Interobserver reproducibility of Gleason grading of prostatic adenocarcinoma among general pathologists.

Context: Gleason grade is the most widely used grading system for prostatic carcinoma and is recommended by World Health Organization. It is essential that there should be good interobserver reproducibility of this grading system as it has important implications in patient management. Aim: To assess interobserver reproducibility of Gleason grading of prostatic adenocarcinoma. Design: A total of 20 cases of prostatic adenocarcinoma were scored using Gleason grade by 21 general pathologists. The scores were then compared using κ-coefficient and consensus score. Results: For Gleason score groups (2-4, 5-6, 7 and 8-10) overall agreement with consensus score was 68%. Exact agreement for Gleason scores with consensus score was 43.3% and 92.3% within ±1 of the consensus score. κ coefficient for primary grade ranged from -0.32 to 0.92 with 60% of the readings in fair to moderate agreement range; and for secondary grade κ ranged from -0.30 to 0.62 with 78% of the readings in slight to fair agreement range. Kappa for Gleason scores ranged from -0.13 to 0.55 with 80% of the readings in slight to fair agreement range; and for Gleason score groups κ ranged from -0.11 to 0.82 with 68.5% of the readings in fair to moderate agreement range. Conclusions: In our study interobserver reproducibility of Gleason scores among general pathologists was at lower level and it highlights the need to improve the observer reproducibility by continuous educational sessions and taking second opinion in cases where grade could significantly influence management.

Stromal luteoma: report of a rare case.

Steroid cell tumours (SCTs) account for less than 0.1% of all ovarian tumours. Three major categories ofSCTs include (1) stromal luteoma, (2) steroid cell tumour not otherwise specified and (3) Leydig cell tumours that do not have another component. Stromal luteomas constitute 20% of SCTs. They usually occur in postmenopausal women and about 60% present with estrogenic manifestations. We report a case of stromal luteoma in an elderly lady who presented with postmenopausal bleeding secondary to endometrial hyperplasia. An interesting finding in our case was the presence of many eosinophilic hyaline globules scattered throughout the tumour, the significance of which remains to be determined.

Superficial extension of squamous cell carcinoma in situ of cervix involving endometrium, bilateral fallopian tubes and ovaries: a case report.

Although squamous cell carcinoma of the cervix is the commonest gynaecological malignancy in India, squamous cell carcinoma of the endometrium is rare. Direct extension from the cervical growth can involve the uterine corpus but superficial spread without invasion of the underlying myometrium is uncommon. We report a case of squamous cell carcinoma in-situ of the cervix with superficial extension to the endometrium and both fallopian tubes with simultaneous involvement of both the ovaries.