Genitourinary

These GU diagnoses are courtesy of my colleague Kenneth Iczkowski, M.D. who specializes in GU pathology:

 

PROSTATE

BIOPSIES

Benign

–  Benign prostatic tissue

(if applicable) with: Chronic inflammation.  Acute inflammation. Atrophy (degree).

 –   Benign fibromuscular stroma

 

Cancer, Grade group 1

–   Prostatic adenocarcinoma, Gleason 3+3 (score = 6, Grade group 1) within ***% of *** out of *** cores, tumor length *** mm

 

Cancer, Grade group 2

–  Prostatic adenocarcinoma, Gleason 3+4 (score = 7, Grade group 2) within ***% of *** out of *** cores, tumor length *** mm

– ***% of tumor is Gleason 4 and *** cribriform

 

Cancer, Grade group 3

–  Prostatic adenocarcinoma, Gleason 4+3 (score = 7, Grade group 3) within ***% of *** out of *** cores, tumor length *** mm

– ***% of tumor is Gleason 4 and *** cribriform

 

Cancer, Grade group 4

–  Prostatic adenocarcinoma, Gleason 4+4 (score = 8, Grade group 4) within ***% of *** out of *** cores, tumor length *** mm

– Tumor *** cribriform

 

Cancer, Grade group 5

–  Prostatic adenocarcinoma, Gleason 4+5 (score = 9, Grade group 5) within ***% of *** out of *** cores, tumor length *** mm

 

Comment at end of most diagnoses whenever there is cancer (if applicable):

Comment: Tumor shows no perieneural invasion or extraprostatic extension.  OR

Comment: Tumor shows no extraprostatic extension.

 

 

PROSTATECTOMY

LYMPH NODES, LEFT ILIAC (LYMPHADENECTOMY)

 –  Five lymph nodes negative for tumor (0/5)

 

PROSTATE AND SEMINAL VESICLES (PROSTATECTOMY)

–   Prostatic adenocarcinoma, Gleason ***+*** (score =***, Grade group ***), see template         

–   ***% of tumor is Gleason 4 pattern

–   Large cribriform pattern ***

–   Extraprostatic extension ***

–   Margin ***

 

 

TRANSURETHRAL RESECTION

PROSTATE (TRANSURETHRAL RESECTION)

– Glandular and stromal hyperplasia, benign   

– Focal chronic inflammation

 OR

– Prostatic adenocarcinoma, Gleason 3+3 (score = 6, Grade group 1) within ***% of chips (*** out of *** chips)

 

 

KIDNEY

KIDNEY, RIGHT, (NEPHRECTOMY)

– Clear cell renal cell carcinoma, 8.0 cm, within upper pole

– ISUP nucleolar grade 3 (of 4)

– Tumor shows no necrosis, lymphovascular invasion, or sarcomatoid component 

OR

– 10% of tumor demonstrates a sarcomatoid component (slide C5)

– Tumor invades into perirenal fat (slide C8) (AJCC Stage pT3a)

 

RADICAL:

– Vascular and ureteral margins negative for tumor; parenchymal resection margins negative for tumor (closest approach 1 mm, slide C8)

 

PARTIAL:

– Parenchymal margin negative for tumor (closest approach 2 mm)

 

– Non-neoplastic kidney with: 20% glomerulosclerosis, vessels with moderate arteriolosclerosis, interstitium with focal chronic inflammation; tubules without abnormality

 

For chromophobe:

Comment: It is the current recommendation that chromophobe renal cell carcinoma should not be graded using the ISUP nucleolar or Fuhrman grading schemes (Am J Surg Pathol 2013;37:311-322.)

Link to this article on PubMed

 

 

BLADDER

URINARY BLADDER, LEFT WALL (BIOPSY)

– Urothelium, negative for tumor or dysplasia

– Muscularis propria *** present

OR

– Urothelial carcinoma, *** grade (ISUP)

– Tumor invades lamina propria (Stage pT1)

– *** for lymphovascular invasion

– Muscularis propria *** present and is ***

 

 

URINARY BLADDER AND PROSTATE (CYSTOPROSTATECTOMY)

Urinary bladder:

– Single microscopic focus (2 mm) of residual, high-grade urothelial carcinoma is noted within muscularis propria (Stage pT2 N2) at the posterior dome

– Posterior dome has ulcer bed with foreign body giant cell reaction, calcium, and necroinflammatory debris

– Remainder of bladder with reactive urothelium and edema; fat necrosis noted in adipose tissue (Slide L11)

 Prostate and seminal vesicles:

– Prostatic adenocarcinoma, Gleason 3+4 (score =7; 5% is pattern 4), bilateral and multifocal, within 25% of gland

– Tumor forms dominant nodules in the right anterior peripheral zone (levels 1–6) measuring up to 14 mm and the left anterior peripheral zone (levels 1–6) measuring up to 14 mm

– Negative for extraprostatic extension (Stage pT2)

– Resection margins negative for tumor

– Seminal vesicles and vasa deferentia negative for tumor

– Non-neoplastic prostate with nodular glandular and stromal hyperplasia

 

Last updated: 11/18/23