Prostate chips grossing

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This article deals with prostate chips grossing. TURP specimens and TURP grossing redirect here.

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.

The prevalence of prostate cancer varies from 7% (in a series 823 TURPs[1]) to 17% (in an older series of 747 TURPs[2]).

Clinically relevant cancer in procedures done for BPH (TURPs and prostatectomies) is seen in approximately 1.5% of specimens.[1]

Protocol

Specimen:

  • Weight ___ grams.
  • Dimensions (in aggregate): ___ x ___ x ___ cm.
  • Number of fragments: [1-6 / multiple (>6)].
  • Appearance: [tan-gray / yellow / orange].
  • Consistency: [rubbery / firm].
  • Other: [none / hemorrhagic appearance / necrotic appearing].

[Submitted in total/Representative sections submitted] in block(s) ___.

Protocol notes

What to look for/feel for:[3]

Entity Colour Firmness
Prostate cancer yellow/orange firm
Benign prostate tan/gray rubbery

Sampling

Number of cassettes:[3]

  • <= 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 = 7-9 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 grade or extent of involvement.[2]
Formula


N = (m -12)/5 + 8
Where:
N = number of blocks.
m = mass of the prostate tissue.

Alternate approaches

See also

Related protocols

References

  1. 1.0 1.1 Skrzypczyk, MA.; Dobruch, J.; Nyk, L.; Szostek, P.; Szempliński, S.; Borówka, A. (2014). "Should all specimens taken during surgical treatment of patients with benign prostatic hyperplasia be assessed by a pathologist?". Cent European J Urol 67 (3): 227-32. doi:10.5173/ceju.2014.03.art2. PMID 25247076.
  2. 2.0 2.1 Trpkov, K.; Thompson, J.; Kulaga, A.; Yilmaz, A. (Aug 2008). "How much tissue sampling is required when unsuspected minimal prostate carcinoma is identified on transurethral resection?". Arch Pathol Lab Med 132 (8): 1313-6. doi:10.1043/1543-2165(2008)132[1313:HMTSIR]2.0.CO;2. PMID 18684032.
  3. 3.0 3.1 Lester, Susan Carole (2005). Manual of Surgical Pathology (2nd ed.). Saunders. pp. 398. ISBN 978-0443066450.