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International Neuroblastoma Pathology Classification

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Adrenal_Neuroblastoma11_Undiff.jpg

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A morphologic classification of peripheral neuroblastic tumors has been established by the International Neuroblastoma Pathology Committee in 1999 and subsequently revised in 2003. It divides the tumor into two prognostic groupsfavorable histology and unfavorable histology. This classification is based on patient age, degree of Schwannian stroma development (stroma-poor, stroma-rich, and stroma-dominant), histologic grade (undifferentiated, poorly-differentiated, and differentiating), and Mitotic-Karyorrhectic Index (low, intermediate, high). The upper part of the image shows a band of residual adrenal cortex. The lower two-thirds shows neuroblastoma, undifferentiated subtype, composed of a uniform population of small cells with round hyperchromatic nuclei and little cytoplasm.

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