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Difference between revisions of "Prostate chips grossing"
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This article deals with '''prostate chips'''. | This article deals with '''prostate chips grossing'''. ''TURP specimens'' and ''TURP grossing'' redirect here. | ||
==Introduction== | ==Introduction== | ||
Prostate chips are generated from ''transurethral resection of the prostate'' (TURP) procedures. These are generally for relieving urinary obstruction due to [[nodular hyperplasia of the prostate]] (benign prostatic hyperplasia); however, urinary obstruction may be secondary to [[prostate cancer]]. Thus, the job of the pathologist here, usually, is excluding an incidental [[cancer]]. | Prostate chips are generated from ''transurethral resection of the prostate'' (TURP) procedures. These are generally for relieving urinary obstruction due to [[nodular hyperplasia of the prostate]] (benign prostatic hyperplasia); however, urinary obstruction may be secondary to [[prostate cancer]]. Thus, the job of the pathologist here, usually, is excluding an incidental [[cancer]]. | ||
The prevalence of prostate cancer varies from | The prevalence of prostate cancer varies from | ||
7% (in a series | 7% (in a series 823 TURPs<ref name=pmid25247076>{{Cite journal | last1 = Skrzypczyk | first1 = MA. | last2 = Dobruch | first2 = J. | last3 = Nyk | first3 = L. | last4 = Szostek | first4 = P. | last5 = Szempliński | first5 = S. | last6 = Borówka | first6 = A. | title = Should all specimens taken during surgical treatment of patients with benign prostatic hyperplasia be assessed by a pathologist? | journal = Cent European J Urol | volume = 67 | issue = 3 | pages = 227-32 | month = | year = 2014 | doi = 10.5173/ceju.2014.03.art2 | PMID = 25247076 }}</ref>) | ||
to 17% (in an older series of 747 TURPs<ref name=pmid18684032>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Thompson | first2 = J. | last3 = Kulaga | first3 = A. | last4 = Yilmaz | first4 = A. | title = How much tissue sampling is required when unsuspected minimal prostate carcinoma is identified on transurethral resection? | journal = Arch Pathol Lab Med | volume = 132 | issue = 8 | pages = 1313-6 | month = Aug | year = 2008 | doi = 10.1043/1543-2165(2008)132[1313:HMTSIR]2.0.CO;2 | PMID = 18684032 }}</ref>). | to 17% (in an older series of 747 TURPs<ref name=pmid18684032>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Thompson | first2 = J. | last3 = Kulaga | first3 = A. | last4 = Yilmaz | first4 = A. | title = How much tissue sampling is required when unsuspected minimal prostate carcinoma is identified on transurethral resection? | journal = Arch Pathol Lab Med | volume = 132 | issue = 8 | pages = 1313-6 | month = Aug | year = 2008 | doi = 10.1043/1543-2165(2008)132[1313:HMTSIR]2.0.CO;2 | PMID = 18684032 }}</ref>). | ||
Clinically relevant cancer in procedures done for BPH (TURPs and prostatectomies) is seen in approximately 1.5% of specimens.<ref name=pmid25247076/> | |||
==Protocol== | ==Protocol== | ||
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===Protocol notes=== | ===Protocol notes=== | ||
What to look for/feel for:<ref name=Ref_Lester398>{{Ref Lester|398}}</ref> | What to look for/feel for:<ref name=Ref_Lester398>{{Ref Lester|398}}</ref> | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
| Line 39: | Line 34: | ||
|tan/gray | |tan/gray | ||
|rubbery | |rubbery | ||
|- | |||
|} | |||
====Sampling==== | |||
Number of cassettes:<ref name=Ref_Lester398>{{Ref Lester|398}}</ref> | |||
*<= 12 grams: [[EIT]]. | |||
*>12 grams: embed 12 grams ''and'' 1 cassette for every additional 5 grams. | |||
**If the prostate chips have a mass of: | |||
***16 grams: 6-8 cassettes for 12 grams + 1 cassette = 7-9 cassettes. | |||
***21 grams: 6-8 cassettes for 12 grams + 2 cassettes = 8-10 cassettes. | |||
***38 grams: 6-8 cassettes for 12 grams + 6 cassettes = 12-14 cassettes. | |||
Note: | |||
*If a minimal cancer is found in a partially submitted specimen, it is reasonable to stop there as submitting more tissue or the remainder is unlikely to change the [[prostate cancer grading|grade]] or extent of involvement.<ref name=pmid18684032>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Thompson | first2 = J. | last3 = Kulaga | first3 = A. | last4 = Yilmaz | first4 = A. | title = How much tissue sampling is required when unsuspected minimal prostate carcinoma is identified on transurethral resection? | journal = Arch Pathol Lab Med | volume = 132 | issue = 8 | pages = 1313-6 | month = Aug | year = 2008 | doi = 10.1043/1543-2165(2008)132[1313:HMTSIR]2.0.CO;2 | PMID = 18684032 }}</ref> | |||
=====Formula===== | |||
<math> | |||
N = (m - 12)/5 + 8 | |||
</math> | |||
<br>Where: | |||
<br>N = number of blocks. | |||
<br>m = mass of the prostate tissue in grams. | |||
Note: | |||
*Conventionally, one rounds up all fraction; in ''Excel'' the function: ''roundup''. | |||
'''Table Generated from Formula''' | |||
{| class="wikitable sortable" | |||
!Mass | |||
!Blocks | |||
|- | |||
|12 g | |||
|8 | |||
|- | |||
|14 g | |||
|9 | |||
|- | |||
|20 g | |||
|10 | |||
|- | |||
|25 g | |||
|11 | |||
|- | |||
|30 g | |||
|12 | |||
|- | |||
|40 g | |||
|14 | |||
|- | |- | ||
|} | |} | ||
| Line 49: | Line 92: | ||
*[[Prostate biopsy]]. | *[[Prostate biopsy]]. | ||
*[[Radical prostatectomy]]. | *[[Radical prostatectomy]]. | ||
*[[Simple prostatectomy]]. | |||
==References== | ==References== | ||