Prostate cancer Pathology Report

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tony04
tony04 Member Posts: 1
edited March 2014 in Prostate Cancer #1
Could someone explain my pathology report i received today im worried.

Clinical History
Prostatectomy . Left and Right apical tissue . Histopathology.

Macroscopic Description

Specimen container labelled ‘ prostate ‘ . Please note, tissue was
collected for tissue banking from the right mid zone and the left mid zone
on 04/15/2010by Dr Lightfoot. The 37 gram prostatectomy,40mm from
superior to inferior , 45mm from left to right , and35mm from anterior to
posterior , with attached seminal vesicles and vasa deferentia up to25mm
long. The seminal vesicles and vasa deferentia are amputated from their
insertion into the prostate is linked blue,and the posterior black. The
prostate is rendered into 7 slices through horizontal sectioning demonstating
heterogenous tan and pale tan solid and cystic nodular parenchyma
There is a suggestion of parenchymal firmness in the right apex.

Please note the radical prostatectomy microscopic diagram form has been
completed for the case. (1.1) left seminal vesile and vas deferens,(1.2).
Right seminal vesile and vas deferens. (1.3) to (1.5) apex longitudinal
(1.5) slice 2 (as per cut up form). (1.8) to (1.20) slices 3 (as per cut out form).
(1.21) to (1.23) slice 4 (as per cut out form). (1.24) to (1.26) slice 5
(as per cut out form). (1.27) to (1.29) slice 6 (as per cut out form).

Specimen container labelled left apical tissue. An irregular fragment of
Pale tan tissue, 9x6x5mm. (2.1) bisected specimen all submmited.
Specimen container labelled right apacal tissue. A single sausage shape
Tan tissue fragment, 8x4mm (3.1) all submitted.

MICROSCOPIC DESCRIPTION
Sections of the radical prostatetectomy specimen show infiltration
By prostetic acinar adenocarcinoma, Gleason score 4x3=7.
The tumour is transacted at the apex bilaterally and is so close to
Several other painted margins. Foci of perineural, invasion as seen
And there is some background high grade PIN. Please see synoptic
Report for further details.

The sections show benign prostetic glands and stroma only with no high
Grade PIN all malignancy.

The sections show prostetic tissue partially infiltrated by prostetic acinar
Adenocarcinoma, Gleason score is 4x 3=7. With focal perineural invasion.

Operative specimen – radical prostatectectomy including seminal vesicles.
Histologic type – acinar.
Gleason grade and score -4+3=7

Site and focality-
Multifocal tumor, predominatly involving the right to lower zone and
The left anterior lower zone with focal extension to the right upper zone.
Tumour involves approximately 20-25% of prostatic volume.

Capsular invasion –ABSENT
Extraprostatic spread =ABSENT
Perineural invasion-PRESENT
Lymphovascular invasion – ABSENT

Margins
Tumour is transacted at the apical margin bilaterally. Pleasr correlate
With specimens 2-3 below.
Tumour is <0.1mm from the anterior mid zone vmargins bilaterally.
Tumour is 2mm from the right anterolateral mid zone neurovascular margin.
Tumour is 1.3 from right posterolateral upper zone margin.

Seminal Vesicles – uninvolved.

Lymph nodes – not assessed.

Other pathological findings.
Focal high grade PIN in the left posterolateral mid zone and right zone.

Stage – UICC/AJCC stage 11 (pt2c,Nx,Mx)

Left apical tissue – benign prostatic tissue only

Right apical tissue-prostatic acinar adenocarcinoma , Gleason score
4+3=7 with focal perineural invasion.

Comments

  • chitown
    chitown Member Posts: 90 Member
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    talk to your oncologist, 2nd opinion from pathologist will help
    i went through the same situation in march..get opinion from professional that you feel you can trust then make an action plan..you have cancer that can be solved and life can get back on track in a few months..i am 2 months off surgery and back to normal life..i have posted a note on the mental process i went through..dont ignore mind and intellect in the process of this temporary body aberration..good luck!
  • bdhilton
    bdhilton Member Posts: 865 Member
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    I would ask my
    I would ask my urologist/surgeon to explain in detail. I found it hard to read… but it sounds good to me
    Capsular invasion –ABSENT
    Extraprostatic spread =ABSENT
    Perineural invasion-PRESENT
    Lymphovascular invasion – ABSENT

    Below is my pathology and from my perspective a lot easier to read…Best of luck and I wish you a quick and uneventful recovery…

    Exam Date and Time: 3/3/2010 12:00 PM Results Date and Time: 3/8/2010 8:18 PM
    Final Diagnosis
    A. Lymph Node, Right Pelvic, Excision:
    -One Lymph Node, Negative for Metastatic Carcinoma
    B. Lymph Node, Left Pelvic, Excision:
    -One Lymph Node, Negative for Metastatic Carcinoma
    C. Prostate and Seminal Vesicles, Radical Prostatectomy:
    -Prostate Adenocarcinoma with Focal Ductal Differentiation, Gleason’s Score 4+3=7, involving both the Right and Left Prostate Lobes
    -A tertiary Gleason’s Pattern 5 Component is Present
    -Extensive Extra Prostatic Extension is Identified Involving the Right Apex, The Right and Left Mid, And The Right Base
    -The Adenocarcinoma Focally Extends To The Inked Margin In The Right mid Prostate (Slides C8 and C9)
    -The Adenocarcinoma Invades Into The Right Seminal Vesicle
    -The Left Seminal Vesicle Is Free Of Tumor
    -The Remaining Surgical Margins Are Free Of Tumor
    -Intraductal Spread of Adenocarcinoma is Present (See Notes).
    -Extensive Perineural Invasion is Present
    No lymph vascular Space is Present
    -The Dominant Tumor Nodule is Present in The Right Prostatic Base and Measures 2.2 CM in the Greatest Dimension.
    -Additional Tumor Nodules Are Present In The Left Apex, Right Apex, Right and Left Mid Prostates, and The Left base. The Adenocarcinoma is Present In 24 of 34 Submitted Slides And Involves Approximately 18% of the Prostatic Volume.

    -High Grade Prostatic Intraepithelial Neoplasia.
    Note: The positive surgical margins are in an area of extra prostatice extension. The ductal differentiation is best appreciated in slides C33 and is focal in nature (less than 5% of the total tumor). A PIN4 immunohistochomical stains perform on block C23 supports the diagnosis of intrductal spread of carcinoma. Dr; Ximing Yang has reviewed selected slides for this case and agrees with the above interpretation of margin status and seminal vesicle invasion.

    This test was developed and its performance characteristics were determined by the Northwestern Memorial Hospital Immujnohistochemistry Laboratory. It has not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. This tst is used for clinical purposes. It should not be regarded as investigational or for research. This laboratory is certified under the Clinical Laboratory Improvement Amendments of 1900 (CLIA-00) as qualified to perform high complexity clinical laboratory testing.

    The positive Control demonstrates appropriate positive staining. The known tissue negative controls were negative. The non-immune serum control was non-reactive.

    Prostatic Cancer Staging Summary:

    Tumor Type: Acinar with Focal Ductal Differentiation

    Gleason Score
    Primary + Secondary: 4+3=7
    Tertiary: Pattern 5

    Location Main Tumor: Prostatic Base
    Location Additional Tumor Nodules: Left Apex, Right Apex, Right Mid, Left Mid, and Left Base

    Extraprostatic Extension
    Focal (<2 Microscopic FOCI): N/A
    Established (Extensive): Present and Extensive

    Margins
    Apical Margin: Free of Tumor
    Bladder and Urethral: Free of Tumor
    Other Surgical Margins: Positive, right mid Prostate

    Seminal Vesicles: Positive for Carcinoma
    Location, If Involved: Right Seminal Vesicles

    Perineural Invasion: Present

    Lymphatic/Vascular Invasion: Not Identified

    Total Lymph Nodes: 2
    Number positive: 0
    Tumor Volume Approximately 18%
    Tumor (T): pT3b
    Metastasis (M): pMX
    Nodes (N): pN0
  • Skid Row Tom
    Skid Row Tom Member Posts: 125
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    Interpretation
    At least for this weekend, I'd relax because things look pretty positive to me. Your Gleason score was 4+3 which is better than 3+4 (which mine was and indicates it's more aggressive). It looks like your margins were good which is an indication that they "got it all". Seminal vesicles were uninvolved which is good. The key words "invasion" and "spread" are all negative except Perineural invasion which is subject to interpretation but generally is not a problem. Contact your doctor for a thorough explanation.
  • 142
    142 Member Posts: 169
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    Interpretation
    At least for this weekend, I'd relax because things look pretty positive to me. Your Gleason score was 4+3 which is better than 3+4 (which mine was and indicates it's more aggressive). It looks like your margins were good which is an indication that they "got it all". Seminal vesicles were uninvolved which is good. The key words "invasion" and "spread" are all negative except Perineural invasion which is subject to interpretation but generally is not a problem. Contact your doctor for a thorough explanation.

    Gleason
    4+3 means there is more 4 than 3, so is worse than 3+4.
    But that aside, the lack of extra capsular extension is good.
    But your doctor should sit and explain all of it to you.

    I'll trade my 5+4.