Radiological stage:  T3b,N1,Mx

The patient proceeded to prostate biopsy.

Specimen: 1. Right prostate biopsy. 2. Left prostate biopsy.

Macroscopy: 1. Right - six cores up to 20 mm. 2. Left - six cores up to 17 mm. 

Microscopy: 1. Right - adenocarcinoma is present, of the usual microacinar type Gleason patterns present: 4, 3 (and tertiary 5) with cribriform pattern 4 Number of cores invaded by tumor: 6 out of 6 Percentage of tissue involved by tumor: 70 %; maximum length in core = 12 mm perineural invasion is not seen. Extraprostatic invasion is not seen.

2. Left - adenocarcinoma is present, of the usual microacinar type. Gleason patterns present: 4, 3 (and tertiary 5) with cribriform pattern 4 Number of cores invaded by tumor: 8 (fragmented) Percentage of tissue involved by tumor: 95 % - maximum length in core = 13 mm perineural invasion is seen. Extraprostatic invasion is not seen Comment: The global combined Gleason score = 9; 4 + 5 (Grade Group = 5). 

Diagnosis:

1. Right - adenocarcinoma - combined Gleason score = 9; 4 + 5 (Grade Group = 5).

2. Left - adenocarcinoma - combined Gleason score = 9; 4 + 5 (Grade Group = 5).