Prostate Gland Pathology
A pathologic report for prostate biopsy specimens (core or transurethral prostate resection) should include the following information: histologic type of cancer; Gleason primary and secondary pattern and total score; total number of cores; number of involved cores; percentage of prostatic tissue involved by tumor (especially for needle biopsies, either in each core or total linear mm of carcinoma/total linear mm of each core tissue); presence of perineural, angiolymphatic, and periprostatic fat invasion and seminal vesicle invasion; presence of high-grade prostate intraepithelial neoplasia (PIN) (if no carcinoma is found, the number of cores involved and pattern of high-grade PIN should be reported); and therapy-related changes.
A pathologic report for prostatectomy specimens should include the following information: structures included in specimen [prostate (complete or not), seminal vesicles, vas deferens, bladder neck]; weight; size in three dimensions; histologic type and location of tumor (if any); Gleason pattern(s) and score; percentage of prostate involved by tumor (need not give exact tumor volume but an indication of minute vs. voluminous); presence of perineural invasion; presence of angiolymphatic invasion; presence of extraprostatic tissue invasion; presence of high-grade PIN; margin status; lymph nodes (number of involved lymph nodes, number of sampled lymph nodes; extranodal tumor extension is not related to survival) and diameter of largest metastasis; acute or chronic inflammation (which often doesn’t correlate with clinical prostatitis); and presence of granulomatous prostatitis (which may elevate PSA and produce suspicious feeling gland).
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