Ladies and Gents just received the Dr. Epstein Pathology report:
The New as of 9/30/2019
HISTOLOGIC TYPE: Adenocarcinoma (conventional, NOS)
GLEASON SCORE DOMINANT NODULE: 3+4=7
Grade Group: 2: 30% Pattern 4
GLEASON SCORE SECONDARY NODULE: 3+3=6
Grade Group: 1
TUMOR EXTENT: Moderate
location, Dominant Nodule: left, posterolateral. apex, mid base
location Secondary Nodule: Right Anterior
Margins: POSITIVE ,
location and nature of positive margins: Left Posterolateral, focal. Positive in an area of intraprostatic incision (II) Summed length of positive margin: 3mm Highest grade at margin 3+4=7
Seminal Vesicle Invasion: None
Lymphatic (Small Vessel) Invasion: Absent
Extent of invasion (8th edition AJCC):
Primary Tumor pT2x: Organ confined elsewhere , unevaluable in area of positive margin
Regional Lymph Nodes: pNx: Cannot be assessed
Summary Margins: Positive
Grade groups range from 1 (Most Favorable) to 5 (Least Favorable)
THE OLD PATH REPORT 8/19/2019
Immunohistochemical stains for pancytokeratin and PSA are performed on block 1P,
which highlight tumor tissue present at the margin, supporting the diagnosis.
Appropriate internal and/or external positive and negative controls have been
reviewed and exhibit the expected reactivity.
Slide 1P was reviewed by Dr. Jakowski who concurs tumor is focally present at
the margin.
Electronically Signed Out By Joseph P. Bergeron, MD
Joseph P. Bergeron, MD
JPB 8/21/2019
CPT: 1: 88309, 88305, 88342, 88341, 88305 <CR>
Pre-Operative Diagnosis:
Prostate cancer
Post-Operative Diagnosis:
Not Provided
Clinical History:
Not Provided
Specimen:
Prostate and periprostatic lymph node
Gross Descript
ion:
Devil Dawg, received in formalin labeled "prostate and periprostatic lymph
nodes". It consists of a prostate with attached bilateral seminal vesicles and
vasa deferentia with a detached portion of tan-yellow, lobulated adipose tissue
that is 2.6 x 1.6 x 0.9 cm in aggregate. The adipose tissue is dissected to
reveal no distinct lymph nodes. The seminal vesicles are a
s follows: Right-2.8
x 1.5 x 1.3 cm, left-2.9 x 1.5 x 1.3 cm. Vasa deferentia are as follows:
Right-5.3 cm in length x 0.8 cm in diameter, left-2.5 cm in length x 0.6 cm in
diameter. The prostate is inked as follows: Right-black, left-blue,
posterior-orange stripe. The vas deferens margins are shaved and the apical and
bladder base margins are shaved and are sectioned. The prostate is sectioned to
reveal tan-pink, nodular and glistening cut surfaces with no distinct masses or
lesions identified grossly. Representative sections: 1A remnant from dissected
adipose tissue; 1B vas deferens margins; 1C right seminal vesicle to prostate;
1D left seminal vesicle to prostate; 1E bladder base margin; 1Fapical margin; 1G
full thickness section of prostate at apex; 1H-1M representative right side of
prostate submitted from apex towards base with anterior in 1K-1M; 1N-1S
representative left side of prostate submitted from apex towards base with
middle section in 1P and anterior sections in 1R and 1S.
CS/pk 8/19/19
Microscopic Descript
ion:
Microscopic examination of the material identified as above has been performed
and the histologic findings incorporated into the final diagnosis.
JPB/pk 8/20/19
Surgical Pathology Cancer Case Summary
Carcinoma of the Prostate
Based on 8th Edition, AJCC Staging Manual
Protocol Posting Date: June 2017; Revised February 2019
PROSTATE GLAND: Radical Prostatectomy
Procedure:
Radical prostatectomy
Histologic Type (select all that apply):
Acinar adenocarcinoma
Histologic Grade (select all that apply): 7
Grade Group and Gleason Score:
Grade group 3 (Gleason Score 4+3=7)
Percentage of Pattern 4 in Gleason Score 7 (3+4, 4+3) Cancer (report if
applicable): 55%
Tumor Quantitation (optional):
Estimated percentage of prostate involved by tumor: 10%
Extraprostatic Extension (EPE):
Not identified
Urinary Bladder Neck Invasion:
Not identified
Seminal Vesicle Invasion:
Not identified
Perineural Invasion (optional): Not identified
Margins:
Involved by invasive carcinoma
Limited (<3 mm)
Linear length of positive margin(s) (millimeters): 0.5 mm
location of Positive Margin(s):
Left lateral
Block(s) with tumor at margin: 1P
Gleason Pattern at Positive Margin(s):
Pattern 3
Treatment Effect (select all that apply):
No known presurgical therapy
Regional Lymph Nodes: No lymph nodes submitted or found
Pathologic Stage Classification (pTNM, AJCC 8th Edition)
TNM Descript
ors (required only if applicable) (select all that apply): none
Primary Tumor (pT):
pT2: Organ confined
Regional Lymph Nodes (pN):
pNX: Regional lymph nodes cannot be assessed
Tumor blocks best suited for ancillary study: 1P
The lesion is categorized as pT2 NX.
General Information
Collected:
08/19/2019 10:25 AM
Any and all input is welcome.
S/F
Post Edited (Devil Dawg) : 9/30/2019 11:37:10 AM (GMT-6)