Histopathology report

• tumour type: acinar (proximal duct) adenocarcinoma/other.

• tumour differentiation: use the Gleason grading system. Each tumour is assigned two grades, based on the most predominant of five different architectural patterns present, ranging from grade 1 (well-differentiated) to grade 5 (undifferentiated). The two grades are summed to give the Gleason score (maximum 10). If only one grade is present, the grade is doubled to give the score, e.g., 3 + 3 = 6.

• tumour volume: the tumour is outlined microscopically on each glass slide and the area involved measured (mm2). The areas for all sections are summed and the overall tumour volume (mm3) is derived from multiplying by the average slice thickness (3-4 mm). This may be expressed as a proportion of the total volume of the prostate, to give the percentage gland involvement.

• tumour edge: pushing/infiltrative.

• extent of local tumour spread

- pT1 clinically inapparent tumour not palpable or visible by imaging. T1a incidental finding in < 5% of tissue resected.

T1b incidental finding in > 5% of tissue resected. T1c identified by needle biopsy.

- pT2 tumour confined within the prostate.

T2a involves < one half of one lobe .

T2b involves > one half of one lobe but not both lobes.

T2c involves both lobes.

- pT3 tumour extends through the prostatic capsule.

T3a extracapsular extension (unilateral or bilateral). T3b invades seminal vesicle(s).

- pT4 tumour is fixed or invades neighbouring structures other than seminal vesicles:

bladder neck, external sphincter, rectum, levator muscles, and/or pelvic wall. Note a positive surgical resection margin at a point lacking extraprostatic tissue can be reported as pT2+, i.e., extracapsular extension cannot be accurately assessed.

• lymphovascular invasion - perineural and lymphovascular space.

- present/not present.

- inside/outside capsule.

• regional lymph nodes.

- pelvic nodes below the bifurcation of the common iliac arteries.

- pN0 no regional lymph node metastasis.

- pN1 metastasis in regional lymph node(s).

• excision margins

- proximal (base), distal (apical), circumferential margins involved/uninvolved.

- distances (in mm) to nearest margins.

• other pathology

- high-grade PIN, effects of radiotherapy or androgen-deprivation therapy (glandular atrophy, apoptosis, vacuolation, stromal fibrosis).

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