Multiple prostate cancer cores with different Gleason grades submitted in the same specimen container without specific site designation: should each core be assigned an individual Gleason score?


:To better represent the Gleason score of radical prostatectomy, the International Society of Urologic Pathologists Consensus Committee recommends assigning individual Gleason scores to prostate cancer cores submitted in separate containers and/or multiple cores in the same container with site identifiers. However, scenarios where multiple cores are submitted in the same container without site identifiers or labeled "left/right" are common. To assess this scenario, we analyzed 110 extended biopsies containing different Gleason scores with corresponding radical prostatectomy for clinically significant grade differences. Because cores are individually labeled and submitted at our institution, we simulated a scenario of multiple intact cores with different Gleason scores in the same container(s) by analyzing as if submitted in containers labeled "left/right." For each biopsy, a Global (all positive cores averaged as 1 long positive core), Worst, and Largest tumor volume Gleason score was determined and compared with grade of radical prostatectomy using kappa statistics. Biopsies containing core(s) with 3+4 and other core(s) 3+3 were excluded because in this situation, both Global and Worst Gleason score will be always 3+4. The following scenarios were considered clinically significant upgrading: biopsy Gleason score 6 / 3+4 to radical prostatectomy 4+3; biopsy 7 to radical prostatectomy 8-10; biopsy 7 to radical prostatectomy 7 with tertiary Gleason pattern 5. Overall, 51 cases met inclusion criteria. Biopsy Worst Gleason score had the best correlation with radical prostatectomy (kappa agreement of 0.37). Clinically significant upgrading at radical prostatectomy was least with Worst (4%) and highest with Global Gleason score (37%). Upgrading and downgrading were noted in 14% and 8%, respectively, of 59 cases containing core(s) with a Gleason score of 3+4 and other core(s) 3+3, suggesting that any amount of higher Gleason pattern should be recorded. When multiple intact cores are submitted in the same container without specific identifiers, individual cores with cancer should be graded and/or the Worst Gleason score should be recorded.


Hum Pathol


Human pathology


Kunju LP,Daignault S,Wei JT,Shah RB




Has Abstract


2009-04-01 00:00:00














  • Disseminated infection with Lacazia loboi and immunopathology of the lesional spectrum.

    abstract::The pathogenesis of lacaziosis continues to be obscure, and works have investigated the blood systemic immune response or the dermal immune response in restricted lesions in different body regions. Some authors describe that the inflammatory infiltrate in lacaziosis lesions showed a predominance of macrophages followe...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Oliveira Carneiro FR,da Cunha Fischer TR,Brandão CM,Pagliari C,Duarte MI,Quaresma JA

    更新日期:2015-02-01 00:00:00

  • Intramural left anterior descending coronary artery: significance of the depth of the muscular tunnel.

    abstract::To establish whether an intramural left anterior descending coronary artery (LADA) is a simple anatomic or a singularly pathologic variant we studied 39 hearts, each with an intramural course of the LADA and no coronary artery disease, valvular derangement, cardiomyopathy, or congenital anomaly. Seventeen of the 39 he...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Morales AR,Romanelli R,Tate LG,Boucek RJ,de Marchena E

    更新日期:1993-07-01 00:00:00

  • Small cell undifferentiated carcinoma of the colon associated with hepatocellular carcinoma in an immunodeficient patient.

    abstract::Small cell undifferentiated carcinoma (oat cell carcinoma) is a malignant epithelial neoplasm with neuroendocrine features. It can appear as a primary tumor in many organs besides the lung, including the colon. We report a case of primary small cell undifferentiated carcinoma of the left colon with omental metastases ...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Zirkin HJ,Levy J,Katchko L

    更新日期:1996-09-01 00:00:00

  • Immunohistologic analysis of mycobacterial antigens by monoclonal antibodies in tuberculosis and mycobacteriosis.

    abstract::Four monoclonal antibodies (MoAbs), 60.15, 61.3, 105.10, and 2.16, directed to different proteins of Mycobacterium tuberculosis were used by an indirect avidin-biotin complex peroxidase-antiperoxidase method to detect mycobacterial antigens in lung, lymph node, and joint tissue specimens of tuberculous patients. Using...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Barbolini G,Bisetti A,Colizzi V,Damiani G,Migaldi M,Vismara D

    更新日期:1989-11-01 00:00:00

  • Expression of Sox2 in human cervical carcinogenesis.

    abstract::Sox2 is a key transcription factor for embryonic development and plays a critical role in determining the fate of stem cells. Recently, Sox2 has been detected in several human tumors, indicating a potential function in tumorigenesis. We initially reported remarkably increased nuclear Sox2 staining in cervical carcinom...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Ji J,Zheng PS

    更新日期:2010-10-01 00:00:00

  • Spindle cell carcinoma of the larynx: review of 26 cases including DNA content and immunohistochemistry.

    abstract::Spindle cell carcinoma (SpCC) is uncommon, with a predilection for the upper aerodigestive tract. Its histogenesis has not been resolved, although most authors support the sarcomatoid carcinoma concept. Ploidy analysis and proliferation indices have not been reported for laryngeal SpCCs. The authors examined the patho...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Lewis JE,Olsen KD,Sebo TJ

    更新日期:1997-06-01 00:00:00

  • Support for p63 expression as an adverse prognostic marker in Merkel cell carcinoma: report on a Canadian cohort.

    abstract::Recent evidence has invoked immunohistochemical expression of p63 in Merkel cell carcinoma as an adverse prognostic factor. Conflicting data led us to evaluate this. An Eastern Canadian cohort diagnosed between 1990 and 2012 was studied. Demographic and clinical data were obtained from pathology records and Provincial...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Fleming KE,Ly TY,Pasternak S,Godlewski M,Doucette S,Walsh NM

    更新日期:2014-05-01 00:00:00

  • Inherited abnormalities of the platelet membrane and secretory granules.

    abstract::Platelet stimulus-activation-contraction-secretion coupling is linked to fundamental modifications in the biochemistry and ultrastructure of the platelet surface and the membranes enclosing storage organelles. It is not surprising, therefore, that membrane defects are common in platelets from patients with inherited h...

    journal_title:Human pathology

    pub_type: 杂志文章,评审


    authors: White JG

    更新日期:1987-02-01 00:00:00

  • Type II ground-glass hepatocytes as a marker of hepatocellular carcinoma in chronic hepatitis B.

    abstract::Ground-glass hepatocytes are seen in chronic hepatitis B virus (HBV) infection and are known to harbor pre-S mutants, which are implicated in the pathogenesis of hepatocellular carcinoma (HCC). However, the association between ground-glass hepatocytes and HCC has yet to be clearly elucidated. The aim in the present st...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Mathai AM,Alexander J,Kuo FY,Torbenson M,Swanson PE,Yeh MM

    更新日期:2013-08-01 00:00:00

  • Papillary renal cell carcinoma: correlation of tumor grade and histologic characteristics with clinical outcome.

    abstract::Histologic prognostic parameters in papillary renal cell carcinoma (PRCC) are unclear. The aims were to review the clinicopathological features of PRCC, including Fuhrman grade and International Society of Urological Pathology (ISUP) nucleolar grade, and to identify parameters that may be independent prognostic indica...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Cornejo KM,Dong F,Zhou AG,Wu CL,Young RH,Braaten K,Sadow PM,Nielsen GP,Oliva E

    更新日期:2015-10-01 00:00:00

  • Orbital osteoclastoma of apparent extraskeletal origin in a pagetic patient: a case report.

    abstract::A large mass in the right orbit, causing proptosis, ptosis of the right upper eyelid, and limitation to eye movements, was surgically removed from a 51-year-old woman suffering from Paget's bone disease (PBD). Histologically, a giant cell tumor of the bone (osteoclastoma) was diagnosed. No bony involvement was apparen...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Pecorella I,Ciardi A,Amadeo G,Baiocchini A,Marasco A,Di Tondo U

    更新日期:2000-12-01 00:00:00

  • Hepatic veno-occlusive disease after high-dose mitomycin C and autologous bone marrow transplantation therapy.

    abstract::Three cases of veno-occlusive disease of the liver were diagnosed in four autopsied patients who had received high-dose mitomycin C therapy followed by autologous bone marrow transplantation, and the pathologic finding are reported. Review of 27 liver, examined post mortem, of patients receiving other high-dose chemot...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Gottfried MR,Sudilovsky O

    更新日期:1982-07-01 00:00:00

  • Distribution of basement membrane in squamous cell carcinoma of the head and neck.

    abstract::The immunohistologic distribution of the basement membrane components, type IV collagen and laminin, was evaluated in 57 alcohol-fixed, paraffin-embedded tissue sections which demonstrated immunostaining patterns with antigen preservation similar to that of frozen tissue sections. Normal and hyperplastic squamous muco...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Sakr WA,Zarbo RJ,Jacobs JR,Crissman JD

    更新日期:1987-10-01 00:00:00

  • Hepatobiliary effects of 90yttrium microsphere therapy for unresectable hepatocellular carcinoma.

    abstract::(90)Yttrium (Therasphere) microspheres administered via hepatic artery are a valuable option for treatment of hepatocellular carcinoma. This therapy targets tumor nodules while largely sparing hepatic parenchyma. This retrospective study examines liver explants from 13 adult patients with hepatocellular carcinoma who ...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Nalesnik MA,Federle M,Buck D,Fontes P,Carr BI

    更新日期:2009-01-01 00:00:00

  • Cytology: screening or diagnostic tool?

    abstract::Previously used only as a screening tool, cytology now emerges as a powerful diagnostic technique, especially since the advent of the fine needle aspiration (FNA) biopsy. This article highlights the use of ancillary techniques, primarily electron microscopy (EM), and immunohistochemistry (IHC). When coupled with routi...

    journal_title:Human pathology

    pub_type: 杂志文章,评审


    authors: Turbat-Herrera EA,Knowles K

    更新日期:1998-12-01 00:00:00

  • Predicting biochemical recurrence after radical prostatectomy: the role of prognostic grade group and index tumor nodule.

    abstract::The aim of the current study was to test whether the grade group assessed in the index tumor nodule predicts biochemical recurrence after surgery. The study cohort series included 144 consecutive patients treated by laparoscopic radical prostatectomy. The following parameters were evaluated in each case: type of radic...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Vau N,Henriques V,Cheng L,Blanca A,Fonseca J,Montironi R,Cimadamore A,Lopez-Beltran A

    更新日期:2019-11-01 00:00:00

  • Epidermal growth factor receptor, phosphatidylinositol-3-kinase catalytic subunit/PTEN, and KRAS/NRAS/BRAF in primary resected esophageal adenocarcinomas: loss of PTEN is associated with worse clinical outcome.

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    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Bettstetter M,Berezowska S,Keller G,Walch A,Feuchtinger A,Slotta-Huspenina J,Feith M,Drecoll E,Höfler H,Langer R

    更新日期:2013-05-01 00:00:00

  • CRABP-II is a highly sensitive and specific diagnostic molecular marker for pancreatic ductal adenocarcinoma in distinguishing from benign pancreatic conditions.

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    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Xiao W,Hong H,Awadallah A,Yu S,Zhou L,Xin W

    更新日期:2014-06-01 00:00:00

  • Fibroblast activation protein predicts prognosis in clear cell renal cell carcinoma.

    abstract::Clear cell renal cell carcinoma is a complex disease with only partial response to therapy and scarce reliable clinical parameters indicative of progression and survival. Fibroblast activation protein expression has been correlated with prognosis in several malignancies but never in renal cancer. We aim to analyze the...

    journal_title:Human pathology

    pub_type: 杂志文章,多中心研究


    authors: López JI,Errarte P,Erramuzpe A,Guarch R,Cortés JM,Angulo JC,Pulido R,Irazusta J,Llarena R,Larrinaga G

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  • PhD graduate training programs in pathology: 2003 report from the American Society for Investigative Pathology workshop on pathology graduate education.

    abstract::Graduate training is one of the most important activities in which we engage. Through PhD training programs in pathology, we continually renew the intellectual vigor of our discipline and assure its position as a vibrant force in the life sciences. To focus on this important issue, the Education Committee of the Ameri...

    journal_title:Human pathology

    pub_type: 杂志文章,评审


    authors: Kemp JD,Bowser R,American Society for Investigative Pathology workshop.

    更新日期:2004-07-01 00:00:00

  • Utility of mammaglobin immunohistochemistry as a proxy marker for the ETV6-NTRK3 translocation in the diagnosis of salivary mammary analogue secretory carcinoma.

    abstract::Mammary analogue secretory carcinoma is a recently described salivary gland neoplasm defined by ETV6-NTRK3 gene fusion. Mammary analogue secretory carcinoma's morphology is not entirely specific and overlaps with other salivary gland tumors. Documenting ETV6 rearrangement is confirmatory, but most laboratories are not...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Bishop JA,Yonescu R,Batista D,Begum S,Eisele DW,Westra WH

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  • The immunohistochemical staining pattern of Gab2 correlates with distinct stages of chronic myeloid leukemia.

    abstract::Grb2-associated binder 2 protein (Gab2) is a member of scaffold proteins, playing crucial roles in (receptor-) tyrosine kinase and cytokine signaling. Chronic myeloid leukemia cells with t(9;22)(q34;q11) express the Bcr/Abl fusion protein, which interacts with Grb2 and Gab2 signaling, thereby triggering hematopoietic ...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Aumann K,Lassmann S,Schöpflin A,May AM,Wöhrle FU,Zeiser R,Waller CF,Hauschke D,Werner M,Brummer T

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  • Chromosome 12p abnormalities and IMP3 expression in prepubertal pure testicular teratomas.

    abstract::Although the histologic appearance of pure testicular teratomas (PTTs) is similar in children and adults, the prognosis is dramatically different. Prepubertal PTTs are rare, with a benign clinical course, whereas the adult cases typically have malignant outcomes. Chromosome 12p abnormalities are seen in most adult tes...

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    pub_type: 杂志文章,多中心研究


    authors: Cornejo KM,Cheng L,Church A,Wang M,Jiang Z

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  • In situ evidence of involvement of Schwann cells in ulcerative colitis: autocrine and paracrine signaling by A disintegrin and metalloprotease-17-mediated tumor necrosis factor alpha production.

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    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Mosnier JF,Jarry A,Camdessanché JP,Antoine JC,Laboisse CL

    更新日期:2009-08-01 00:00:00

  • Androgen receptor, androgen-producing enzymes and their transcription factors in extramammary Paget disease.

    abstract::Extramammary Paget disease (EMPD) has been known to frequently express androgen receptor (AR). Therefore, androgens could play roles in the biological behavior of Paget cells. 5α-Reductase (5α-red) types 1 and 2 and 17β-hydroxysteroid dehydrogenase type 5 (17β-HSD5) are pivotal in situ regulators of androgen productio...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Azmahani A,Nakamura Y,Ozawa Y,McNamara KM,Fujimura T,Haga T,Hashimoto A,Aiba S,Sasano H

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  • Surgical pathology and the patient: a systematic review evaluating the primary audience of pathology reports.

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    journal_title:Human pathology

    pub_type: 杂志文章,评审


    authors: Mossanen M,True LD,Wright JL,Vakar-Lopez F,Lavallee D,Gore JL

    更新日期:2014-11-01 00:00:00

  • Impaired expression of acyl-CoA-synthetase 5 in epithelial tumors of the small intestine.

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    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Gassler N,Schneider A,Kopitz J,Schnölzer M,Obermüller N,Kartenbeck J,Otto HF,Autschbach F

    更新日期:2003-10-01 00:00:00

  • Viral genotypes and p53 expression in Epstein-Barr virus-associated primary malignant lymphomas of the intestines.

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    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Kim YS,Kim JB,Kang YK,Nam ES,Park SH,Kim I

    更新日期:1999-10-01 00:00:00

  • BAP1 loss is unusual in well-differentiated papillary mesothelioma and may predict development of malignant mesothelioma.

    abstract::Literature on BRCA1-associated protein 1 (BAP1) expression status in well-differentiated papillary mesothelioma (WDPM) is limited. In the present study, we examined the prevalence of BAP1 loss in WDPM by immunohistochemistry with clinical correlation, along with CDKN2A deletion status by fluorescence in situ hybridiza...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Lee HE,Molina JR,Sukov WR,Roden AC,Yi ES

    更新日期:2018-09-01 00:00:00

  • Fetal thrombotic vasculopathy: the clinical significance of extensive avascular villi.

    abstract::Thrombosis of large fetal vessels in the placenta leads to regions of downstream avascular villi (AV). Avascular villi have been associated with adverse outcomes in anecdotal reports, but no controlled study of their significance has been done. We prospectively gathered cases of extensive AV (n = 29) occurring over a ...

    journal_title:Human pathology

    pub_type: 杂志文章


    authors: Redline RW,Pappin A

    更新日期:1995-01-01 00:00:00