Case ID: 793

Publication date: 25 Apr, 2024

Consensus grade: GS 9-10 (ISUP 5)

User Diagnosis Difficulty Comment
Pathologist 1 GS 4+4=8 (ISUP 4) Borderline higher
Pathologist 2 GS 4+4=8 (ISUP 4) Borderline higher
Pathologist 3 GS 4+4=8 (ISUP 4) Borderline higher

Grading is complicated by extensive crush artefact. Cannot exclude gleason pattern component

Pathologist 4 GS 9-10 (ISUP 5) Typical

5+4 = 9

Pathologist 5 GS 9-10 (ISUP 5) Typical
Pathologist 6 GS 9-10 (ISUP 5) Borderline lower
Pathologist 7 GS 9-10 (ISUP 5) Typical
Pathologist 8 GS 9-10 (ISUP 5) Typical

cords/single cells are recognizable

Pathologist 9 GS 9-10 (ISUP 5) Typical

I would ask for some chromo A staining in daily practice

Pathologist 10 GS 9-10 (ISUP 5) Borderline higher
Pathologist 11 GS 9-10 (ISUP 5) Typical
Pathologist 12 GS 9-10 (ISUP 5) Typical
Pathologist 13 GS 9-10 (ISUP 5) Typical
Pathologist 14 GS 9-10 (ISUP 5) Typical

Possibly some IDC-P present too.

Pathologist 15 GS 9-10 (ISUP 5) Borderline lower
Pathologist 16 GS 9-10 (ISUP 5) Borderline lower

crushed

Pathologist 17 GS 9-10 (ISUP 5) Typical
Pathologist 18 GS 9-10 (ISUP 5) Borderline lower
Pathologist 19 GS 9-10 (ISUP 5) Typical
Pathologist 20 GS 9-10 (ISUP 5) Typical
Pathologist 21 GS 9-10 (ISUP 5) Typical
Pathologist 22 GS 9-10 (ISUP 5) Borderline lower
Pathologist 23 GS 9-10 (ISUP 5) Typical


Case description (by case creator):

Single cells infiltrating in the stroma. Nuclear features are not part of the Gleason grading but the immature, dark chromatin seen here is typical for GP5 and helps to establish the diagnosis. There is a minority component of poorly formed glandular structures.