Prostate gland & seminal vesicles
General
Grossing & features to report
Author: Komal Arora, M.D.
Last author update: 1 June 2012
Last staff update: 20 April 2023
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed search: Grossing / features to report prostate
Cite this page: Arora K. Grossing & features to report. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/prostategrossing.html. Accessed April 24th, 2024.
Grossing
Needle core biopsies
Radical prostatectomy
Systemic sampling (12 - 13 blocks)
Transurethral resection biopsies (prostate chips)
- Inking of all prostate core biopsies with colored inks, in sequential order, helps maintain specimen identity (Arch Pathol Lab Med 2009;133:295)
Radical prostatectomy
- Totally embed or systemic sampling (Mod Pathol 2011;24:6, International Journal of Breast Cancer 2012:2012, Article ID 932784)
Systemic sampling (12 - 13 blocks)
- Ink surface with 2 colors to designate left versus right
- Amputate apex and serial section parallel to urethra
- For base, thin shave or amputate and serial section parallel to urethra
- Submit base of seminal vesicles, margins of right and left vas deferens
- Serial section prostate perpendicular to urethra, submit all gross tumor (look in peripheral zone, posterior or posterior-lateral area for asymmetry in size, color, density between left and right sides)
- Special device may assist in generating sections of uniform thickness (J Magn Reson Imaging 2010;32:992)
Transurethral resection biopsies (prostate chips)
- If specimen 12 g or less, submit all
- If specimen more than 12g, submit at least 12 g
- If unsuspected carcinoma found that involves 5% or less of tissue examined, submit remaining tissue (may increase stage from T1a to T1b)
- Reference: Arch Pathol Lab Med 2006;130:936
Gross images
Images hosted on other servers:
Device to generate uniform thickness of sections in radical prostatectomy
Whole mount sectioning
Features to report
Prostatectomies
Biopsies (core or transurethral prostate resection)
- Structures included in specimen (prostate [complete or not], seminal vesicles, vas deferens, bladder neck)
- Weight, size in 3 dimensions
- Histologic type and location of tumor (if any)
- Gleason pattern / grade and score
- % of prostate involved by tumor (need not give volume but an indication of minute vs. voluminous)
- Presence of perineural invasion (diameter may be prognostic factor (Hum Pathol 2001;32:828)
- Presence of angiolymphatic invasion (Am J Surg Pathol 1996;20:1351, J Urol 2005;174:2181)
- Presence of extraprostatic tissue invasion
- Presence of high grade PIN
- Margins
- Lymph nodes (# involved, # sampled) and diameter of largest metastasis (Am J Surg Pathol 1998;22:1491)
- Acute or chronic inflammation (often doesn’t correlate with clinical prostatitis)
- Granulomatous prostatitis (may elevate PSA, produce suspicious feeling gland)
- Note: extranodal tumor extension not related to survival (Mod Pathol 2000;13:113)
Biopsies (core or transurethral prostate resection)
- Histologic type
- Gleason primary and secondary grades and total score
- # cores involved, # cores total
- % of prostatic tissue involved by tumor or total linear mm of carcinoma / total linear mm of tissue
- Presence of perineural, angiolymphatic, periprostatic fat invasion, seminal vesicle invasion, extraprostatic tissue invasion
- Presence of high grade PIN (if no carcinoma, report # of cores involved and pattern of high grade PIN)
- Therapy related changes
Additional references
