors under many different names.
Source Of Funding
None
Author Block
Jennifer B Gordetsky, Jeffrey A Stump*, Jonathan C Craig, Aida Valencia, Nashville, TN
Introduction
We investigated the history of the classification of renal tumors, researching how and when its changing landscape was reflected in medical textbooks with a focus on Robbins Pathology and Campbell's Urology.
Methods
Landmark articles on renal neoplasia available in PubMed were evaluated. Textbooks including Robbins Pathology, Campbell’s Urology, and other popular texts were reviewed for the incorporation of scientific discoveries.
Results
A timeline of discoveries is presented in Figure 1. Information in medical textbooks lagged scientific discoveries. Case reports of renal tumors were described in the 1800s, yet in the textbook “Pathology and Morbid Anatomy” (1889), “carcinomata” of the kidney are absent. In 1926, “Young’s Practice of Urology” states, “...the greatest uncertainty reigns as to the histogenesis of these tumors, and competent pathologists have described them as sarcoma, hypernephroma, angiosarcoma, endothelioma, and carcinoma”. The original term “hypernephroma” (1894) designated these tumors as adrenal in origin, a theory rejected in a scientific literature review published in 1936. The 1st edition of Campbell (1954) and Robbins (1957) question but do not completely reject the adrenal origin theory. Electron microscopy definitively proved renal cell origin in 1959. In 1976, papillary renal cell carcinoma (RCC) was recognized as a separate entity from clear cell RCC. Campbell separates out "papillary adenocarcinoma" from "classic hypernephroma" in 1979. In 1984 Robbins recognized that most tumors were “clear cell” and associated with VHL. Campbell first mentioned VHL in 1992. Pathologic-based classification occurred in both texts in the late 1990s; Robbins specifying clear cell, papillary, and chromophobe as subtypes, and Campbell using chromophobe, adenocarcinoma NOS (clear/granular), and collecting duct carcinoma. Campbell finally abandoned “hypernephroma” completely in the 10th edition (2011), citing the 2004 WHO, which classified RCC as a group of different tumor subtypes based on molecular studies.
Conclusions
Histology, immunohistochemistry, and molecular techniques revolutionized our understanding of renal tumors. As we continue this journey, Dr. Young’s comment holds true; competent pathologists will continue to describe renal tumors under many different names.
Source Of Funding
None
Sessions
History of Urology Forum
206