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Some advice please

Djinnie's picture
Posts: 945
Joined: Apr 2013

I received my results today, the tumour was a little larger than first indicated

4.3 x 3 x 2.3 cm. Non aggressive  Fuhrman 3

There were no cancer cells found within the margins.

I follow up with a CT TAP (Thorax, Abdomen, Pelvic) in September.

Also  intense lesions of chronic interstitial nephritis were found

It was a little difficult understanding everything as our French is not so good on medical terms. However, the Urologist appeared to say this type was the most prevelant.

The doctor stated that it could come back again, particularly as this is the second time in 10yrs and it could spread, possibly appear in the left kidney. There obviously is no way of knowing.

I wondered if anyone could explain to me what Fuhrman 3 means. I thought if it was not aggressive the likelyhood of it spreading was very small.

I know there is no hard and fast rule with any type of cancer, there are always so many other contributing factors.

I had not come across Fuhrman mentioned in other members results, so if anyone has an understanding of it I would appreciate the advice.





Galrim's picture
Posts: 305
Joined: Apr 2013

Fuhrman (nuclear) grade:
1 - Small, round, uniform nuclei (10 microns), inconspicuous nucleoli, look like lymphocytes (very rare)
2 - Slightly irregular nuclei, see nucleoli at 40x only, nuclear diameter 15 microns, open chromatin [40% of tumors]
3 - See nucleoli at 10x, nuclei very irregular, diameter 20 microns, open chromatin [30-40% of tumors]
4 - Mitoses; bizarre, multilobated, pleomorphic cells plus grade 3 features, macronucleoli [15% of tumors]

In laymans terms, the grading describes how much the cancer cells differ from normal kidney cells.

Additionally, it is a part of the combined prognostic factors that can be used to predict the likelyhood of re-occurrence.

The lower the grade, the less agressive it is.

Dont be overly alarmed, grade 3 isnt good obviously, but then again your tumor was relatively small which is a positive thing when it comes to the risk of re-occurrence.

More specific info: http://www.pathologyoutlines.com/topic/kidneytumormalignantnucleargrading.html


Texas_wedge's picture
Posts: 2803
Joined: Nov 2011

Fuhrman was the guy who devised the grading system that's in general use, so you're being told that you're (Fuhrman) grade 3.

The grading runs from 1 (lowest grade) to 4  (most aggressive) so you're a way short of most aggressive but close enough to merit regular scans for the immediate future.

When you were told you had the 'most prevalent' form that would mean that the type is clear cell.

Clear margins is very good news and the tumor was not large so your prognosis is good, Djinnie, though, as you say, with this, the sneaky disease. you can never take anything for granted.

Djinnie's picture
Posts: 945
Joined: Apr 2013

Hi Galrim & Texas ,

Thank you so much for taking the time to explain the results, I understand a lot of what the Doctor was trying to get across to me now. It was a very confusing meeting.

I consider my self fortunate that it was found in time and has now gone. Having regular check ups will always be a security blanket at least.


All the best 



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