Case ID: 1412
Publication date: 13 Jan, 2025
Consensus grade: GS 3+4=7 (ISUP 2)
Show diagnosis by expert panel members| User | Diagnosis | Difficulty | Comment |
|---|---|---|---|
| Pathologist 1 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 2 | GS 3+4=7 (ISUP 2) | Typical |
Generally, one should avoid assigning a grade to carcinoma around a nerve although in this case there is apparently cribriform pattern 4 around the nerve. This does not change the overall ISUP grade since there is a separate focus of cribriform 4. |
| Pathologist 3 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 4 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 5 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 6 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 7 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 8 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 9 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 10 | GS 3+4=7 (ISUP 2) | Borderline higher | |
| Pathologist 11 | GS 3+3=6 (ISUP 1) | Typical |
Not all cribriform is grade 4-- the collapsible fenestrations here are Gleason 3 according to original Gleason grading. |
| Pathologist 12 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 13 | GS 3+4=7 (ISUP 2) | Typical | |
| Pathologist 14 | GS 3+4=7 (ISUP 2) | Borderline lower | |
| 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+4=7 (ISUP 2) | Typical | |
| Pathologist 19 | GS 3+3=6 (ISUP 1) | Typical |
I am not grading the perineural invasion. |
Case description (by case creator):
Focal cribriform arrangement with perineural invasion. We are not supposed to grade cancer in perineural invasion areas.
Does cribriform “count” as Gleason 4 when in a perineural location?
