prostateview
Teaching concept only — not for diagnosis, PI‑RADS scoring, biopsy planning, or intra-operative navigation. How to use it safely.
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Module 8

Specimen handling and the histology interface

Cores, labelling, and reading the pathology report: Gleason, ISUP and the features that matter.

The biopsy is only half the job. How you handle and label the cores, and how you read the report that comes back, decides what happens to the patient. Let us demystify the pathology.

MRI slices live

The raw multi-parametric scan.

3D reconstruction live

Segmented gland, zones and lesion as a rotatable model.

Beside-patient spatial teaching future spatial workflow

Future spatial-computing workflows for placing the anatomy model in clinical space.

01 Cores and labelling 4 min

Keep targeted and systematic cores in separate, clearly labelled pots, and record the site of each. It feels tedious, but the pathologist cannot tell where a core came from unless you tell them, and location changes management.

Key point Label everything by site, and keep targeted and systematic cores separate.
You understand why labelling discipline matters before the sample even leaves the room.

How should targeted and systematic cores be handled?

02 Gleason to ISUP 5 min

The Gleason score grades how abnormal the cancer glands look. You add the most common pattern to the second pattern. Modern reports translate this into the cleaner ISUP Grade Group, 1 to 5:

  • ISUP 1 = Gleason 3+3
  • ISUP 2 = 3+4
  • ISUP 3 = 4+3
  • ISUP 4 = 8
  • ISUP 5 = 9 to 10
The one to memorise 3+4 is ISUP 2 (favourable), 4+3 is ISUP 3 (less favourable). The order of the numbers matters.
You can convert a Gleason score to its Grade Group.

Gleason 3+4 corresponds to which ISUP Grade Group?

03 The features that change management 4 min

Beyond the grade, look for: the maximum cancer length in a core and the number of positive cores (how much disease there is), PNI, and the cribriform pattern, which signals a worse prognosis.

Key point Grade, extent, perineural invasion and cribriform pattern together shape the plan, not the grade alone.
You know which extra report features actually matter.

Which growth pattern is linked to worse outcomes?

04 Why labelling drives treatment 3 min

Accurate core mapping is what later makes focal therapy, nerve-sparing surgery and confident surveillance possible. The discipline at the start of the pathway pays off at the treatment end.

You can connect good labelling to real treatment options. End of Module 8.

Accurate core labelling makes what possible later?

That is Module 8. You can handle specimens properly and read a prostate pathology report with confidence.

Next: Complications and their management →