Charlotte F Kweldam1, Daan Nieboer2, Ferran Algaba3, Mahul B Amin4, Dan M Berney5, Athanase Billis6, David G Bostwick7, Lukas Bubendorf8, Liang Cheng9, Eva Compérat10, Brett Delahunt11, Lars Egevad12, Andrew J Evans13, Donna E Hansel14, Peter A Humphrey15, Glen Kristiansen16, Theodorus H van der Kwast13, Cristina Magi-Galluzzi17, Rodolfo Montironi18, George J Netto19, Hemamali Samaratunga20, John R Srigley21, Puay H Tan22, Murali Varma23, Ming Zhou24, Geert J L H van Leenders1. 1. Department of Pathology, Erasmus Medical Centre, Rotterdam, The Netherlands. 2. Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands. 3. Department of Pathology, Universitat Autónoma de Barcelona, Barcelona, Spain. 4. Department of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. 5. Department of Cellular Pathology, The Royal London Hospital, London, UK. 6. Department of Anatomical Pathology, School of Medical Sciences, State University of Campinas (Unicamp), Campinas, Brazil. 7. Bostwick Laboratories, Orlando, FL, USA. 8. Institute for Pathology, University Hospital Basel, Basel, Switzerland. 9. Department of Pathology & Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. 10. Service d'Anatomie & Cytologie Pathologiques du Pr Capron, Hôpital de la Pitié-Salpêtrière, Paris, France. 11. Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. 12. Department of Oncology and Pathology, Karolinska University Hospital, Stockholm, Sweden. 13. Department of Pathology & Laboratory Medicine, University Health Network, University of Toronto, Toronto, ON, Canada. 14. Department of Pathology, University of California San Diego, La Jolla, CA, USA. 15. Department of Pathology, Yale University School of Medicine, New Haven, CT, USA. 16. Institute of Pathology, University of Bonn, Bonn, Germany. 17. Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA. 18. Section of Pathological Anatomy, Department of Biomedical Sciences and Public Health, Polytechnic University of the Marche Region (Ancona), Ancona, Italy. 19. Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA. 20. Aquesta Pathology and University of Queensland, Brisbane, Qld, Australia. 21. Trillium Health Partners, Mississauga and McMaster University, Hamilton, ON, Canada. 22. Department of Pathology, Singapore General Hospital, Singapore. 23. Department of Medical Genetics, Haematology and Pathology, Cardiff University, Cardiff, UK. 24. Department of Pathology, NYU Langone Medical Center, New York, NY, USA.
Abstract
AIMS: To assess the interobserver reproducibility of individual Gleason grade 4 growth patterns. METHODS AND RESULTS: Twenty-three genitourinary pathologists participated in the evaluation of 60 selected high-magnification photographs. The selection included 10 cases of Gleason grade 3, 40 of Gleason grade 4 (10 per growth pattern), and 10 of Gleason grade 5. Participants were asked to select a single predominant Gleason grade per case (3, 4, or 5), and to indicate the predominant Gleason grade 4 growth pattern, if present. 'Consensus' was defined as at least 80% agreement, and 'favoured' as 60-80% agreement. Consensus on Gleason grading was reached in 47 of 60 (78%) cases, 35 of which were assigned to grade 4. In the 13 non-consensus cases, ill-formed (6/13, 46%) and fused (7/13, 54%) patterns were involved in the disagreement. Among the 20 cases where at least one pathologist assigned the ill-formed growth pattern, none (0%, 0/20) reached consensus. Consensus for fused, cribriform and glomeruloid glands was reached in 2%, 23% and 38% of cases, respectively. In nine of 35 (26%) consensus Gleason grade 4 cases, participants disagreed on the growth pattern. Six of these were characterized by large epithelial proliferations with delicate intervening fibrovascular cores, which were alternatively given the designation fused or cribriform growth pattern ('complex fused'). CONCLUSIONS: Consensus on Gleason grade 4 growth pattern was predominantly reached on cribriform and glomeruloid patterns, but rarely on ill-formed and fused glands. The complex fused glands seem to constitute a borderline pattern of unknown prognostic significance on which a consensus could not be reached.
AIMS: To assess the interobserver reproducibility of individual Gleason grade 4 growth patterns. METHODS AND RESULTS: Twenty-three genitourinary pathologists participated in the evaluation of 60 selected high-magnification photographs. The selection included 10 cases of Gleason grade 3, 40 of Gleason grade 4 (10 per growth pattern), and 10 of Gleason grade 5. Participants were asked to select a single predominant Gleason grade per case (3, 4, or 5), and to indicate the predominant Gleason grade 4 growth pattern, if present. 'Consensus' was defined as at least 80% agreement, and 'favoured' as 60-80% agreement. Consensus on Gleason grading was reached in 47 of 60 (78%) cases, 35 of which were assigned to grade 4. In the 13 non-consensus cases, ill-formed (6/13, 46%) and fused (7/13, 54%) patterns were involved in the disagreement. Among the 20 cases where at least one pathologist assigned the ill-formed growth pattern, none (0%, 0/20) reached consensus. Consensus for fused, cribriform and glomeruloid glands was reached in 2%, 23% and 38% of cases, respectively. In nine of 35 (26%) consensus Gleason grade 4 cases, participants disagreed on the growth pattern. Six of these were characterized by large epithelial proliferations with delicate intervening fibrovascular cores, which were alternatively given the designation fused or cribriform growth pattern ('complex fused'). CONCLUSIONS: Consensus on Gleason grade 4 growth pattern was predominantly reached on cribriform and glomeruloid patterns, but rarely on ill-formed and fused glands. The complex fused glands seem to constitute a borderline pattern of unknown prognostic significance on which a consensus could not be reached.
Authors: Charlotte F Kweldam; Intan P Kümmerlin; Daan Nieboer; Ewout W Steyerberg; Chris H Bangma; Luca Incrocci; Theodorus H van der Kwast; Monique J Roobol; Geert J van Leenders Journal: Mod Pathol Date: 2017-05-19 Impact factor: 7.842
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Authors: Patrick Leo; Sacheth Chandramouli; Xavier Farré; Robin Elliott; Andrew Janowczyk; Kaustav Bera; Pingfu Fu; Nafiseh Janaki; Ayah El-Fahmawi; Mohammed Shahait; Jessica Kim; David Lee; Kosj Yamoah; Timothy R Rebbeck; Francesca Khani; Brian D Robinson; Natalie N C Shih; Michael Feldman; Sanjay Gupta; Jesse McKenney; Priti Lal; Anant Madabhushi Journal: Eur Urol Focus Date: 2021-04-30
Authors: Anne Offermann; Silke Hohensteiner; Christiane Kuempers; Julika Ribbat-Idel; Felix Schneider; Finn Becker; Marie Christine Hupe; Stefan Duensing; Axel S Merseburger; Jutta Kirfel; Markus Reischl; Verena Lubczyk; Rainer Kuefer; Sven Perner Journal: Front Med (Lausanne) Date: 2017-09-29
Authors: Geert J L H van Leenders; Theodorus H van der Kwast; David J Grignon; Andrew J Evans; Glen Kristiansen; Charlotte F Kweldam; Geert Litjens; Jesse K McKenney; Jonathan Melamed; Nicholas Mottet; Gladell P Paner; Hemamali Samaratunga; Ivo G Schoots; Jeffry P Simko; Toyonori Tsuzuki; Murali Varma; Anne Y Warren; Thomas M Wheeler; Sean R Williamson; Kenneth A Iczkowski Journal: Am J Surg Pathol Date: 2020-08 Impact factor: 6.298