I had an RP in March of this year. The 3 psa tests I've had since then have been <0.1 my question my surgeon calls me intermediate risk, but according to my pathology report with T3a I think I'm high risk.
Final Diagnosis:
1. Periprostatic fat, excision:
- Adipose tissue with no tumor seen.
2. Right peri vesicle bundle margin, excision:
- Fibroconnective tissue and nerves only; no tumor seen.
- Prostatic epithelium is not identified.
3. Prostate and seminal vesicles, prostatectomy:
- Prostatic adenocarcinoma, Gleason's score 7 (4+3) [Grade Group 3].
- The adenocarcinoma invades into thick intersecting smooth muscle bundles
at the right base, consistent with bladder neck
invasion.
- Lymphovascular invasion is not identified.
- Seminal vesicles with no tumor seen.
- Resection margins are negative for carcinoma; adenocarcinoma is less
than 0.001 cm to the right base margin (see part #2).
4. Right pelvic lymph nodes, excision:
- No tumor seen in three lymph nodes (0/3).
5. Left pelvic lymph nodes, excision:
- No tumor seen in six lymph nodes (0/6).
MH/al/mm
Report Name: Prostate - Radical Prostatectomy
Status: Submitted
Part(s) Involved:
3: Prostate and seminal vesicles
Synoptic Report:
Specimen
Procedure: Radical prostatectomy
Tumor
Histologic Type: Acinar adenocarcinoma
Histologic Grade
Grade Group and Gleason Score: Grade group 3 (Gleason Score 4 + 3 =
7)
Percentage of Pattern 4: 65%
Extraprostatic Extension (EPE): Not identified
Urinary Bladder Neck Invasion: Present
Seminal Vesicle Invasion: Not identified
Treatment Effect: No known presurgical therapy
Ma
rgins
Margins: Uninvolved by invasive carcinoma
Lymph Nodes
Number of Lymph Nodes Involved: 0
Number of Lymph Nodes Examined: 9
Pathologic Stage Classification (pTNM, AJCC 8th Edition)
Primary Tumor (pT): pT3a
Regional Lymph Nodes (pN): pN0
CAP eCC February 2020 Annual Release
Gross Description:
Received in five parts
Source of Tissue: 1. Labeled #1, "periprostatic fat"
Gross Description: Received fresh labeled, "Thomas G. King, MR# 1213910,
periprostatic fat." It consists of multiple soft yellow-tan lobular
fibrofatty tissue fragments measuring 2.7 x 2.5 x 0.8 cm in aggregate. The
specimen is sectioned to reveal a soft yellow-tan lobular fibrofatty cut
surface. Entirely submitted in one block as 1A.
___________________________________________________________________
Source of Tissue: 2. Labeled #2, "right perivesical bundle margin"
Gross Description: Received fresh labeled, "Thomas G. King, MR# 1213910,
right perivesical
bundle margin." It consists of a soft red-brown
irregular tissue fragment measuring 0.2 x 0.1 x 0.1 cm. Entirely frozen in
one block as 2FS. The residual frozen section tissue is very tiny and may
not survive processing.
___________________________________________________________________
Source of Tissue: 3. Labeled #3, "prostate and seminal vesicles"
Gross Description: Received fresh labeled, "Thomas G. King, MR# 1213910,
prostate and seminal vesicles." It consists of a 21 gram, 3.0 x 2.5 x 2.5
cm red-tan hemorrhagic prostate with intact capsule, patent urethra, and
bilateral seminal vesicles and vasa deferentia. The right seminal vesicle
measures 3.2 x 1.5 x 0.7 cm, right vas 4.0 x 0.5 x 0.5 cm, left seminal
vesicle 3.0 x 1.0 x 0.5 cm, and left vas 4.5 0.5 x 0.5 cm. The right side
is inked black and the left side is inked blue and the specimen is
sectioned from apex to bladder neck to reveal tan-pink soft to firm
nodular cut surface. Sectioning of the bilateral semina
l vesicles and vasa
deferentia reveals tan fluid filled spaces. Representative sections are
submitted as designated for microscopic evaluation.
Designation of Sections: 3A- right apex, 3B- left apex, 3C- right base,
3D- left base, 3E- right anterior mid, 3F- right posterior mid, 3G-3H-
right posterior superior, 3I- left anterior mid, 3J- left posterior mid,
3K-3L- left posterior superior, M- right seminal vesicle and vas deferens,
3N- left seminal vesicle and vas deferens.
*Tumor and normal are given to Tumor Bank.
**90% of the specimen is submitted.
___________________________________________________________________
Source of Tissue: 4. Labeled #4, "right pelvic lymph nodes"
Gross Description: Received fresh labeled, "Thomas G. King, MR# 1213910,
right pelvic lymph nodes." It consists of a soft yellow-tan lobular
fibrofatty tissue fragment measuring 4.0 x 3.0 x 1.5 cm. The specimen is
sectioned to reveal three firm yellow-tan lymph nodes ranging from 0.3 cm
up to 1
.0 cm in diameter. The specimen is entirely submitted in 4A-4C.
Designation of Sections: 4A- one bisected lymph node, 4B- two small lymph
nodes, 4C- remaining fibrofatty tissue entirely submitted
___________________________________________________________________
Source of Tissue: 5. Labeled #5, "left pelvic lymph nodes"
Gross Description: Received fresh labeled, "Thomas G. King, MR# 1213910,
left pelvic lymph nodes." It consists of a soft yellow-tan lobular
fibrofatty tissue measuring 4.5 x 3.5 x 2.0 cm. The specimen is sectioned
to reveal multiple firm yellow-tan lymph nodes ranging from 0.5 cm up to
2.2 cm in diameter. The specimen is entirely submitted in 5A-5D.
Designation of Sections: 5A-5B- one large bisected lymph node in each
cassette, 5C- four small lymph nodes, 5D- remaining fibrofatty tissue
entirely submitted
RA/mm 3/30/21 2300
___________________________________________________________________
Intraoperative Diagnosis:
2FS: Fibrous tissue and
nerves, no tumor seen.
Intraoperative Pathologist: Douglas B. Flieder, MD
Pathology Fellow: Ashley Lentini, MD
Pathologist(s): Min Huang, MD, PhD
Electronically Signed By Min Huang, MD, PhD
Pathologist
4/1/2021 18:38
This case has been personally examined and interpreted by the attending
pathologist.
Reviewing my final Path report, post RP
Opinions on my husband’s Pylarify scan results? Is additional radiation possible? 
Gleason 9, Age 72, stage 3 or 4 ?
