Case ID: 768

Publication date: 27 Apr, 2024

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

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

enough poorly formed glands

Pathologist 2 GS 3+4=7 (ISUP 2) Borderline lower
Pathologist 3 GS 3+3=6 (ISUP 1) Typical
Pathologist 4 GS 3+3=6 (ISUP 1) Typical
Pathologist 5 GS 3+4=7 (ISUP 2) Borderline lower
Pathologist 6 GS 3+4=7 (ISUP 2) Borderline lower
Pathologist 7 GS 3+3=6 (ISUP 1) Borderline higher

mostly G3

Pathologist 8 GS 3+3=6 (ISUP 1) Borderline higher

difficult case
borderline with poorly formed gland but still tangential cuts

Pathologist 9 GS 3+3=6 (ISUP 1) Typical
Pathologist 10 GS 3+4=7 (ISUP 2) Typical
Pathologist 11 GS 3+4=7 (ISUP 2) Borderline higher
Pathologist 12 GS 3+4=7 (ISUP 2) Borderline lower

The issue here is threshold for the number of poorly formed acini required to call pattern 4. I would need to see at least 3 levels to be most confident in assigning a grade

Pathologist 13 GS 3+4=7 (ISUP 2) Typical

5-10% pattern 4

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

Poorly formed glands. "Single cells" interpreted as tangential sectioning.

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

give 6 without hesitation

Pathologist 23 GS 3+4=7 (ISUP 2) Borderline lower
Pathologist 24 GS 3+4=7 (ISUP 2) Borderline lower


Case description (by case creator):

Most of the tumor is GP3 but there are also some poorly formed glands.