Case ID: 193
Publication date: 03 Jun, 2015
Consensus grade: GS 3+4=7 (ISUP 2)
Show diagnosis by expert panel members| User | Diagnosis | Difficulty | Comment |
|---|---|---|---|
| Pathologist 1 | other | Borderline lower |
3+5, single cells |
| Pathologist 2 | GS 3+4=7 (ISUP 2) | Borderline higher | |
| Pathologist 3 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 4 | GS 3+4=7 (ISUP 2) | Borderline higher |
There may be a small tertiary pattern 5 present. For ISUP, some would call this a 3+5; I use classic Gleason grading. |
| Pathologist 5 | GS 3+4=7 (ISUP 2) | Borderline higher |
poorly formed glands |
| Pathologist 6 | GS 3+4=7 (ISUP 2) | Borderline higher |
poorly formed glands |
| Pathologist 7 | GS 3+4=7 (ISUP 2) | Borderline lower |
sclerous stroma and tangentila cutting ? of the glands, Some ribriform minor aspects |
| Pathologist 8 | GS 3+4=7 (ISUP 2) | Typical |
These are the cases that I find most difficult to grade. I don't believe that this is as aggressive as cases with focal cribriform growth, but I feel obligated to give it a "gestalt" 3+4=7 based on current rules. I'm sure that some even consider a higher grade. |
| Pathologist 9 | GS 3+4=7 (ISUP 2) | Borderline lower | |
| Pathologist 10 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 11 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 12 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 13 | GS 4+4=8 (ISUP 4) | Typical |
Would grade 3+5 |
| Pathologist 14 | GS 3+4=7 (ISUP 2) | Borderline higher |
Mostly 3 with a minor 4 (irregular strands) |
| Pathologist 15 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 16 | GS 3+4=7 (ISUP 2) | Borderline higher | |
| Pathologist 17 | GS 3+4=7 (ISUP 2) | Typical |
3+ typical poorly formed glands |
| Pathologist 18 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 19 | GS 3+4=7 (ISUP 2) | Borderline higher |
Same difficultly with estimating relative proportion of patterns 3 and 4 from images. Some cords of tumour cells are present raising the possibility of grade 5 but several glands are narrowed and angulated ("pinched off") so this is probably tangential sectioning rather than true pattern 5. |
| Pathologist 20 | GS 3+4=7 (ISUP 2) | Typical |
is this crush artefact making 3 into 4 |
| Pathologist 21 | GS 4+3=7 (ISUP 3) | Borderline lower | |
| Pathologist 22 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 23 | GS 4+3=7 (ISUP 3) | Borderline higher | |
| Pathologist 24 | GS 3+4=7 (ISUP 2) | Borderline higher | |
| Pathologist 25 | GS 4+3=7 (ISUP 3) | Borderline higher |
Case description (by case creator):
3+4=7 which has a component that may be interpreted as borderline GP5. There are occasional strips of epithelium but there is stromal desmoplasia and some may be compressed glands.
