Prostate adenocarcinoma: Difference between revisions
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===Gleason scoring=== | ===Gleason scoring=== | ||
[[File:Gleasonscore.jpg|370px|right]] | [[File:Gleasonscore.jpg|370px|right]] | ||
[[File:Invasive cribriform prostate carcinoma.jpg|thumb|Cribriform pattern: Gleason grade 4]] | |||
Rate the dominant, or most common cell morphology (scored 1—5), in addition to the non-dominant cell pattern with the highest grade (scored 1—5). | Rate the dominant, or most common cell morphology (scored 1—5), in addition to the non-dominant cell pattern with the highest grade (scored 1—5). | ||
Revision as of 11:31, 29 October 2019
Authors:
Mikael Häggström; Authors of integrated Creative Commons article[1] [note 1]
Gross processing
As prostatectomy or biopsy.
Microscopic evaluation
Indicators
A) blue mucin (arrow) in acinar adenocarcinoma.
B) Multiple nucleoli (arrow) in acinar adenocarcinoma.
C) two mitoses (arrow) in reactive epithelium
D) double and marginated nucleoli (arrows) in acinar adenocarcinoma.[1]
- Collagenous micronodules
- Glomerulations
- Perineural invasion
- Angiolymphatic invasion
- Extraprostatic extension
- Relatively common and highly specific
- [1]
- Multiple nucleoli
- Eccentric nucleoli[1]
- Less specific findings.
- Mitoses (also seen in for example high-grade prostatic intraepithelial neoplasia (HGPIN) and prostate inflammation).[1]
- Prominent nucleoli[1]
- Intraluminal eosinophilic secretion[1]
- Intraluminal blue mucin[1]
In uncertain cases, a diagnosis of malignancy can be discarded by immunohistochemical detection of basal cells.[1]
Gleason scoring
Rate the dominant, or most common cell morphology (scored 1—5), in addition to the non-dominant cell pattern with the highest grade (scored 1—5).
Staging
Depending on sample type:
- Multiple biopsy specimens: Adenocarcinoma presence in how many of the biopsies
- Prostatectomy: Stage by TNM:
From the AJCC 7th edition[2] and International Union Against Cancer (UICC) 7th edition.[3]
- Evaluation of the (primary) tumor ('T')
- TX: cannot evaluate the primary tumor
- T0: no evidence of tumor
- T1: tumor present, but not detectable clinically or with imaging
- T1a: tumor was incidentally found in 5% or less of prostate tissue resected (for other reasons)
- T1b: tumor was incidentally found in greater than 5% of prostate tissue resected
- T1c: tumor was found in a needle biopsy performed due to an elevated serum PSA
- T2: the tumor can be felt (palpated) on examination, but has not spread outside the prostate
- T2a: the tumor is in half or less than half of one of the prostate gland's two lobes
- T2b: the tumor is in more than half of one lobe, but not both
- T2c: the tumor is in both lobes but within the prostatic capsule
- T3: the tumor has spread through the prostatic capsule (if it is only part-way through, it is still T2)
- T3a: the tumor has spread through the capsule on one or both sides
- T3b: the tumor has invaded one or both seminal vesicles
- T4: the tumor has invaded other nearby structures
- Evaluation of the regional lymph nodes ('N')
- NX: cannot evaluate the regional lymph nodes
- N0: there has been no spread to the regional lymph nodes
- N1: there has been spread to the regional lymph nodes
- Evaluation of distant metastasis ('M')
- MX: cannot evaluate distant metastasis
- M0: there is no distant metastasis
- M1: there is distant metastasis
- M1a: the cancer has spread to lymph nodes beyond the regional ones
- M1b: the cancer has spread to bone
- M1c: the cancer has spread to other sites (regardless of bone involvement)
Report
- Diagnosis
- Gleason score
- Stage, or number of biopsies where tumor is found.
- Any perineural or angiolymphatic invasion.
See also: General notes on reporting
Notes
- ↑ "Rare" here refers to prevalence at least in core biopsies.(Cruz 2016)
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 Initially largely copied from: Cruz, Andrea O.; Santana, Amanda L. S.; Santos, Andréia C.; Athanazio, Daniel A. (2016). "Frequency of the morphological criteria of prostate adenocarcinoma in 387 consecutive prostate needle biopsies: emphasis on the location and number of nucleoli ". Jornal Brasileiro de Patologia e Medicina Laboratorial. doi:. ISSN 1676-2444.
- ↑ American Joint Committee on Cancer. Edge, Stephen B, ed. (2010). AJCC cancer staging manual. (7th ed.). New York: Springer. p. 457–468. ISBN 9780387884400.
- ↑ . TNM | UICC (in en). Union for International Cancer Control. Retrieved on 11 November 2017.
Image sources