Case ID: 752

Publication date: 28 Aug, 2015

Consensus grade: GS 3+4=7 (ISUP 2)

User Diagnosis Difficulty Comment
Pathologist 1 GS 3+4=7 (ISUP 2) Borderline lower
Pathologist 2 GS 3+3=6 (ISUP 1) Borderline higher

Cribriform here is G3, not 4, by classic Gleason grading.

Pathologist 3 GS 3+3=6 (ISUP 1) Borderline higher

Plus high grade PIN, possibly (looks like grade 4).

Pathologist 4 GS 3+3=6 (ISUP 1) Borderline higher

Interpreted the "fused" gland as HGPIN

Pathologist 5 GS 3+3=6 (ISUP 1) Borderline lower

HG-PIN in 1 gland space

Pathologist 6 GS 3+4=7 (ISUP 2) Typical
Pathologist 7 GS 3+4=7 (ISUP 2) Typical
Pathologist 8 GS 3+4=7 (ISUP 2) Borderline higher

mostly G3, one G4 cribriform gland

Pathologist 9 GS 3+4=7 (ISUP 2) Borderline lower

need immunohistochemistry to clarify the cribriform glands loose basal cells or not

Pathologist 10 GS 3+3=6 (ISUP 1) Borderline higher
Pathologist 11 GS 3+4=7 (ISUP 2) Borderline lower
Pathologist 12 GS 3+4=7 (ISUP 2) Typical
Pathologist 13 GS 3+4=7 (ISUP 2) Typical
Pathologist 14 GS 3+4=7 (ISUP 2) Typical
Pathologist 15 GS 3+4=7 (ISUP 2) Typical
Pathologist 16 GS 3+3=6 (ISUP 1) Borderline higher
Pathologist 17 GS 3+4=7 (ISUP 2) Typical
Pathologist 18 GS 3+4=7 (ISUP 2) Typical
Pathologist 19 GS 3+4=7 (ISUP 2) Typical
Pathologist 20 GS 3+4=7 (ISUP 2) Borderline lower
Pathologist 21 GS 3+3=6 (ISUP 1) Borderline higher

?intraductal cribriform. Not quite enough for fusion/poorly formed.

Pathologist 22 GS 3+3=6 (ISUP 1) Typical

3+4 also a good option, but I wonder if the high magnifiation cribriform is not a kind of IDC, therefor i remain on 6 + a comment about IDC

Pathologist 23 GS 3+4=7 (ISUP 2) Typical

Cribriform focus may be IDC?

Pathologist 24 GS 3+4=7 (ISUP 2) Borderline lower


Case description (by case creator):

Mostly GP3 but there is a poorly circumscribed cribriform gland which justifies GP4. An immunostain for p63/AMACR was done (not shown here) and this particular gland was negative for basal cells.