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Browsing by Author "Hansel, Donna E."
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Item Gleason Grade 4 Prostate Adenocarcinoma Patterns: An Inter-observer Agreement Study among Genitourinary Pathologists(Wiley, 2016-09) Kweldam, Charlotte F.; Nieboer, Daan; Algaba, Ferran; Amin, Mahul B.; Berney, Dan M.; Billis, Athanase; Bostwick, David G.; Bubendorf, Lukas; Cheng, Liang; Compérat, Eva; Delahunt, Brett; Egevad, Lars; Evans, Andrew J.; Hansel, Donna E.; Humphrey, Peter A.; Kristiansen, Glen; van der Kwast, Theodorus H.; Magi-Galluzzi, Cristina; Montironi, Rodolfo; Netto, George J.; Samaratunga, Hemamali; Srigley, John R.; Tan, Puay H.; Varma, Murali; Zhou, Ming; van Leenders, Geert J. L. H.; Department of Pathology and Laboratory Medicine, IU School of MedicineAims 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.Item Update for the practicing pathologist: The International Consultation On Urologic Disease-European association of urology consultation on bladder cancer(SpringerNature, 2015-05) Amin, Mahul B.; Smith, Steven C.; Reuter, Victor E.; Epstein, Jonathan I.; Grignon, David J.; Hansel, Donna E.; Lin, Oscar; McKenney, Jesse K.; Montironi, Rodolfo; Paner, Gladell P.; Al-Ahmadie, Hikmat A.; Algaba, Ferran; Ali, Syed; Alvarado-Cabrero, Isabel; Bubendorf, Lukas; Cheng, Liang; Cheville, John C.; Kristiansen, Glen; Cote, Richard J.; Delahunt, Brett; Eble, John N.; Genega, Elizabeth M.; Gulmann, Christian; Hartmann, Arndt; Langner, Cord; Lopez-Beltran, Antonio; Magi-Galluzzi, Cristina; Merce, Jorda; Netto, George J.; Oliva, Esther; Rao, Priya; Ro, Jae Y.; Srigley, John R.; Tickoo, Satish K.; Tsuzuki, Toyonori; Umar, Saleem A.; Van der Kwast, Theo; Young, Robert H.; Soloway, Mark S.; Department of Pathology and Laboratory Medicine, IU School of MedicineThe International Consultations on Urological Diseases are international consensus meetings, supported by the World Health Organization and the Union Internationale Contre le Cancer, which have occurred since 1981. Each consultation has the goal of convening experts to review data and provide evidence-based recommendations to improve practice. In 2012, the selected subject was bladder cancer, a disease which remains a major public health problem with little improvement in many years. The proceedings of the 2nd International Consultation on Bladder Cancer, which included a 'Pathology of Bladder Cancer Work Group,' have recently been published; herein, we provide a summary of developments and consensus relevant to the practicing pathologist. Although the published proceedings have tackled a comprehensive set of issues regarding the pathology of bladder cancer, this update summarizes the recommendations regarding selected issues for the practicing pathologist. These include guidelines for classification and grading of urothelial neoplasia, with particular emphasis on the approach to inverted lesions, the handling of incipient papillary lesions frequently seen during surveillance of bladder cancer patients, descriptions of newer variants, and terminology for urine cytology reporting.